Childhood asthma outcomes during the COVID-19 pandemic: Findings from the PeARL multi-national cohort

Nikolaos G. Papadopoulos, Alexander G. Mathioudakis, Adnan Custovic, Antoine Deschildre, Wanda Phipatanakul, Gary Wong, Paraskevi Xepapadaki, Rola Abou‐taam, Ioana Agache, Jose A. Castro‐rodriguez, Zhimin Chen, Pierrick Cros, Jean‐christophe Dubus, Zeinab Awad El‐sayed, Rasha El‐owaidy, Wojciech Feleszko, Vincenzo Fierro, Alessandro Fiocchi, Luis Garcia‐marcos, Anne GohElham M. Hossny, Yunuen R. Huerta Villalobos, Tuomas Jartti, Pascal Le Roux, Julia Levina, Aida Inés López García, Ángel Mazón Ramos, Mário Morais‐almeida, Clare Murray, Karthik Nagaraju, Major K. Nagaraju, Elsy Maureen Navarrete Rodriguez, Leyla Namazova‐baranova, Antonio Nieto Garcia, Cesar Fireth Pozo Beltrán, Thanaporn Ratchataswan, Daniela Rivero Yeverino, Eréndira Rodríguez Zagal, Cyril E. Schweitzer, Marleena Tulkki, Katarzyna Wasilczuk, Dan Xu, Anna Alekseeva, Bethan Almeida, Maud Andre, Polina Arimova, Aurore Blonde, Amparito Cunningham, Sofia Da Mota, Kamilla Efendieva, Vera Kalugina, Sébastien Kiefer, Anais Klein, Chrystopherson Gengyny Caballero López, Juan Jesús Ríos López, Caroline Moratellti, Miguel Fuentes Pérez, Meryl Simermann, José Sergio Papaqui Tapia, Aurelie Tatopoulos, Elena Vishneva, Κonstantin Volkov, Leonard Bacharier, Matteo Bonini, Timothy Craig, Zuzana Diamant, Francine M Ducharme, James E. Gern, Jonathan Grigg, Eckard H Hamelmann, Gunilla Hedlin, Tuomas Jartti, Omer Kalayci, Alan Kaplan, Jon Konradsen, Piotr Kuna, Susanne Lau, Peter Le Souef, Robert F Lemanske, Mika J Makela, Paolo M Matricardi, René‐maximiliano Gómez, Michael Miligkos, Paulo Mc Pitrez, David Price, Petr Pohunek, Graham C Roberts, Aziz Sheikh, Ioanna Tsiligianni, Steve Turner, Arunas Valiulis, Tonya Winders, Osman M Yusuf, Heather Zar

Research output: Contribution to journalArticlepeer-review

Abstract

Background
The interplay between COVID‐19 pandemic and asthma in children is still unclear. We evaluated the impact of COVID‐19 pandemic on childhood asthma outcomes.

Methods
The PeARL multinational cohort included 1,054 children with asthma and 505 non‐asthmatic children aged between 4 and 18 years from 25 pediatric departments, from 15 countries globally. We compared the frequency of acute respiratory and febrile presentations during the first wave of the COVID‐19 pandemic between groups and with data available from the previous year. In children with asthma, we also compared current and historical disease control.

Results
During the pandemic, children with asthma experienced fewer upper respiratory tract infections, episodes of pyrexia, emergency visits, hospital admissions, asthma attacks, and hospitalizations due to asthma, in comparison with the preceding year. Sixty‐six percent of asthmatic children had improved asthma control while in 33% the improvement exceeded the minimal clinically important difference. Pre‐bronchodilatation FEV1 and peak expiratory flow rate were improved during the pandemic. When compared to non‐asthmatic controls, children with asthma were not at increased risk of LRTIs, episodes of pyrexia, emergency visits, or hospitalizations during the pandemic. However, an increased risk of URTIs emerged.

Conclusion
Childhood asthma outcomes, including control, were improved during the first wave of the COVID‐19 pandemic, probably because of reduced exposure to asthma triggers and increased treatment adherence. The decreased frequency of acute episodes does not support the notion that childhood asthma may be a risk factor for COVID‐19. Furthermore, the potential for improving childhood asthma outcomes through environmental control becomes apparent.
Original languageEnglish
JournalAllergy
Early online date20 Feb 2021
DOIs
Publication statusPublished - 20 Feb 2021

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