RESUMO
Introduction: The effect of lockdown measures due to COVID-19 pandemic in children with respiratory underlying conditions are still unclear. We analyzed the impact of lockdown measures in the management and evolution of children with asthma and preschool wheeze during the first wave of COVID-19. Matherial and Methods: observational study carried out in children with recurrent wheezing or asthma before and after the implementation of the lockdown by using: a questionnaire aimed to examine pre-existing respiratory disorders, step treatment (according to Spanish Guide for Asthma Management) and level of asthma control before/after lockdown (CAN questionnaire), COVID history and laboratory testing including IgG SARS-CoV-2. Results: we enrolled 475 asthmatic and preschool wheezers (60.6% males), mean age 5.6 years. There were not differences in asthma treatment comparing both periods, since 81.7% maintained the same treatment (p=0.103). According to CAN questionnaire 87.7% remained well controlled during confinement. Nearly a third of children (34.9%) needed reliever treatment, mainly in older children. Determination of IgG SARS-CoV-2 was performed in 233 children (49.1%) of whom 17 (7.3%) tested positive. Seven patients positive to IgG SARS-CoV-2 were assisted in the emergency department and two required hospital admission. Conclusions: During the COVID-19 lockdown most of the children with asthma and recurrent wheezing maintained their preventive treatments unchanged and remained well controlled from their underlying disease. Our results suggest that children that tested positive to IgG SARS-CoV-2 showed significant increase in paediatric hospital admissions and attendances to urgent care settings.
Assuntos
COVID-19 , Insuficiência Respiratória , AsmaRESUMO
Background: Covid-19 pandemic became an unexpected stressor for the entire population and, particularly, for pregnant women and lactating mothers. The alarming infectious risk together with the lockdown period could affect the emotional state of mothers-to-be, as well as breastfeeding rates, mother-baby bonding, or neonatal weight gain. The aim of this study is to describe the impact of this world health emergency in mother-baby pairs right after the first wave of Sars-Cov-2 pandemic (from March to May 2020). Study design: a prospective observational study was carried out in mother-child dyads from those women who gave birth between June and August 2020 in a tertiary hospital. 91 mother-baby pairs were initially enrolled and 56 of them completed the follow-up. The study design had two separate steps: i) Step one: A clinical interview plus three psychometric tests (EPDS: Edinburgh Postnatal Depression Scale, PBQ: Postpartum Bonding Questionnaire and STAI-S: State-Trait Anxiety Inventory); ii) Step two: mother-child dyads were followed using a round of three brief telephone interviews (conducted at the newborn’s 7, 14 and 28 days of age) to accurately depict the newborn’s outcome in the neonatal period. Results: In terms of maternal mental health, 25% of the sample screens positively in the EPDS, requiring further evaluation to rule out depressive symptoms. STAI-state and PBQ detect no abnormalities in either anxiety levels or mother-child bonding in our sample, as 100% of the mothers score below the cut-off points in each test (34 and 26 respectively). When comparing feeding practices (breast/bottle feeding) in 2020 to those practices during pre-pandemic years (2017-2019), a significant increase in breastfeeding was found in pandemic times. All newborns in the sample showed an adequate weight gain during their first month of life. Conclusion: Women and newborns in our sample did not experience an increase in adverse outcomes in the neonatal period in terms of maternal mental health, breastfeeding rates, bonding and further neonatal development.