“The level of asthma control among pediatric patients improved during the COVID-19 lockdown period, likely because of reduced exposure to typical asthma triggers due to the confinement,” the authors of a recent study write. “The maintenance of treatment resulted in a reduction of asthma of in some patients, likely because of the good level of disease control. In other patients, treatment maintenance increased, either due to symptoms or because of fear and anxiety related to the COVID-19 pandemic.” They added that the fear of having little access to hospital facilities due to the pandemic may have induced some patients to increase their therapy.
For a study published in in Immunity, Inflammation and Disease, the researchers aimed to investigate the level of asthma control in asthmatic children and the maintenance therapy used during COVID-19, a disease primarily affecting respiratory health. “The lockdown imposed by the COVID-19 pandemic resulted in a completely different style of life for patients with chronic lung diseases such as asthma, and affected the attitude of patients toward their disease,” they write.
Among children attending an asthma clinic, the researchers identified those who had been prescribed the same therapy in March-April 2019 and March-April 2020. The level of asthma control and the maintenance therapy used during the lockdown (March-April 2020) were compared with those of March-April 2019. In addition, the study team separately analyzed a small group of children with severe asthma treated with omalizumab during the lockdown.
Biological Therapies Proved Effective in Asthma Control
Ninety-two asthmatic children (67 males) were enrolled in the study. Compared to 2019, in 2020 a higher proportion of children modified their maintenance therapy (38% vs 15.2%), with a significant increase in both the proportion of children who increased their therapy and in that of children who decreased it. The level of control was significantly higher in 2020. Also, the children who were treated with omalizumab demonstrated a good level of control in 2020.
“In comparing the lockdown period in March and April 2020 with the same 2-month period in 2019, we found a better level of asthma control in about one-third of children,” the study authors write. “This is in line with findings of a recent global survey, which reports that while most children showed the usual level of asthma control during the COVID-19 pandemic, 20% showed a control better than expected with a 2.60 risk ratio of having a better than expected versus worse that expected level of control.” They add that this result is likely due to the reduced exposure to main asthma trigger factors, such as viral infections, outdoor allergens, physical activities, and air pollution.
In the group of children treated with omalizumab, the researchers found that symptom control was better in 2020. “Again, this result could be related to the reduced exposure to typical asthma triggers, but it may also be explained by the effectiveness of the biological drug on the overall level of asthma control, as suggested by the correlation between the level of control and the number of months since the first omalizumab administration,” the authors explain. “In keeping with this result, the World Health Organization advised to continue administering biological therapies during the COVID-19 pandemic in patients for whom such therapies are clearly indicated and have been effective.”
Pediatric Asthma Control During the COVID-19 Pandemic