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1.
Rev Alerg Mex ; 69 Suppl 1: s15-s23, 2022.
Article in Spanish | MEDLINE | ID: covidwho-1634851

ABSTRACT

The COVID-19 pandemic has collapsed the health systems of many countries in the world and comorbidities in adults have exponentially increased their mortality; in matters of asthma, it has not been possible to establish a defining relationship in mortality. The clinical manifestations of asthmatic patients with SARS COV 2 are presented in a wide range; from asymptomatic to those who experience acute respiratory failure. The most sensitive method for the diagnosis of SARS-CoV-2 infection is RT-PCR. Antigen and serologic tests are quicker than RT-PCR, but they are less sensitive. Radiologic studies and the computed tomography of the chest assist in the diagnosis and follow-up of SARS-CoV-2 infection. The use of spirometry for diagnosis and follow-up is restricted due to the elevated risk of contagion. It has been shown that eosinophilia and TH2 inflammation, due to their antiviral immune effect, are protective factors against severe SARS-CoV-2/COVID-19. Patients with mild asthma express less angiotensin converting enzyme receptors (ACE2), and those with neutrophilic asthma express it in greater proportion, which suggests more severe presentations of COVID-19. The conventional asthma treatment modulates the SARS-CoV-2/COVID-19 immune response, which is why patients with controlled asthma have non-severe manifestations of COVID 19, however, the mechanisms are not clear.


La pandemia de COVID-19 ha colapsado los sistemas de salud de muchos países del mundo y las comorbilidades en adultos han incrementado exponencialmente su mortalidad; respecto al asma, no se ha podido establecer una relación determinante en la mortalidad. Las manifestaciones clínicas del paciente con asma y SARS-CoV-2 se presentan con una amplia gama, desde asintomáticas hasta las que experimentan insuficiencia respiratoria aguda. El método más sensible para el diagnóstico de la infección por SARS-CoV-2 es la RT-PCR. Las pruebas de antígeno y serológicas son más rápidas que la RT-PCR, pero menos sensibles. Los estudios radiológicos y la tomografía computarizada de tórax auxilian en el diagnóstico y seguimiento de la infección por SARS-CoV-2. El uso de la espirometría se restringe para el diagnóstico y seguimiento debido al alto riesgo de contagio. Se ha demostrado que la eosinofilia y la inflamación TH2, debido a su efecto inmunológico antivírico, son factores protectores contra SARS-CoV-2/COVID-19 severo. Los pacientes con asma leve expresan menos receptores de la enzima convertidora de angiotensina (ECA2) y aquellos con asma neutrofílica expresan mayor proporción, lo que sugiere presentaciones más severas de COVID-19. El tratamiento convencional del asma modula la respuesta inmunitaria del SARS-CoV-2/COVID-19, por lo cual, los pacientes con asma controlados tienen manifestaciones no graves de COVID-19, aunque los mecanismos no están claros.


Subject(s)
Asthma , COVID-19 , Asthma/diagnosis , Asthma/epidemiology , Humans , Pandemics , RNA, Viral , SARS-CoV-2
2.
BMJ Open Respir Res ; 9(1)2022 01.
Article in English | MEDLINE | ID: covidwho-1627442

ABSTRACT

INTRODUCTION: The impact of acute COVID-19 on people with asthma appears complex, being moderated by multiple interacting disease-specific, demographic and environmental factors. Research regarding longer-term effects in this group is limited. We aimed to assess impacts of COVID-19 and predictors of persistent symptoms, in people with asthma. METHODS: Using data from an online UK-wide survey of 4500 people with asthma (median age 50-59 years, 81% female), conducted in October 2020, we undertook a mixed methods analysis of the characteristics and experience of those reporting having had COVID-19. RESULTS: The COVID-19 group (n=471, 10.5%) reported increased inhaler use and worse asthma management, compared with those not reporting COVID-19, but did not differ by gender, ethnicity or household income. Among the COVID-19 group, 56.1% reported having long COVID, 20.2% were 'unsure'. Those with long COVID were more likely than those without long COVID to describe: their breathing as worse or much worse after their initial illness (73.7% vs 34.8%, p<0.001), increased inhaler use (67.8% vs 34.8%, p<0.001) and worse or much worse asthma management (59.6% vs 25.6%, p<0.001). Having long COVID was not associated with age, gender, ethnicity, UK nation or household income.Analysis of free text survey responses identified three key themes: (1) variable COVID-19 severity, duration and recovery; (2) symptom overlap and interaction between COVID-19 and asthma; (3) barriers to accessing healthcare. CONCLUSIONS: Persisting symptoms are common in people with asthma following COVID-19. Measures are needed to ensure appropriate healthcare access including clinical evaluation and investigation, to distinguish between COVID-19 symptoms and asthma.


Subject(s)
Asthma , COVID-19 , Asthma/drug therapy , Asthma/epidemiology , COVID-19/complications , Female , Humans , Male , Middle Aged , SARS-CoV-2 , United Kingdom/epidemiology
3.
Ital J Pediatr ; 48(1): 1, 2022 Jan 06.
Article in English | MEDLINE | ID: covidwho-1613246

ABSTRACT

BACKGROUND: The role of allergic sensitization seems to be protective against SARS CoV2 infection. The aim of this study was to evaluate, using online surveys, the impact of COVID-19 on Italian allergic children, comparing the prevalence of AR and asthma symptoms between the first and second pandemic wave. METHODS: Both surveys were emailed to Italian pediatricians in April 2020 (first survey) and in March 2021 (second survey). The first one was related to the impact of COVID-19 and the most frequently reported symptoms. The second one was superimposed on the previous one, taking into account some additional aspects in the management of disease. RESULTS: A total of 99 pediatricians participated in the first survey and 267 in the second one. The first survey showed that, asthma and allergic rhinoconjunctivitis prevalence was mostly between 0 and 20% throughout the country. The second survey showed a lower prevalence of both diseases nationwide in comparison to the first one. Comparing the two surveys, statistically significant differences were reported only in the distribution of asthma prevalence in Southern Italy while no differences were highlighted in the North and in the Center. Finally regarding allergic rhinoconjunctivitis prevalence, no differences were noticed nationwide. CONCLUSIONS: Allergic rhinoconjunctivitis and asthma, if under control, did not represent risk factors for the susceptibility to SARS CoV2. Therefore, it is strongly recommended to continue therapies during COVID-19 outbreak, according to the international guidelines. However, being COVID-19 a new disease, actual knowledge will undergo continuous improvements over time.


Subject(s)
Asthma/epidemiology , COVID-19/complications , COVID-19/epidemiology , Conjunctivitis, Allergic/epidemiology , Rhinitis, Allergic/epidemiology , Asthma/complications , Child , Conjunctivitis, Allergic/complications , Humans , Italy , Prevalence , Rhinitis, Allergic/complications , Risk Factors , Surveys and Questionnaires
5.
Allergol Immunopathol (Madr) ; 50(1): 99-103, 2022.
Article in English | MEDLINE | ID: covidwho-1597725

ABSTRACT

BACKGROUND: The novel disease caused by the new coronavirus SARS-CoV-2 has caused an unprecedented global pandemic. Care providers of asthmatic children are increasingly con-cerned; as viral infections are one of the primary triggers of asthma flare-up. However, the effect of SARS-CoV-2 as well as the generated worldwide lockdown on asthmatic children is unknown. OBJECTIVE: The aim of this study was to analyze the effects of pandemic SARS-CoV-2 in pediat-ric asthma control. MATERIAL AND METHODS: A retrospective, open, transversal study was performed at five ter-tiary hospitals. Recruited patients were aged <18 years and had physician-diagnosed asthma. Information regarding the 2019 and 2020 seasons were provided. RESULTS: Data were collected from 107 children (age range: 3-18 years, mean age: 12 years). Well-controlled asthma was observed in 58 (54.2%) patients in 2020 versus 30 (28%) in 2019, and 15 (14%) patients had poorly controlled asthma in 2020 versus 28 (26.2%) in 2019. In 2020, a decrease in exacerbations caused by allergies to pollen, dust mites, molds, and through other causes not related to SARS-CoV-2 infection was observed. An increase in exacerbations was observed due to animal dander, stress, physical exercise, and SARSCoV-2 infection. Children had a reduced need for asthma-controlling medication, made fewer visits to healthcare providers and had lesser need of treatment with oral corticosteroids if compared with the same season of 2019. CONCLUSION: Pediatric asthma control improved, the need for controller medication declined, and fewer visits to healthcare providers were made during the pandemic if compared with the 2019 season.


Subject(s)
Asthma , COVID-19 , Adolescent , Asthma/drug therapy , Asthma/epidemiology , Child , Child, Preschool , Disease Management , Humans , Pandemics , Retrospective Studies
6.
J Korean Med Sci ; 36(49): e339, 2021 Dec 20.
Article in English | MEDLINE | ID: covidwho-1581391

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic is affecting people at any age and there is limited information about the effect of the COVID-19 pandemic on quality of life (QoL) in adolescents with asthma. In the present study, it was aimed to assess the attitudes of adolescents with asthma toward the COVID-19 pandemic and determine the effects of the pandemic on their QoL. METHODS: In total, 125 adolescents with asthma and 98 healthy adolescents participated in the present study. The questionnaire form consisted of three parts. In the first part, all the participants were asked whether they complied with the protective measures against COVID-19. The second part included questions for measuring the participants' level of concern about COVID-19, while the third part consisted of EUROHIS-QOL 8. RESULTS: The patient and control groups were similar in terms of the female/male ratio (55/70 and 48/50, respectively) and mean participant age (14.6 ± 2 and 15.1 ± 1.65 years, respectively) (P = 0.459 and P = 0.062, respectively). The prevalence of COVID-19 in the patients (n = 2, 1.6%) was lower than that in the controls (n = 6, 6.1%); however, the difference was not statistically significant (P = 0.142). The total EUROHIS-QOL score was significantly lower in the patients (31.2 ± 6.7) than in the controls (33.7 ± 4.4) (P < 0.001). The total QoL scores of asthmatic adolescents without other allergic disease (31.4 ± 6.7) was also lower than those of the controls (33.7 ± 4.4) (P = 0.009). Treatment disruption was significantly more common in patients who received subcutaneous immunotherapy (n = 20, 48.8%) than in those who did not (n = 8, 9.5%) (P < 0.001). Moreover, the patients had lower EUROHIS-QOL scores in the overall QoL, general health, finance, and home domains. CONCLUSION: Our results indicate that the mean QoL score of asthmatic adolescents during COVID-19 pandemic is lower than in the healthy population. Disruption in their treatment was most common in patients with asthma who were receiving subcutaneous immunotherapy.


Subject(s)
Asthma/epidemiology , Asthma/psychology , COVID-19/epidemiology , Adolescent , Adrenal Cortex Hormones/therapeutic use , Asthma/complications , Attitude to Health , COVID-19/complications , COVID-19/psychology , Case-Control Studies , Child , Female , Humans , Male , Pandemics , Prevalence , Quality of Life , Quarantine , Surveys and Questionnaires , Young Adult
7.
Eur Respir Rev ; 30(162)2021 Dec 31.
Article in English | MEDLINE | ID: covidwho-1573627

ABSTRACT

As the world faces the coronavirus disease 2019 (COVID-19) pandemic due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, concerns have been raised that asthma patients could be at increased risk of SARS-CoV-2 infection and disease severity. However, it appears that asthma is not an independent risk factor for both. Furthermore, asthma is not over-represented in hospitalised patients with severe pneumonia due to SARS-CoV-2 infection and there was no increased risk of asthma exacerbations triggered by SARS-CoV-2. There is accumulating evidence that asthma phenotypes and comorbidities are important factors in evaluating the risk for SARS-CoV-2 infection and disease severity, as findings suggest that Th2-high inflammation may reduce the risk of SARS-Cov-2 infection and disease severity in contrast to increased risk in patients with Th2-low asthma. The use of inhaled corticosteroids (ICS) is safe in asthma patients with SARS-CoV-2 infection. Furthermore, it has been proposed that ICS may confer some degree of protection against SARS-CoV-2 infection and the development of severe disease by reducing the expression of angiotensin converting enzyme-2 and transmembrane protease serine in the lung. In contrast, chronic or recurrent use of systemic corticosteroids before SARS-CoV-2 infection is a major risk factor of poor outcomes and worst survival in asthma patients. Conversely, biological therapy for severe allergic and eosinophilic asthma does not increase the risk of being infected with SARS-CoV-2 or having worse COVID-19 severity. In the present review we will summarise the current literature regarding asthma and COVID-19.


Subject(s)
Asthma , COVID-19 , Adrenal Cortex Hormones/adverse effects , Asthma/diagnosis , Asthma/drug therapy , Asthma/epidemiology , Humans , Pandemics , SARS-CoV-2
8.
Rev Alerg Mex ; 68(4): 218-224, 2021.
Article in Spanish | MEDLINE | ID: covidwho-1573100

ABSTRACT

OBJECTIVE: To determine the prevalence and risk factors associated with tobacco use during the period of confinement in light of the COVID-19 pandemic. METHODS: Through an analytical and cross-sectional study, the data of 2, 372 participants were analyzed. The information was collected through a self-administered questionnaire that was built with the Google Forms tool, which was distributed and applied via email and WhatsApp; the private messaging platform. The relationship between the independent variables and the outcome was determined by multivariate logistic regression analysis. RESULTS: Out of the total population, 69.3 % were women, the median age was 20.11±2.01 years, the prevalence of asthma was 12.2 %, and the active tobacco use was 13.3 %. There was a higher number of patients with asthma who smoked (14.2 vs. 13.2 %) than of those who didn't have asthma. The multivariate logistic regression analysis showed that factors like considering that COVID-19 does not exist and not being confined were related to tobacco use in patients with asthma during the implementation of the contingency plan that the COVID-19 pandemic represents. CONCLUSIONS: During confinement to home for COVID-19, the prevalence of tobacco use is higher in patients with asthma than in individuals without this ailment; the factors that favor the aforementioned are present in the family environment.


Objetivo: Determinar la prevalencia y factores de riesgo asociados al tabaquismo durante el periodo de confinamiento ante la pandemia de COVID-19. Métodos: Mediante un estudio analítico y transversal se analizaron los datos de 2372 participantes. La recolección de la información se realizó con un cuestionario autoadministrado construido con la herramienta Google Forms, el cual se distribuyó y aplicó a través de correo electrónico y de la plataforma de mensajería privada WhatsApp. La relación entre las variables independientes y la resultante fue determinada a través de regresión logística multivariada. Resultados: De la población total, 69.3 % fue del sexo femenino, la edad media de 20.11 ± 2.01 años, la prevalencia de asma de 12.2 % y la de tabaquismo activo, de 13.3 %. Una mayor proporción de pacientes con asma fumaba (14.2 versus 13.2 %), en comparación con quienes no padecían asma. La regresión logística multivariante mostró que considerar que COVID-19 no existe y no cumplir con el confinamiento se relacionaron con el tabaquismo en pacientes con asma durante la aplicación del plan de contingencia que representa la pandemia de COVID-19. Conclusiones: Durante el confinamiento en casa por COVID-19, la prevalencia de tabaquismo es mayor en pacientes con asma comparados con los individuos sin esta enfermedad. Los factores que favorecen lo anterior están presentes en el entorno familiar.


Subject(s)
Asthma , COVID-19 , Adolescent , Adult , Asthma/epidemiology , Cross-Sectional Studies , Female , Humans , Pandemics , SARS-CoV-2 , Tobacco Use/epidemiology , Young Adult
9.
Medicina (Kaunas) ; 57(12)2021 Nov 29.
Article in English | MEDLINE | ID: covidwho-1542661

ABSTRACT

A systematic review of the literature was conducted to analyse the factors that affect the probability of the paediatric asthma population suffering from COVID-19 or SARS-CoV-2, such as asthma phenotypes, inhaled corticosteroids, and the effects of lockdown. This systematic review was based on PRISMA guidelines. A bibliographic search was conducted using BNE, BVS (LILAC), CSIC (IME, ISOC), IBECS, Scielo, Scopus, Medline, and PubMed, using the following search profile: (COVID-19 or 2019-NCOV or SARS-CoV-2 or COV-19) AND asthma AND (children or adolescents or youths or children or teenagers). The results were limited to those articles published between December 2019 and December 2020, selecting only articles published in Spanish, English and French that included the study population (children aged 0-18 years). Among the 1066 results of the bibliographic search and seven articles selected from a manual search, only 19 articles were found to fit our eligibility criteria. Most of the articles highlight the effects of lockdown on the paediatric asthma population, increased therapeutic compliance, and the role of inhaled corticosteroids and intrinsic factors such as ACE2 receptors as causes of the decreased prevalence of COVID-19 among the paediatric asthma population. This population has unique characteristics that serve as protective factors against COVID-19. The safety measures implemented during the lockdown period along with inhaled corticosteroid treatment also contributed to this protection.


Subject(s)
Asthma , COVID-19 , Adolescent , Asthma/drug therapy , Asthma/epidemiology , Communicable Disease Control , Humans , SARS-CoV-2
12.
Eur Respir Rev ; 30(162)2021 Dec 31.
Article in English | MEDLINE | ID: covidwho-1523278

ABSTRACT

Asthma is a heterogenous disease, and its prevalence and severity are different in males versus females through various ages. As children, boys have an increased prevalence of asthma. As adults, women have an increased prevalence and severity of asthma. Sex hormones, genetic and epigenetic variations, social and environmental factors, and responses to asthma therapeutics are important factors in the sex differences observed in asthma incidence, prevalence and severity. For women, fluctuations in sex hormone levels during puberty, the menstrual cycle and pregnancy are associated with asthma pathogenesis. Further, sex differences in gene expression and epigenetic modifications and responses to environmental factors, including SARS-CoV-2 infections, are associated with differences in asthma incidence, prevalence and symptoms. We review the role of sex hormones, genetics and epigenetics, and their interactions with the environment in the clinical manifestations and therapeutic response of asthma.


Subject(s)
Asthma , COVID-19 , Adult , Asthma/diagnosis , Asthma/drug therapy , Asthma/epidemiology , Child , Female , Gonadal Steroid Hormones , Humans , Male , Pregnancy , Prevalence , SARS-CoV-2 , Sex Factors
13.
J Infect Dev Ctries ; 15(10): 1415-1425, 2021 10 31.
Article in English | MEDLINE | ID: covidwho-1518652

ABSTRACT

INTRODUCTION: We aimed to evaluate clinical and laboratory findings of hospitalized asthma and chronic obstructive pulmonary disease (COPD) patients with COVID-19 and demonstrate that they have different symptoms and/or laboratory results and outcomes than COVID-19 patients with comorbidity (CoV-com) and without comorbidity (CoV-alone). METHODOLOGY: The data of the demographic, clinical, laboratory findings of hospitalized CoV-alone, asthma, COPD patients with COVID-19 (CoV-asthma, CoV-COPD, respectively), and CoV-com were analyzed. RESULTS: Out of 1082 patients hospitalized for COVID-19, 585 (54.1%) had CoV-alone, 40 (3.7%) had CoV-asthma, 46 (4.3%) had CoV-COPD and 411 (38%) had CoV-com. Cough, shortness of breath, fever and weakness were the most common four symptoms seen in all COVID-19 patients. Shortness of breath, myalgia, headache symptoms were more common in CoV-asthma than the other groups (p < 0.001, p < 0.01, p < 0.05 respectively). Sputum was more common in CoV-COPD than other groups (p < 0.01). COPD group most frequently had increased values, different from the other groups with CRP>5ng/mL in 91.3%, D-dimer > 0.05mg/dL in 89.1%, troponin > 0.014micg/L in %63.9, INR>1.15 in 52.2%, CK-MB>25U/L in 48.5%, PT>14s in 40.9% of patients (p < 0.05, p < 0.001, p < 0.001, p < 0.001, p < 0.05, p < 0.001, respectively). NT-ProBNP was found to have the highest AUC value and the best differentiating parameter for CoV-asthma from CoV-alone. Typical CT findings were present in 44.4% of CoV-alone, 57.5% of CoV-asthma, 28.3% of CoV-COPD and 38.9% of CoV-com groups. CoV-COPD and CoV-com patients died more frequently than other groups (17.8%, 18.5%). CONCLUSIONS: CoV-asthma and CoV-COPD patients might have different symptoms and laboratory parameters than other COVID-19 patients which can guide the physicians.


Subject(s)
Asthma/epidemiology , COVID-19/epidemiology , Pulmonary Disease, Chronic Obstructive/epidemiology , Adult , Aged , Asthma/diagnostic imaging , COVID-19/diagnostic imaging , Comorbidity , Cross-Sectional Studies , Female , Hospitalization/statistics & numerical data , Humans , Lung/diagnostic imaging , Lung/pathology , Male , Middle Aged , Pulmonary Disease, Chronic Obstructive/diagnostic imaging , Retrospective Studies , SARS-CoV-2/genetics , SARS-CoV-2/pathogenicity , Tomography, X-Ray Computed , Turkey/epidemiology
14.
BMJ Open ; 11(11): e052971, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1495469

ABSTRACT

INTRODUCTION: Asthma is a common long-term disorder and strategies to improve asthma control are still a challenge. Integrated delivery of health systems is critical for effective asthma care: there is limited information on experiences of care coordination for asthma from Latin America, especially on perspectives of health personnel and in the context of the COVID-19 pandemic. METHODS AND ANALYSIS: This protocol details a qualitative approach to analyse health workers' perspectives of healthcare coordination for asthma control during COVID-19 pandemic in Ecuador and Brazil, at primary and specialised levels, through in-depth semistructured interviews using a video communications platform. The analysis will identify knowledge and perspectives based on coordination of clinical information, clinical management and administrative coordination. Theoretical sampling will be used to obtain approximately equal numbers of women and men within each level of healthcare; data saturation will be used to determine sample size. Transcripts will be analysed using content-coding procedures to mark quotations related to major topics and subthemes included in the interview guide, and narrative analysis will be based on a theoretical framework for healthcare coordination to identify new themes and subthemes. ETHICS AND DISSEMINATION: Ethical approval was obtained from the ethics committees of Hospital General Docente Calderón, Quito, Ecuador; and Universidade Federal da Bahia, Salvador, Brazil. The findings of this study will be disseminated through peer-reviewed articles, conference presentations and condensed summaries for key stakeholders and partners.


Subject(s)
Asthma , COVID-19 , Asthma/epidemiology , Asthma/therapy , Brazil/epidemiology , Delivery of Health Care , Ecuador/epidemiology , Female , Health Personnel , Humans , Male , Pandemics , Qualitative Research , SARS-CoV-2
15.
Int J Environ Res Public Health ; 18(21)2021 Oct 29.
Article in English | MEDLINE | ID: covidwho-1488582

ABSTRACT

The coronavirus disease (COVID-19) pandemic altered environmental factors. We studied the impact of these changes on asthma exacerbation (AE) by comparing the AE-related environmental factors between COVID-19 (2020) and pre-COVID-19 (2011-2019) eras. Between 2011 and 2020, 278,465 children (<16 years old) visited our emergency department, and 7476 were diagnosed with AE. The number of patients showed spring and fall peaks in 2011-2019. Multivariate analyses showed significant positive relationships of the number of AE patients with the average temperature among all patients and 0-5-year-olds and with sulfur dioxide (SO2) levels in 2011-2019 among 0-5-year-olds. Although the spring peak in the number of patients was not observed in 2020 after declaration of a state of emergency, the fall peak was again observed after the state of emergency was lifted. No changes in average temperature were detected, but SO2 was significantly reduced following declaration of the state of emergency in 2020. Therefore, SO2 reduction might have contributed to the disappearance of the peak of AE. However, a fall peak was observed again in 2020, although SO2 levels continued to be low. These data suggest that person to person interaction seems to be associated with AE, presumably due to unknown viral infections.


Subject(s)
Air Pollutants , Air Pollution , Asthma , COVID-19 , Adolescent , Air Pollutants/analysis , Air Pollution/analysis , Asthma/epidemiology , Child , Child, Preschool , Emergency Service, Hospital , Humans , Japan/epidemiology , Pandemics , SARS-CoV-2 , Sulfur Dioxide/analysis
17.
Pediatr Pulmonol ; 57(1): 20-25, 2022 01.
Article in English | MEDLINE | ID: covidwho-1473909

ABSTRACT

BACKGROUND: With the onset of the coronavirus disease 2019 (COVID-19) pandemic, many experts expected that asthma-associated morbidity because of severe acute respiratory syndrome coronavirus 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. 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 childhood asthma control test (c-ACT). RESULTS: A total of 22,159 subjects were included in 10 studies. Random effect model was used to account for the data. Compared with the same period before the COVID-19 pandemic, asthma exacerbation reduced (odds ratio [OR] = 0.26, 95% confidence interval [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.


Subject(s)
Asthma , COVID-19 , Asthma/epidemiology , Asthma/prevention & control , Child , Hospitalization , Humans , Pandemics , SARS-CoV-2
18.
Ther Adv Respir Dis ; 15: 17534666211049738, 2021.
Article in English | MEDLINE | ID: covidwho-1463195

ABSTRACT

BACKGROUND: Patients with obstructive lung diseases may be at risk of hospitalization and/or death due to COVID-19. AIM: To estimate the frequency of severe COVID-19, and COVID-19-related mortality in a well-defined large population of patients with asthma and chronic inflammatory lung disease (COPD). Further to assess the frequency of asthma and COPD as registered comorbidities at discharge from hospital, and in death certificates. METHODS: At the start of the pandemic, the Swedish National Airway Register (SNAR) included 271,404 patients with a physician diagnosis of asthma and/or COPD. In September 2020, after the first COVID-19 wave in Sweden, the database was linked with the National Patient Register (NPR), the Swedish Intensive Care Register and the Swedish Cause of Death Register, which all provide data about COVID-19 based on International Classification of Diseases (ICD-10) codes. Severe COVID-19 was defined as hospitalization and/or intensive care or death due to COVID-19. RESULTS: Among patients in SNAR, 0.5% with asthma, and 1.2% with COPD were identified with severe COVID-19. Among patients < 18 years with asthma, only 0.02% were severely infected. Of hospitalized adults, 14% with asthma and 29% with COPD died. Further, of patients in SNAR, 56% with asthma and 81% with COPD were also registered in the NPR, while on death certificates the agreement was lower (asthma 24% and COPD 71%). CONCLUSION: The frequency of severe COVID-19 in asthma and COPD was relative low. Mortality for those hospitalized was double as high in COPD compared to asthma. Comorbid asthma and COPD were not always identified among patients with severe COVID-19.


Subject(s)
Asthma/epidemiology , COVID-19/physiopathology , Hospitalization , Pulmonary Disease, Chronic Obstructive/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Asthma/mortality , COVID-19/mortality , Databases, Factual , Female , Humans , Intensive Care Units/statistics & numerical data , Male , Middle Aged , Pulmonary Disease, Chronic Obstructive/mortality , Registries , Severity of Illness Index , Sweden/epidemiology , Young Adult
19.
Int J Tuberc Lung Dis ; 25(10): 873-875, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1456464
20.
Pediatr Pulmonol ; 57(1): 66-74, 2022 01.
Article in English | MEDLINE | ID: covidwho-1449941

ABSTRACT

BACKGROUND: Lockdown measures during the SARS-CoV-2 pandemic determined radical changes to behavioral and social habits, that were reflected by a reduction in the transmission of respiratory pathogens and in anthropogenic atmospheric emissions. OBJECTIVE: This ecological study aims to provide a descriptive evaluation on how restrictive measures during the SARS-CoV-2 pandemic impacted Pediatric Emergency Department (PED) referrals for asthma exacerbations, and their potentially associated environmental triggers in Bologna, a densely populated urban area in Northern Italy. METHODS: Files of children evaluated for acute asthma during 2015 to 2020 at the PED of Sant'Orsola University Hospital of Bologna were retrospectively reviewed. Historical daily concentration records of particulate (PM2.5 , PM10 ) and gaseous (NO2 , C6 H6 ) air pollutants, and pollen were concurrently evaluated, including specific PM chemical tracers for traffic-related air pollution (TRAP). RESULTS: In 2020, asthma-related PED referrals decreased compared to referral rates of the previous 5 years (p < 0.01). This effect was particularly marked during the first lockdown period (March to May), when the drastic drop in PED referrals was associated with a reduction of high-priority cases up to 85% and by 54%, on average. A concomitant reduction in the concentrations of traffic-related air pollutants was observed in the range of 40%-60% (p < 0.01). CONCLUSIONS: The lower rate of asthma exacerbations in childhood was in this study paralleled with reduced TRAP levels during the pandemic. Synergic interactions of the multiple consequences of lockdowns likely contributed to the reduced exacerbations, including decreased exposure to ambient pollutants and fewer respiratory infections, identified as the most important factor in the literature.


Subject(s)
Air Pollutants , Air Pollution , Asthma , COVID-19 , Air Pollutants/analysis , Air Pollutants/toxicity , Air Pollution/analysis , Air Pollution/statistics & numerical data , Asthma/epidemiology , Communicable Disease Control , Emergency Service, Hospital , Environmental Monitoring , Humans , Pandemics , Particulate Matter/analysis , Referral and Consultation , Retrospective Studies , SARS-CoV-2
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