Pediatric asthma control during the COVID-19 pandemic: a systematic review and meta-analysis.

Yang, Ze; Wang, Xiang; Wan, Xi-Gang; Wang, Meng-Lei; Qiu, Zong-Hua; Chen, Jia-Li; Shi, Man-Hao; Zhang, Shi-Yi; Xia, Yong-Liang

BACKGROUND With the onset of the COVID-19 pandemic, many experts expected that asthma-associated morbidity because of SARS-CoV-2 infection would dramatically increase. However, some studies suggested that there was no apparent increasing in asthma related morbidity in children with asthma, it is even possible children may have improved outcomes. In order to understand the relationship between the COVID-19 pandemic and asthma outcomes, we performed this article. METHODS We searched PubMed, Embase, and Cochrane Library to find literature from December 2019 to June 2021 related to Covid-19 and children's asthma control, among which results such as abstracts, comments, letters, reviews and case reports were excluded. The level of asthma control during the COVID-19 pandemic was synthesized and discussed by outcomes of asthma exacerbation, emergency room visit, asthma admission and c-ACT. RESULTS A total of 22159 subjects were included in 10 studies. Random effect model was used to account for the data. Compared to the same period before the COVID-19 pandemic, asthma exacerbation reduced(OR=0.26, 95%CI= [0.14,0.48], Z=4.32, P<0.0001), the odds of emergency room visit decreased as well(OR =0.11, 95%CI= [0.04,0.26], Z=4.98, P<0.00001). The outcome of asthma admission showed no significant difference (OR =0.84, 95%CI= [0.32,2.20], Z=0.36, P=0.72). The outcome of c-ACT scores were not analyzed because of the different manifestations used. Overall, c-ACT scores reduced during the pandemic. CONCLUSION Compared to the same period before the COVID-19 pandemic, the level of asthma control has been significantly improved. We need to understand the exact factors leading to these improvements and find methods to sustain it. This article is protected by copyright. All rights reserved.