Childhood asthma outcomes during the COVID-19 pandemic: Findings from
the PeARL multi-national cohort
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.