Impact of COVID-19 on pediatric asthma: practice adjustments and disease burden.

Papadopoulos, Nikolaos G.; Custovic, Adnan; Deschildre, Antoine; Mathioudakis, Alexander G.; Phipatanakul, Wanda; Wong, Gary; Xepapadaki, Paraskevi; Agache, Ioana; Bacharier, Leonard; Bonini, Matteo; Castro-Rodriguez, Jose A.; Chen, Zhimin; Craig, Timothy; Ducharme, Francine M.; El-Sayed, Zeinab Awad; Feleszko, Wojciech; Fiocci, Alessandro; Garcia-Marcos, Luis; Gern, James E.; Goh, Anne; Gómez, René Maximiliano; Hamelmann, Eckard H.; Hedlin, Gunilla; Hossny, Elham M.; Jartti, Tuomas; Kalayci, Omer; Kaplan, Alan; Konrandsen, Jon; Kuna, Piotr; Lau, Susanne; Le Souef, Peter; Lemanske, Robert F.; Makela, Mika J.; Morais-Almeida, Mário; Murray, Clare; Nagaraju, Karthik; Namazova-Baranova, Leyla; Garcia, Antonio Nieto; Osman, Yusuf; Pitrez, Paulo MC.; Pohunek, Petr; Pozo Beltrán, Cesar Fireth; Roberts, Graham C.; Valiulis, Arunas; Zar, Heather J.

Abstract Background It is unclear whether asthma may affect susceptibility or severity of the 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 (PeARL) think-tank and the World Allergy Organization Pediatric Asthma Committee. It included questions on service provision, disease burden and on the clinical course of confirmed cases of COVID-19 infection among children with asthma. Results Ninety-one respondents, caring for an estimated population of >133,000 children with asthma, completed the survey. COVID-19 significantly impacted pediatric asthma services: 39% ceased physical appointments, 47% stopped accepting new patients, 75% limited patients visits. Consultations were almost halved to a median of 20 (IQR: 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, while 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. Conclusion 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.