Real‐life impact of COVID‐19 pandemic lockdown on the management of pediatric and adult asthma: A survey by the EAACI Asthma Section

• Published in: Allergy Vol. 76; no. 9; pp. 2776 - 2784
• Main Authors: Eguiluz‐Gracia, Ibon, Berge, Maarten, Boccabella, Cristina, Bonini, Matteo, Caruso, Cristiano, Couto, Mariana, Erkekol, FerdaOner, Rukhadze, Maia, Sanchez‐Garcia, Silvia, Giacco, Stefano, Jutel, Marek, Agache, Ioana
• Format: Journal Article Web Resource
• Language: English
• Published: Denmark John Wiley & Sons, Inc 01.09.2021; Blackwell Publishing Ltd; John Wiley and Sons Inc
• Subjects: Allergies; Asthma; Bronchodilators; Children; Chronic illnesses; COVID-19; COVID‐19 lockdown; Diagnosis; exacerbations; lung function test; Methacholine; Original; ORIGINAL ARTICLES; Pandemics; Patients; peak expiratory flow; Pediatrics; Respiratory function; lung function test; asthma; peak expiratory flow; COVID-19 lockdown; exacerbations
• ISSN: 0105-4538; 1398-9995
• DOI: 10.1111/all.14831

Background The restrictions imposed by the COVID‐19 pandemic impact heavily the management of chronic diseases like asthma. This study aimed to evaluate the management of adults and children with asthma during COVID‐19‐related lockdown. Methods A survey was launched by the European Academy of Allergy and Clinical Immunology (EAACI) via e‐mail, website, and social media to EAACI members and members of peer societies. Results The survey was completed by 339 healthcare professionals from 52 countries. 79% of follow‐up consultations were replaced by phone calls, whereas 49% of newly referred patients attended the clinic. 62%, 76%, 66%, 76%, and 87% of responders did not conduct spirometry, impulse oscillometry, bronchodilator test, FeNO, or methacholine provocation, respectively, for asthma diagnosis in adults. The numbers were similar for children. 73% of responders based the initial asthma diagnosis and the prescription of inhaled therapy on clinical parameters only. Lung function tests were used in 29% of cases to monitor asthma worsening, and only 56% of participants were recommended to their patients ambulatory peak expiratory flow (PEF) measurements. Using a 1 (not at all) to 5 (very much) scale, the responders considered that the quality of healthcare provided and the patients’ asthma status had deteriorated during the lockdown with 3.2 points and 2.8 points, respectively. Conclusion Collectively, these results suggest that all necessary resources should be allocated to ensure the performance of lung function tests for initial diagnosis, whereas digital remote monitoring should be reinforced for the follow‐up of children and adults with asthma. During the first wave of COVID‐19 pandemic, 38% of new and 77% of follow‐up consultations for pediatric and adult asthma patients were performed by phone calls. In 10% of cases, both types of consultations continued as face‐to‐face visits, whereas in 6% of cases all consultations were cancelled. Forced spirometry was not conducted during the initial assessment and subsequent monitoring of 56%‐62% of pediatric and adult asthma patients. Only 56% of HCP encouraged asthma patients to perform regular ambulatory peak expiratory flow measurement. Lung function tests were conducted in only 29% of children and adults with asthma who reported a worsening of their clinical condition. Using a 1 (nothing) to 5 (very much) scale, HCP scored with 2.8 the deleterious impact of COVID‐19 lockdown on the health status of children and adults with asthma. Abbreviations: COVID‐19, coronavirus disease 2019; HCP, health care providers; PEF, peak expiratory flow