Impact of COVID-19 on Pediatric Asthma: Practice Adjustments and Disease Burden.


Journal

The journal of allergy and clinical immunology. In practice
ISSN: 2213-2201
Titre abrégé: J Allergy Clin Immunol Pract
Pays: United States
ID NLM: 101597220

Informations de publication

Date de publication:
09 2020
Historique:
received: 08 05 2020
revised: 25 05 2020
accepted: 01 06 2020
pubmed: 21 6 2020
medline: 18 9 2020
entrez: 21 6 2020
Statut: ppublish

Résumé

It is unclear whether asthma may affect susceptibility or severity of coronavirus disease 2019 (COVID-19) in children and how pediatric asthma services worldwide have responded to the pandemic. To describe the impact of the COVID-19 pandemic on pediatric asthma services and on disease burden in their patients. An online survey was sent to members of the Pediatric Asthma in Real Life think tank and the World Allergy Organization Pediatric Asthma Committee. It included questions on service provision, disease burden, and the clinical course of confirmed cases of COVID-19 infection among children with asthma. Ninety-one respondents, caring for an estimated population of more than 133,000 children with asthma, completed the survey. COVID-19 significantly impacted pediatric asthma services: 39% ceased physical appointments, 47% stopped accepting new patients, and 75% limited patients' visits. Consultations were almost halved to a median of 20 (interquartile range, 10-25) patients per week. Virtual clinics and helplines were launched in most centers. Better than expected disease control was reported in 20% (10%-40%) of patients, whereas control was negatively affected in only 10% (7.5%-12.5%). Adherence also appeared to increase. Only 15 confirmed cases of COVID-19 were reported among the population; the estimated incidence is not apparently different from the reports of general pediatric cohorts. Children with asthma do not appear to be disproportionately affected by COVID-19. Outcomes may even have improved, possibly through increased adherence and/or reduced exposures. Clinical services have rapidly responded to the pandemic by limiting and replacing physical appointments with virtual encounters.

Sections du résumé

BACKGROUND
It is unclear whether asthma may affect susceptibility or severity of coronavirus disease 2019 (COVID-19) in children and how pediatric asthma services worldwide have responded to the pandemic.
OBJECTIVE
To describe the impact of the COVID-19 pandemic on pediatric asthma services and on disease burden in their patients.
METHODS
An online survey was sent to members of the Pediatric Asthma in Real Life think tank and the World Allergy Organization Pediatric Asthma Committee. It included questions on service provision, disease burden, and the clinical course of confirmed cases of COVID-19 infection among children with asthma.
RESULTS
Ninety-one respondents, caring for an estimated population of more than 133,000 children with asthma, completed the survey. COVID-19 significantly impacted pediatric asthma services: 39% ceased physical appointments, 47% stopped accepting new patients, and 75% limited patients' visits. Consultations were almost halved to a median of 20 (interquartile range, 10-25) patients per week. Virtual clinics and helplines were launched in most centers. Better than expected disease control was reported in 20% (10%-40%) of patients, whereas control was negatively affected in only 10% (7.5%-12.5%). Adherence also appeared to increase. Only 15 confirmed cases of COVID-19 were reported among the population; the estimated incidence is not apparently different from the reports of general pediatric cohorts.
CONCLUSIONS
Children with asthma do not appear to be disproportionately affected by COVID-19. Outcomes may even have improved, possibly through increased adherence and/or reduced exposures. Clinical services have rapidly responded to the pandemic by limiting and replacing physical appointments with virtual encounters.

Identifiants

pubmed: 32561497
pii: S2213-2198(20)30599-7
doi: 10.1016/j.jaip.2020.06.001
pmc: PMC7297686
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2592-2599.e3

Subventions

Organisme : Medical Research Council
ID : MR/K002449/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/K002449/2
Pays : United Kingdom

Investigateurs

Rola Abou Taam (RA)
Hugo Azuara (H)
Jacques Brouard (J)
Pierrick Cros (P)
Cindy De Lira (C)
Jean-Christophe Dubus (JC)
Teija Dunder (T)
Kamilla Efendieva (K)
Carole Egron (C)
Andrzej Emeryk (A)
Yunuen R Huerta Villalobos (YR)
Nidia Karen (N)
Pascal Le Roux (P)
Julia Levina (J)
Monica Medley (M)
Major Najaraju (M)
Daniela Rivero Yeverino (DR)
Marja Ruotsalainen (M)
Stanley Szefler (S)
Cyril Schweitzer (C)
Berenice Velasco Benhumea (BV)
Rosalaura Villarreal (R)
Laurence Weiss (L)
Anna Zawadzka-Krajewska (A)

Informations de copyright

Copyright © 2020 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

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Auteurs

Nikolaos G Papadopoulos (NG)

Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester, United Kingdom; Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece. Electronic address: ngpallergy@gmail.com.

Adnan Custovic (A)

Department of Paediatrics, Imperial College London, London, United Kingdom.

Antoine Deschildre (A)

Pediatric Pulmonology and Allergy Department, Hôpital Jeanne de Flandre, Lille, France.

Alexander G Mathioudakis (AG)

Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester, United Kingdom; North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom.

Wanda Phipatanakul (W)

Children's Hospital Boston, Pediatric Allergy and Immunology, Boston, Mass.

Gary Wong (G)

Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong.

Paraskevi Xepapadaki (P)

Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece.

Ioana Agache (I)

Allergy & Clinical Immunology, Transylvania University, Brasov, Romania.

Leonard Bacharier (L)

Division of Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Washington University, St Louis, Mo.

Matteo Bonini (M)

Department of Cardiovascular and Thoracic Sciences, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy; National Heart and Lung Institute (NHLI), Imperial College London, London, United Kingdom.

Jose A Castro-Rodriguez (JA)

Division of Pediatrics, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.

Zhimin Chen (Z)

Pulmonology Department, Children's Hospital Zhejiang University School of Medicine, Zhejiang, China.

Timothy Craig (T)

Department of Allergy and Immunology, Penn State University, State College, Pa.

Francine M Ducharme (FM)

Department of Pediatrics, University of Montréal, Department of Social and Preventive Medicine, University of Montréal, Montréal, QC, Canada.

Zeinab Awad El-Sayed (ZA)

Pediatric Allergy and Immunology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt.

Wojciech Feleszko (W)

Department of Pediatric Respiratory Diseases and Allergy, The Medical University of Warsaw, Warsaw, Poland.

Alessandro Fiocchi (A)

Allergy Department, Bambino Gesù Children's Hospital, Rome, Italy.

Luis Garcia-Marcos (L)

Pediatric Respiratory and Allergy Units, "Virgen de la Arrixaca" Children's University Clinical Hospital, University of Murcia, Murcia, Spain; Institute for Biomedical Research of Murcia, IMIB-Arrixaca, & Network of Asthma and Adverse and Allergic Reactions (ARADyAL), Murcia, Spain.

James E Gern (JE)

Department of Pediatrics and Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis.

Anne Goh (A)

Department of Internal Medicine, Rush Medical College, Chicago, Ill.

René Maximiliano Gómez (RM)

Research & Education, Ayre Foundation, Salta, Argentina; Allergy & Asthma Department, Alas Medical Institute, Salta, Argentina.

Eckard H Hamelmann (EH)

Children's Center Bethel, EvKB, University Bielefeld, Bielefeld, Germany.

Gunilla Hedlin (G)

Paediatric Allergy, Centre for Allergy Research, Karolinska Institutet, Solna, Sweden.

Elham M Hossny (EM)

Pediatric Allergy and Immunology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt.

Tuomas Jartti (T)

Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland.

Omer Kalayci (O)

Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey.

Alan Kaplan (A)

Family Physician Airways Group of Canada, Edmonton, AB, Canada.

Jon Konradsen (J)

Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.

Piotr Kuna (P)

Department of Internal Medicine, Asthma and Allergy, Medical University of Lodz, Lodz, Poland.

Susanne Lau (S)

Charité Universitätsmedizin Berlin, Pediatric Pulmonology, Immunology and Intensive Care Medicine, Berlin, Germany.

Peter Le Souef (P)

School of Paediatrics & Child Health, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, Crawley, WA, Australia.

Robert F Lemanske (RF)

Departments of Pediatrics and Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis.

Mika J Mäkelä (MJ)

Department of Allergy, Helsinki University Central Hospital, Helsinki, Finland.

Mário Morais-Almeida (M)

Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal.

Clare Murray (C)

Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester, United Kingdom.

Karthik Nagaraju (K)

VN Allergy & Asthma Research Centre, Chennai, Tamilnadu, India.

Leyla Namazova-Baranova (L)

Pediatric Department, Pirogov Russian National Research Medical University, the Ministry of Health, Moscow, Russia.

Antonio Nieto Garcia (AN)

Pediatric Pulmonology & Allergy Unit, Children's Hospital la Fe, Valencia, Spain.

Osman M Yusuf (OM)

Allergy and Respiratory Research Group, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom.

Paulo M C Pitrez (PMC)

Pediatric Pulmonology Division, Hospital Moinhos de Vento, Porto Alegre, Brazil.

Petr Pohunek (P)

Pediatric Pulmonology, Pediatric Department, 2nd Faculty of Medicine, Charles University, Prague, University Hospital Motol, Prague, Czech Republic.

Cesar Fireth Pozo Beltrán (CF)

Teaching and Research Department and Paediatric Allergy Department, Hospital with Specialties Juan María de Salvatierra, La Paz, Baja California Sur México, La Paz, Mexico; Allergy & Immunology Department, Hospital Infantil de Medico Federico Gomez, Mexico City, Mexico.

Graham C Roberts (GC)

Paediatric Allergy and Respiratory Medicine within Medicine at the University of Southampton, Southampton, United Kingdom.

Arunas Valiulis (A)

Clinic of Children's Diseases, Institute of Clinical Medicine, Medical Faculty of Vilnius University, Vilnius, Lithuania.

Heather J Zar (HJ)

Department of Pediatrics & Child Health, MRC Unit on Child & Adolescent Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.

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