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Childhood asthma outcomes during the COVID-19 pandemic: Findings from the PeARL multi-national cohort
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  • Nikolaos Papadopoulos,
  • Alexander Mathioudakis,
  • A Custovic,
  • Antoine DESCHILDRE,
  • Wanda Phipatanakul,
  • Gary Wong,
  • PARASKEVI XEPAPADAKI,
  • Rola Abou Taam,
  • Ioana Agache,
  • Jose Castro-Rodriguez,
  • Zhimin Chen,
  • Pierrick Cros,
  • Jean Christophe Dubus,
  • Zeinab El-Sayed,
  • Rasha El-Owaidy,
  • Wojciech Feleszko,
  • Vincenzo Fierro,
  • Alessandro Fiocchi,
  • Luis Garcia-Marcos,
  • Anne Eng Neo Goh,
  • Elham Hossny,
  • Yunuen Huerta Villalobos,
  • Tuomas Jartti,
  • Pascal Le ROUX,
  • Julia Levina ,
  • Aída López-García,
  • Angel Mazon,
  • Mário Morais-Almeida,
  • Clare Murray,
  • Karthik Nagaraju,
  • Major Nagaraju,
  • Elsy Maureen Navarrete Rodriguez,
  • Leyla Namazova-Baranova,
  • Antonio Nieto,
  • Cesar Fireth Pozo Beltrán ,
  • Thanaporn Ratchataswan ,
  • Daniele Rivero-Yeverino,
  • Erendira Rodriguez-Zagal,
  • Cyril Schweitzer ,
  • Marleena Tulkki ,
  • Katarzyna Wasilczuk ,
  • Dan XU
Nikolaos Papadopoulos
The University of Manchester

Corresponding Author:ngpallergy@gmail.com

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Alexander Mathioudakis
The University of Manchester
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A Custovic
Imperial College London
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Antoine DESCHILDRE
Institut Pasteur de Lille
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Wanda Phipatanakul
Children's Hospital, Boston
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Gary Wong
Boston Children’s Hospital
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PARASKEVI XEPAPADAKI
National and Kapodistrian University of Athens
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Rola Abou Taam
Hôpital universitaire Necker-Enfants malades
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Ioana Agache
Transylvania University, Brasov
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Jose Castro-Rodriguez
Pontificia Universidad Catolica de Chile
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Zhimin Chen
Zhejiang University School of Medicine Children's Hospital
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Pierrick Cros
CHRU de Brest
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Jean Christophe Dubus
Assistance Publique Hopitaux de Marseille
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Zeinab El-Sayed
Ain Shams University
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Rasha El-Owaidy
Ain Shams University
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Wojciech Feleszko
Medical University of Warsaw
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Vincenzo Fierro
Bambino Gesu Pediatric Hospital
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Alessandro Fiocchi
Bambino Gesu Pediatric Hospital
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Luis Garcia-Marcos
University of Murcia
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Anne Eng Neo Goh
KK Women's and Children's Hospital
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Elham Hossny
Ain Shams University
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Yunuen Huerta Villalobos
Hospital General Regional 1 Dr Carlos Mac Gregor Sanchez Navarro
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Tuomas Jartti
University of Oulu
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Pascal Le ROUX
CH le Havre
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Julia Levina
Russian Academy of Sciences
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Aída López-García
Hospital Universitario de Puebla
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Angel Mazon
Children's Hospital La Fe
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Mário Morais-Almeida
CUF-Descobertas Hospital
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Clare Murray
University of Manchester
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Karthik Nagaraju
VN Allergy & Asthma Research Centre
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Major Nagaraju
Saveetha Medical College Department of General Medicine
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Elsy Maureen Navarrete Rodriguez
Hospital Infantil de Mexico Federico Gomez
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Leyla Namazova-Baranova
Russian National research medical university of MoH RF
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Antonio Nieto
Children's Hospital La Fe
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Cesar Fireth Pozo Beltrán
Hospital Juan María de Salvatierra
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Thanaporn Ratchataswan
Boston Children's Hospital
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Daniele Rivero-Yeverino
Allergist
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Erendira Rodriguez-Zagal
Allergist
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Cyril Schweitzer
CHRU de Nancy
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Marleena Tulkki
University of Turku
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Katarzyna Wasilczuk
Medical University of Warsaw
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Dan XU
Zhejiang University School of Medicine
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Abstract

Background: The interplay between COVID-19 pandemic and asthma in children is still unclear. We evaluated the impact of COVID-19 on childhood asthma outcomes. Methods: The PeARL multinational cohort included 1,054 children with asthma and 505 non-asthmatic children aged between 4-18 years from 25 pediatric departments, from 15 countries globally. We compared the frequency of acute respiratory and febrile presentations during the first wave of the COVID-19 pandemic between groups and with data available from the previous year. In children with asthma, we also compared current and historical disease control. Results: During the pandemic, children with asthma experienced fewer upper respiratory tract infections, episodes of pyrexia, emergency visits, hospital admissions, asthma attacks and hospitalizations due to asthma, in comparison to the preceding year. Sixty-six percent of asthmatic children had improved asthma control while in 33% the improvement exceeded the minimal clinically important difference. Pre-bronchodilatation FEV1 and peak expiratory flow rate were improved during the pandemic. When compared to non-asthmatic controls, children with asthma were not at increased risk of LRTIs, episodes of pyrexia, emergency visits or hospitalizations during the pandemic. However, an increased risk of URTIs emerged. Conclusion: Childhood asthma outcomes, including control, were improved during the first wave of the COVID-19 pandemic, probably because of reduced exposure to asthma triggers and increased treatment adherence. The decreased frequency of acute episodes does not support the notion that childhood asthma may be a risk factor for COVID-19. Furthermore, the potential for improving childhood asthma outcomes through environmental control becomes apparent.
29 Oct 2020Submitted to Allergy
30 Oct 2020Submission Checks Completed
30 Oct 2020Assigned to Editor
31 Oct 2020Reviewer(s) Assigned
22 Nov 2020Review(s) Completed, Editorial Evaluation Pending
01 Dec 2020Editorial Decision: Revise Minor
17 Dec 20201st Revision Received
18 Dec 2020Submission Checks Completed
18 Dec 2020Assigned to Editor
21 Dec 2020Reviewer(s) Assigned
22 Dec 2020Review(s) Completed, Editorial Evaluation Pending
21 Jan 2021Editorial Decision: Revise Minor
24 Jan 20212nd Revision Received
25 Jan 2021Submission Checks Completed
25 Jan 2021Assigned to Editor
27 Jan 2021Review(s) Completed, Editorial Evaluation Pending
27 Jan 2021Editorial Decision: Accept
24 Mar 2021Published in Allergy. 10.1111/all.14787