ABSTRACT
Different health care strategies have been implemented worldwide due to the pandemic. We explore a new approach to guarantee the follow-up of severe asthmatic (SA) children. Method(s): A retrospective/prospective cohort study. All children (GINA guidelines) from the SA clinic at Garrahan Hospital were included. Clinic attendance (virtual [V] or face-to-face [FF]), asthma control (ACT), asthma exacerbations (AE) and hospitalizations (H) were evaluated in the same group during two periods: March 2019- March 2020 (FFP) and April 2020-April 2021 (VP). During VP children performed a validated electronic ACT that was sent monthly through an electronic APP, 48 hours after they were contacted via a phone call. Student's/Wilcoxon paired tests. P <0.05 Results: All SA patients (n 74) were seen every two months during FFP;47% male;median age 13 years (IQR 10- 15) and 68 (92%) of them during VP. In FFP, 393 visits were registered (5.3 visit/pat/year);246 ACT were performed (3.3 ACT/pat/year), 22% (n 54) were uncontrolled (ACT<20). During VP, 816 ACT were sent with 642 replies (79%), 9.4 ACT/pat/year;19% (n 120) <20. There were 46 (67%) patients with AE during FFP vs 31 (46%) in VP (p 0.0004);AE in FFP 135 vs 79 in VP (p 0.0031), (2 vs 1.1 AE/pat/year) with AE decrease of 41%;91 prescribed steroid courses in FFP (1.3 courses/pat/year) vs 49 in VP (0.72 courses/pat/year) (p 0.006), with a reduction of 46%. There were no differences in H (FFP 10, VP 6;p 0.39). In FFP 19% of patients were under biologics while 12% during VP. Conclusion(s): Virtual team clinics and electronic ACT at home were introduced easily and effectively during pandemic to manage SA children. Follow-up of almost all patients could be ensured.