Pediatric asthma symptom control during lockdown for the COVID‐19 pandemic in Spring 2020: A prospective community‐based study in Cyprus and Greece

Kouis, Panayiotis; Michaelidou, Eleni; Kinni, Paraskevi; Michanikou, Antonis; Anagnostopoulou, Pinelopi; Dimitriou, Helen; Karanicolas, Kostas; Matthaiou, Andreas M.; Achilleos, Souzana; Papatheodorou, Stefania; Koutrakis, Petros; Middleton, Nicos; Galanakis, Emmanouil; Yiallouros, Panayiotis Κ.

doi:10.1002/ppul.25765

Cited by 5 publications

(14 citation statements)

References 41 publications

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“…Our study focuses on ED presentations that are reflective of acute asthma exacerbations, and outpatient asthma activity including patient adherence is beyond the scope of our data. However, recent reports indicate that outpatient encounters for asthma and steroid prescriptions declined during COVID lockdown, while self-reported symptom control improved (Rensing et al, 2001; Ferraro et al, 2021; Salciccioli et al, 2021; Shah et al, 2021; Kouis et al, 2022). Therefore, it is unlikely that the loss of seasonality we observed in ED visits for asthma reflects a shifting of clinical activity to an alternative setting.…”

Section: Discussionmentioning

confidence: 99%

Effect of the COVID-19 Lockdown on Asthma Biological Rhythms

et al. 2022

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Asthma has a striking temporal character, in which time-of-day, patient age, and season each influence disease activity. The extent to which rhythms in asthma activity reflect exposure to specific disease triggers remains unclear. In this study, we examined how virus mitigation strategies enacted during the COVID-19 pandemic (“lockdown measures”) affected rhythms in asthma clinical activity in children. To this end, we retrospectively analyzed asthma clinical presentations in children aged <18 years to our regional academic medical center, comparing 4 years of medical records prior to COVID-19 lockdown measures with the 12 months immediately after the institution of such measures. We correlated these data to positive viral test results, febrile seizures, and allergic clinical surrogates (allergic reaction visits and Emergency Department [ED] antihistamine prescriptions, respectively) over the same time frame. In the 12 months following the institution of the COVID-19 lockdown, positivity rates for common respiratory viruses dropped by 70.2% and ED visits for asthma among children dropped by 62% compared to pre-COVID years. Lockdown suppressed seasonal variation in positive viral tests and asthma ED visits, while diurnal rhythms in asthma visits were unchanged. Asthma seasonality correlated most strongly with rhinovirus positivity both before and after the institution of COVID lockdown measures. Altogether, our data support a causal role for viruses in driving seasonal variability in asthma exacerbations in children.

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Section: Discussionmentioning

confidence: 99%

Effect of the COVID-19 Lockdown on Asthma Biological Rhythms

et al. 2022

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“… 59 , 66 , 72 , 73 , 74 , 75 , 76 , 77 , 78 Improvements were normally associated with time spent at home, and stronger effects were found in some studies among individuals with severe disease. 52 Despite strong associations of lockdown measures and improvements in allergic children, anxiety levels and perceptions of elevated health risk were increased among carers, 79 regardless of the actual health state of the child. 61 Although increased levels of anxiety at the time of pandemic were described in the general population, particularly fuelled by the infodemic, 80 , 81 some studies reported higher anxiety and poor health‐related quality of life in mothers of allergic children.…”

Section: Pandemic Impact On Patient Care and Mitigation Strategiesmentioning

confidence: 99%

“…Nonpharmaceutical interventions, such as handwashing, masks, and social/physical distancing, reduction in the concentrations of traffic‐related air pollutants 54,55 and decline in other respiratory infections incidence, may have contributed to reduced impact on allergic disease 56,57 particularly respiratory, 58–63 number of exacerbations 59,62,64–71 and the odds of emergency room visit and/or hospital admissions 59,66,72–78 . Improvements were normally associated with time spent at home, and stronger effects were found in some studies among individuals with severe disease 52 . Despite strong associations of lockdown measures and improvements in allergic children, anxiety levels and perceptions of elevated health risk were increased among carers, 79 regardless of the actual health state of the child 61 .…”

Section: Pandemic Impact On Patient Care and Mitigation Strategiesmentioning

confidence: 99%

“…Although there were detrimental effects on children and young people's physical and mental well-being during the pandemic, some studies reported improvements in seasonal respiratory allergy symptom control, particularly during lockdown measures. 52,53 Nonpharmaceutical interventions, such as handwashing, masks, and social/physical distancing, reduction in the concentrations of traffic-related air pollutants 54,55 and decline in other respiratory infections incidence, may have contributed to reduced impact on allergic disease 56,57 particularly respiratory, [58][59][60][61][62][63] number of exacerbations 59,62,[64][65][66][67][68][69][70][71] and the odds of emergency room visit and/ or hospital admissions. 59,66,[72][73][74][75][76][77][78] Improvements were normally associated with time spent at home, and stronger effects were found in some studies among individuals with severe disease.…”

Section: Are There Any Known Benefits and Harms Of Lockdown Measures ...mentioning

confidence: 99%

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Allergic diseases and immunodeficiencies in children, lessons learnt from COVID‐19 pandemic by 2022: A statement from the EAACI‐section on pediatrics

Munblit

Greenhawt

Brough

et al. 2022

Pediatric Allergy Immunology

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By the April 12, 2022, the COVID‐19 pandemic had resulted in over half a billion people being infected worldwide. There have been 6.1 million deaths directly due to the infection, but the pandemic has had many more short‐ and long‐term pervasive effects on the physical and mental health of the population. Allergic diseases are among the most prevalent noncommunicable chronic diseases in the pediatric population, and health‐care professionals and researchers were seeking answers since the beginning of pandemic. Children are at lower risk of developing severe COVID‐19 or dying from infection. Allergic diseases are not associated with a higher COVID‐19 severity and mortality, apart from severe/poorly controlled asthma. The pandemic disrupted routine health care, but many mitigation strategies, including but not limited to telemedicine, were successfully implemented to continue delivery of high‐standard care. Although children faced a multitude of pandemic‐related issues, allergic conditions were effectively treated remotely while reduction in air pollution and lack of contact with outdoor allergens resulted in improvement, particularly respiratory allergies. There is no evidence to recommend substantial changes to usual management modalities of allergic conditions in children, including allergen immunotherapy and use of biologicals. Allergic children are not at greater risk of multisystem inflammatory syndrome development, but some associations with Long COVID were reported, although the data are limited, and further research is needed. This statement of the EAACI Section on Pediatrics provides recommendations based on the lessons learnt from the pandemic, as available evidence.

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“…[2][3][4] In concert, the activity of several inflammatory airway diseases, especially asthma and chronic obstructive pulmonary disease (COPD), diminished. 1,[5][6][7][8][9][10][11] By the spring of 2021, however, COVID-19 vaccines became widely available, attitudes toward preventative measures became less strict, and common viruses began to uptrend by May 2021. [12][13][14] Here, we report how viral rebound during the relaxation of COVID-19 precautions affected asthma and COPD exacerbations.…”

Section: Introductionmentioning

confidence: 99%