Children with Asthma Exposed to COVID-19 Show a Decrease in Severity from Baseline: A Systematic Review from March 2020 to September 2022
DOI:
https://doi.org/10.14738/jbemi.96.13436Keywords:
Asthma, caregivers, children, health center, SARS-CoV-2.Abstract
Introduction: During the COVID-19 pandemic, children have been affected by SARS- CoV-2 infection, primarily affecting the respiratory system. Children with chronic respiratory diseases such as asthma, emphysema, and chronic bronchitis can experience an exacerbation of the preexisting conditions. The study's primary aim was to identify the severity of asthma in COVID-19-exposed children aged 4-12 years. Methods: We extracted the data from the PubMed database between March 2020 and September 2022. During the COVID-19 pandemic, PubMed-published articles involving children living with asthma aged 4-12 years were identified. The study included children who had tested positive for SARS-CoV-2 and excluded children with any other comorbidities. Results:We identified 169 PubMed- published articles and filtered 28 articles. Seven articles met the inclusion criteria and were included in the study. The children with asthma hospitalized owing to COVID-19 worldwide was 1% to 2.7%. Incidence was 12.8 times less frequent in children than in adults. Increased expression of the angiotensin-converting enzyme-2 gene in the bronchial epithelium of patients with type 2-low or T1-high asthma tended to have higher known risk factors for COVID-19. Among school-age children (N=277,285), 1.2% were hospitalized, 0.1% had intensive care unit admissions, and <0.1% died. Of those patients (hospitalized, ICU admissions, and those who died from COVID-19), all had at least one underlying medical condition, and 55% had chronic lung disease, including asthma. Conclusion: Most children with recurrent wheezing and asthma were well-controlled by their underlying asthma and did not require significant changes to their maintenance treatments. It concludes that children who tested positive for SARS-CoV-2 had fewer pediatric hospital admissions and attendance at urgent care settings. The reduction in asthma morbidities is due to improved adherence and decreased exposure to allergens and viral infections in children.
References
Oreskovic, N.M., Kinane, T.B., Aryee, E., et al., The unexpected risks of COVID-19 on asthma control in children. J Allergy Clin Immunol Pract, 2020. 8: p. 2489-91.
Liu, S., Zhi, Y., Ying, S., COVID-19, and asthma: reflection during the pandemic. Clin Rev Allergy Immunol, 2020. 59: p. 78-88.
CDC. coronavirus disease 2019 (COVID-19). https://www.cdc. gov/coronavirus/2019-ncov/casesupdates/cases-in-us.html.
WHO. Coronavirus disease (COVID-19) pandemic. https://www. who.int/emergencies/diseases/novelcoronavirus-2019.
Saqib, M.A.N., Siddiqui, S., Qasim, M., et al., Effect of COVID-19 lockdown on patients with chronic diseases. Diabetes Metab Syndr. 2020. 14: p. 1621-3.
Liu, S., Zhi, Y., Ying, S., COVID-19 and asthma: reflection during the pandemic. Clin Rev Allergy Immunol, 2020. 59: p. 78-88.
National Institute for Clinical Excellence. COVID-19 rapid guideline: severe asthma, 2020. https://www.nice.org.uk/guidance/ ng166.
Bloom, C.I., Drake, T.M., Docherty, A.B., et al., Risk of adverse outcomes in patients with underlying respiratory conditions admitted to hospital with COVID-19: a national, multicentre prospective cohort study using the ISARIC who clinical characterisation protocol UK. Lancet, 2021. Respir Med. doi:10.1016/S2213-2600(21)00013-8.
Schultze, A., Walker, A.J., MacKenna, B., et al., Risk of COVID-19-related death among patients with chronic obstructive pulmonary disease or asthma prescribed inhaled corticosteroids: an observational cohort study using the Open SAFELY platform. Lancet Respir Med, 2020. 8: p. 1106-20.
Williamson, E.J., Walker, A.J., Bhaskaran, K., et al., Factors associated with COVID-19-related death using Open SAFELY. Nature, 2020. 584: p. 430-6. 57
Chan, J.F., et al (2020) A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet, 2020. p. 3957.
Chudasama, Y.V., Gillies, C.L., Zaccardi, F., et al., Impact of COVID-19 on routine care for chronic diseases: a global survey of views from healthcare professionals. Diabetes Metab Syndr, 2020. 14: p. 965-7.
Papadopoulos, N.G., Custovic, A., Deschildre, A., et al., Impact of COVID-19 on pediatric asthma: practice adjustments and disease burden. J Allergy Clin Immunol Pract, 2020. 8: p. 2592-9.
Kaye, L., Theye, B., Smeenk, I., et al. Changes in medication adherence among patients with asthma and COPD during the COVID-19 pandemic. J Allergy Clin Immunol Pract, 2020.8: p. 2384-5.
Moore, S.A., Faulkner, G., Rhodes, R.E., et al., Impact of the COVID-19 virus outbreak on movement and play behaviours of Canadian children and youth: a national survey. Int J Behav Nutr Phys Act, 2020.17: p. 85.
Wu, Z., McGoogan, J.M., Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese center for disease control and prevention. JAMA, 2020. 323(13): p. 1239-42.
Parkin, P.C., Macarthur, C., Saunders, N.R., et al., Development of a clinical asthma score for use in hospitalized children between 1 and 5 years of age. J Clin Epidemiol, 1996. 49: p. 821-825.
Liu, L.L., Gallaher, M.M., Davis, R.L., et al., Use of a respiratory clinical score among different providers. Pediatr Pulmonol, 2004. 37: p. 243-248.
Skevaki, C., Karsonova, A., Karaulov, A., et al., Asthma-associated risk for COVID-19 development. J Allergy Clin Immunol, 2020. 146(6): p. 1295-301.
Green, I., Merzon, E., Vinker, S., et al., Covid-19 susceptibility in bronchial asthma. J Allergy Clin Immunol Pract, 2021. 9(2): p. 684-92.
Abe, K., Miyawaki, A., Nakamura, M., et al., Trends in hospitalizations for asthma during the COVID-19 outbreak in Japan. J Allergy Clin Immunol Pract, 2021. 9(1): p. 494-6.
Ruano, F.J., Somoza, A´lvarez, M.L., Haroun-Dı´az, E., et al., Impact of the COVID-19 pandemic in children with allergic asthma. J Allergy Clin Immunol Pract, 2020. 8(9): p. 3172-4.
Zheng, F., Liao, C., Fan, Q-H., et al., Clinical characteristics of children with coronavirus disease 2019 in Hubei, China. Curr Med Sci, 2020. 40(2): p. 275-80.
Sun, D., Li, H., Lu, X-X., et al., Clinical features of severe pediatric patients with coronavirus disease 2019 in Wuhan: a single center’s observational study. World J Pediatr, 2020. 16(3): p. 251-9.
Papadopoulos, N.G., Mathioudakis, A.G., Custovic, A., Deschildre, A., Phipatanakul, W., Wong, G., Xepapadaki, P., Abou-Taam, R., Agache, I., Castro-Rodriguez, J.A., Chen, Z., Cros, P., Dubus, J.C., El-Sayed, Z.A., El-Owaidy, R., Feleszko, W., Fierro, V., Fiocchi, A., Garcia-Marcos, L., Goh, A., Hossny, E.M., Huerta, Villalobos, Y.R., Jartti, T., Le, Roux, P., Levina, J., López, García, A.I., Ramos, Á.M., Morais-Almeida, M., Murray, C., Nagaraju, K., Nagaraju, M.K., Navarrete, Rodriguez, E.M., Namazova-Baranova, L., Nieto, Garcia, A., Pozo Beltrán, C.F., Ratchataswan, T., Rivero, Yeverino, D., Rodríguez, Zagal, E., Schweitzer, C.E., Tulkki, M., Wasilczuk, K., Xu, D., PeARL collaborators, on behalf of the PeARL Think Tank. Childhood asthma outcomes during the COVID-19 pandemic: Findings from the PeARL multi-national cohort. Allergy, 2021. 76(6): p. 1765-1775. doi: 10.1111/all.14787. Epub 2021 Mar 24. PMID: 33608919; PMCID: PMC8013557.
Al-Iede, M., Waters, K., Aleidi, S.M., Alqutawneh, B., Alnawaiseh, H., Alshraideh, A., Almaaitah, S., Mahmoud, R., Abualsoud, R., Kiswani, A., Al-Zayadneh, E., Yousef, A.M., Impact of COVID-19 lockdown on children with asthma in Jordan: a parental questionnaire. BMJ Paediatr Open, 2021. 5(1): p. e001136. doi: 10.1136/bmjpo-2021-001136. PMID: 34222681; PMCID: PMC8228568.
Hepkaya, E., Kilinc, A.A., Cebi, M.N., Koyuncu, Z., Cokugras, H., General health status of children with asthma during the COVID-19 pandemic. Pediatr Int, 2021. 63(3): p. 331-337. doi: 10.1111/ped.14453. Epub 2021 Mar 2.
Daoud, Pérez, Z., Rázquin, Arias, M., López-Escobar, A., Díaz-Conradi, A., Arce, A., Ruggeri, N., Romero, Blanco, I., Díaz-Delgado, B., Ventura, Wichner, P.S., The impact of COVID-19 lockdown on children with recurrent wheezing and asthma in Spain. J Paediatr Child Health, 2022. 58(9): p. 1635-1641. doi: 10.1111/jpc.16068. Epub 2022 Jun 24. PMID: 35748401; PMCID: PMC9350390.
Leeb, R.T., Price, S., Sliwa, S., et al., Covid-19 trends among school-aged children - united states, March 1-September 19, 2020. MMWR Morb Mortal Wkly Rep, 2020. 69(39): p. 1410-5.
Metbulut, A.P., Mustafaoğlu, Ö., Şen, G., et al., Evaluation of the clinical and laboratory findings of asthmatic children with SARS-CoV-2 infection. Int Arch Allergy Immunol, 2021. p. 1-8. doi:10.1159/000517153
Jia, Y., Bao, J., Yi, M., Zhang, Z., Wang, J., Wang, H., Li, Y., Chen, O., Impact of the COVID-19 pandemic on asthma control among children: a qualitative study from caregivers' perspectives and experiences. BMJ Open, 2021. 11(5): p. e046525. doi: 10.1136/bmjopen-2020-046525. PMID: 33986062; PMCID: PMC8126436.
Boechat, J.L., Wandalsen, G.F., Kuschnir, F.C., Delgado, L., COVID-19 and pediatric asthma: clinical and management challenges. Int J Environ Res Public Health, 2021. 18(3): p. 1093.
Kulhas, Celik, I., Metbulut, A.P., Uneri, O.S., Senses, Dinc, G., Dibek, Misirlioglu, E., Effect of patient and parental anxiety on adherence to subcutaneous allergen immunotherapy during the coronavirus disease 2019 pandemic. Ann Allergy Asthma Immunol, 2021. 126(5): p. 595-7.
Cekic, S., Karali, Z., Cicek, F., Canitez, Y., Sapan, N., The Impact of the COVID-19 Pandemic in Adolescents with Asthma. J Korean Med Sci, 2021. 36(49): p. e339. doi: 10.3346/jkms.2021.36.e339. PMID: 34931499; PMCID: PMC8688346.
Wu, H., Zhu, H., Yuan, C., et al., Clinical and immune features of hospitalized pediatric patients with coronavirus disease 2019 (COVID-19) in Wuhan, China. JAMA Netw Open, 2020. 3(6): p. e2010895. https://doi.org/10.1001/jamanetworkopen.2020.10895
Krivec, U., Kofol, Seliger, A., Tursic, J., COVID-19 lockdown dropped the rate of paediatric asthma admissions. Arch Dis Child, 2020. 105: p. 809-810.
Niespodziana, K., Borochova, K., Pazderova, P., et al., Toward personalization of asthma treatment according to trigger factors. J Allergy Clin Immunol, 2020. 145: p. 1529-1534.
Eguiluz-Gracia, I., Mathioudakis, A.G., Bartel, S., et al., The need for clean air: the way air pollution and climate change affect allergic rhinitis and asthma. Allergy, 2020. 75: p. 2170-2184.
Taquechel, K., Diwadkar, A.R., Sayed, S., et al., Pediatric asthma healthcare utilization, viral testing, and air pollution changes during the COVID-19 Pandemic. J Allergy Clin Immunol Pract, 2020. 8(10): p. 3378. https://doi.org/10.1016/j.jaip.2020.07.057
Chavasse, R., Almario, A., Christopher, A., Kappos, A., Shankar, A., The indirect impact of COVID-19 on children with asthma. Arch Bronconeumol, 2020. 56(11): p. 768-769. https://doi.org/10.1016/j.arbres.2020.07.00
Brooks, S.K., Webster, R.K., Smith, L.E., Woodland, L., Wessely, S., Greenberg, N., et al., The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet, 2020. 395(10227): p. 912-20.
Jiao, W.Y., Wang, L.N., Liu, J., Fang, S.F., Jiao, F.Y., Pettoello-Mantovani, M., et al., Behavioral and emotional disorders in children during the COVID-19 epidemic. J Pediatr, 2020. 221: p. 264-266.
Sprang, G., Silman, M., Posttraumatic stress disorder in parents and youth after health-related disasters. Disaster Med Public Health Prep, 2013. 7(1): p. 105-10.
Saraçlar, Y., Kuyucu, S., Tuncer, A., Sekerel, B., Saçkesen, C., Kocabaş, C., Prevalence of asthmatic phenotypes and bronchial hyperresponsiveness in Turkish schoolchildren: an International Study of Asthma and Allergies in Childhood (ISAAC) phase 2 study. Ann Allergy Asthma Immunol, 2003. 91(5): p. 477-84.
Kulhas, Celik, I., Metbulut, A.P., Uneri, O.S., Senses, Dinc, G., Dibek, Misirlioglu, E., Effect of patient and parental anxiety on adherence to subcutaneous allergen immunotherapy during the coronavirus disease 2019 pandemic. Ann Allergy Asthma Immunol, 2021. 126(5): p. 595-7. 59
De-Figueiredo, C.S., Sandre, P.C., Portugal, L.C., Mázala-de-Oliveira, T., da-Silva, Chagas, L., Raony, Í., et al., COVID-19 pandemic impact on children and adolescents’ mental health: Biological, environmental, and social factors. Prog Neuropsychopharmacol Biol Psychiatry, 2021. 106: p. 110171.
Mindell, J.A., Williamson, A.A., Benefits of a bedtime routine in young children: sleep, development, and beyond. Sleep Med Rev, 2018. 40: p. 93-108.
Cellini, N., Di, Giorgio, E., Mioni, G., Di, Riso, D., Sleep and psychological difficulties in Italian school-age children during COVID-19 lockdown. J Pediatr Psychol, 2021. 46(2): p. 153-67.
Hawke, L.D., Monga, S., Korczak, D., Hayes, E., Relihan, J., Darnay, K., et al., Impacts of the COVID-19 pandemic on youth mental health among youth with physical health challenges. Early Interv Psychiatry, 2021. 15(5): p. 1146-53.
Horne, R., Price, D., Cleland, J., et al., Can asthma control be improved by understanding the patient's perspective? BMC Pulm Med. 2007. 7: p. 8.
Gautier, C., Charpin, D., Environmental triggers and avoidance in the management of asthma. J Asthma Allergy, 2017. 10: p. 47-56.
Pelaia, G., Vatrella, A., Gallelli, L., et al., Respiratory infections and asthma. Respir Med, 2006. 100: p. 775-84.
Nnodum, B.N., McCormack, M.C., Putcha, N., et al., Impact of physical activity on reporting of childhood asthma symptoms. Lung, 2017. 195: p. 693-8.
Dales, R., Chen, L., Frescura, A.M., et al., Acute effects of outdoor air pollution on forced expiratory volume in 1 S: a panel study of schoolchildren with asthma. Eur Respir J, 2009. 34: p. 316-23.
Kaye, L., Theye, B., Smeenk, I., et al., Changes in medication adherence among patients with asthma and COPD during the COVID-19 pandemic. J Allergy Clin Immunol Pract, 2020. 8: p. 2384-5.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Juel Chowdhury, Rejoice Puthuchira Ravi, Jesha Mohammed Ali Mundodan, Hayat Mohamedbek, Soha Shawqi Albayat
This work is licensed under a Creative Commons Attribution 4.0 International License.
