How asthmatic children dealt with the coronavirus pandemia? Adherence to Controller Medications and Level of Control among Children with Asthma Registered in Mashhad University of Medical Sciences

Document Type : original article

Authors

1 Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

2 Clinical Research Development Unit of Akbar Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Community Medicine, Treatment Affairs, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background: Coronavirus disease 2019 pandemic had a great effect on the lives of asthmatic children. In this study we assessed changes in medication adherence and asthma control rate among our registered children with pediatric asthma.
Methods: This cross-sectional study was conducted on 113 patients registered in our asthma and allergy clinic in Mashhad, Iran. We called them via phone and completed a questionnaire on the level of asthma medication adherence and the asthma control test (ACT) before and in the 6 months after COVID-19 emergence. We investigated the changes in medication adherence and asthma control due to COVID-19 pandemic.
Results: A total of 113 asthmatic children in the age range of 1 to 15 (mean, 7.02±3.24 years) were included in the study. There were zero confirmed positive cases among them since COVID-19 introduction. The minority of patients (8.8%) had weak adherence, most of the children (35.4%) completed one course of prescribed medications, 33% had longer adherence, and only 25 patients (22.1%) had full adherence during the pandemic. Overall, our patients experienced better asthma control with a 1.51 rise in ACT score to arrive in 23.64 points out of 25. They had no asthma exacerbation and emergency visit. Over half of the families compiled the national preventive measures; as 85% of children had followed the stay-at-home order during the first peak of the pandemic.
Conclusion: Our patients managed to come to a higher asthma control level despite their generally decreased adherence to medications during the pandemic. COVID-19 not only could not worsen asthma status in our children but surprisingly improved it. This shows that the preventive measures should be strongly applied for the asthmatic population.

Keywords

References

  1. Centers for Disease Control; COVID-19 Risk Factors. Accessed 14 September 2020 (cited May 2020). Available from, URL; https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html#:~:text=Like%20adults%2C%20children%20with%20obesity,on%20vaccination%20information%20for%20children.
  2. World Health Organization; COVID-19 and Asthma. Accessed 14 September 2020 (cited May 2020). Available from, URL; https://www.who.int/publications-detail-redirect/who-2019-ncov-sci-brief-asthma-2021.1.
  3. Kaye L, Theye B, Smeenk I, Gondalia R, Barrett MA, Stempel DA, Changes in medication adherence among patients with asthma and COPD during the COVID-19 pandemic. The Journal of Allergy and Clinical Immunology: In Practice, 2020. 8(7): p. 2384-2385.
  4. Papadopoulos NG, Custovic A, Deschildre A, Mathioudakis AG, Phipatanakul W, Wong G, Xepapadaki P, Agache I, Bacharier L, Bonini M, Castro-Rodriguez JA, Chen Z, Craig T, Ducharme FM, El-Sayed ZA, Feleszko W, Fiocchi A, Garcia-Marcos L, Gern JE, Goh A, Gómez RM, Hamelmann EH, Hedlin G, Hossny EM, Jartti T, Kalayci O, Kaplan A, Konradsen J, Kuna P, Lau S, Souef PL, Lemanske RF, Mäkelä MJ, Morais-Almeida M, Murray C, Nagaraju K, Namazova-Baranova L, Garcia AN, Yusuf OM, Pitrez PMC, Pohunek P, Pozo Beltrán CF, Roberts GC, Valiulis A, Zar HJ; Pediatric Asthma in Real Life Collaborators, Impact of COVID-19 on Pediatric Asthma: Practice Adjustments and Disease Burden. The Journal of Allergy and Clinical Immunology: In Practice, 2020. 8(8): p. 2592-2599.e3.
  5. Zhang B, Jin R, Guan RZ, Lin RJ, Chang DY, Zhang LH, Ding J, (Evaluation of the efficacy of Chinese Children's Asthma Action Plan on the long-term management of children with asthma at home). Zhonghua Yi Xue Za Zhi, 2020. 100(46): p. 3702-3705.
  6. Ulrich L, Macias C, George A, Bai S, Allen E, Unexpected decline in pediatric asthma morbidity during the coronavirus pandemic. Pediatr Pulmonol, 2021. 56(7): p. 1951-1956.
  7. AlOlayan AM, Alhammad MA, Almutairi AA, Alshammari MT, Albuhairi S, Adherence to Asthma Controller Therapy among Children in Majmaah City, Saudi Arabia. Cureus, 2021. 13(4): p. e14633.
  8. Ullmann N, Allegorico A, Bush A, Porcaro F, Negro V, Onofri A, Cherchi C, Santis SD, Rosito L, Cutrera R, Effects of the COVID-19 pandemic and lockdown on symptom control in preschool children with recurrent wheezing. Pediatr Pulmonol, 2021. 56(7): p. 1946-1950.
  9. Guijon OL, Morphew T, Ehwerhemuepha L, Galant SP, Evaluating the impact of coronavirus disease 2019 on asthma morbidity: A comprehensive analysis of potential influencing factors. Ann Allergy Asthma Immunol, 2021.
  10. Ferraro VA, Zamunaro A, Spaggiari S, Riso DD, Zanconato S, Carraro S, Pediatric asthma control during the COVID-19 pandemic. Immun Inflamm Dis, 2021. 9(2): p. 561-568.
  11. 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.
  12. Brindisi G, Vittori VD, Nola RD, Pignataro E, Anania C, Castro GD, Cinicola B, Gori A, Cicinelli E, Zicari AM, Updates on Children with Allergic Rhinitis and Asthma during the COVID-19 Outbreak. J Clin Med, 2021. 10(11).
  13. Papadopoulos NG, Mathioudakis AG, Custovic A, Deschildre A, Phipatanakul W, Wong G, Xepapadaki P, Abou-Taam R, Agache I, Castro-Rodriguez JA, Chen Z, Cros P, Dubus JC, El-Sayed ZA, El-Owaidy R, Feleszko W, Fierro V, Fiocchi A, Garcia-Marcos L, Goh A, Hossny EM, Villalobos YRH, Jartti T, Roux PL, Levina J, García AIL, Ramos ÁM, Morais-Almeida M, Murray C, Nagaraju K, Nagaraju MK, Rodriguez EMN, Namazova-Baranova L, Garcia AN, Beltrán CFP, Ratchataswan T, Yeverino DR, Zagal ER, Schweitzer CE, 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.
  14. Corrado A, Renda T, Polese G, Rossi A; SERENA (Studio ossERvazionalE per il monitoraggio dell'asma non coNtrollAto)/AIPO Study Group, Assessment of asthma control: the SERENA study. Respiratory medicine, 2013. 107(11): p. 1659-1666.
  15. Sheehan WJ, Patel SJ, Margolis RHF, Fox ER, Shelef DQ, Kachroo N, Pillai D, Teach SJ, Pediatric asthma exacerbations during the COVID-19 pandemic: Absence of the typical fall seasonal spike in Washington, DC. J Allergy Clin Immunol Pract, 2021. 9(5): p. 2073-2076.
  16. Chiapinotto S, Sarria EE, Mocelin HT, Lima JAB, Mattiello R, Fischer GB, Impact of non-pharmacological initiatives for COVID-19 on hospital admissions due to pediatric acute respiratory illnesses. Paediatr Respir Rev, 2021.
  17. de Boer G, Braunstahl GJ, Hendriks R, Tramper-Stranders G, Asthma exacerbation prevalence during the COVID-19 lockdown in a moderate-severe asthma cohort. BMJ Open Respir Res, 2021. 8(1).

 

  1. Levene R, Fein DM, Silver EJ, Joels JR, Khine H, The ongoing impact of COVID-19 on asthma and pediatric emergency health-seeking behavior in the Bronx, an epicenter. Am J Emerg Med, 2021. 43: p. 109-114.
  2. Simoneau T, Greco KF, Hammond A, Nelson K, Gaffin JM, Impact of the COVID-19 Pandemic on Pediatric Emergency Department Use for Asthma. Ann Am Thorac Soc, 2021. 18(4): p. 717-719.
  3. Ramgopal S, Pelletier JH, Rakkar J, Horvat CM, Forecast modeling to identify changes in pediatric emergency department utilization during the COVID-19 pandemic. Am J Emerg Med, 2021. 49: p. 142-147.
  4. Song J, Zeng M, Wang H, Qin C, Hou HY, Sun ZY, Xu SP, Wang GP, Guo CL, Deng YK, Wang ZC, Ma J, Pan L, Liao B, Du ZH, Feng QM, Liu Y, Xie JG, Liu Z, Distinct effects of asthma and COPD comorbidity on disease expression and outcome in patients with COVID‐19. Allergy, 2021. 76(2): p. 483-496.
  5. Choi YJ, Park JY, Lee HS, Suh J, Song JY, Byun MK, Cho JH, Kim HJ, Lee JH, Park JW, Park HJ, Effect of asthma and asthma medication on the prognosis of patients with COVID-19. European Respiratory Journal, 2021. 57(3).
  6. Chhiba KD, Patel GB, Vu THT, Chen MM, Guo A, Kudlaty E, Mai Q, Yeh C, Muhammad LN, Harris KE, Bochner BS, Grammer LC, Greenberger PA, Kalhan R, Kuang FL, Saltoun CA, Schleimer RP, Stevens WW, Peters AT, Prevalence and characterization of asthma in hospitalized and nonhospitalized patients with COVID-19. Journal of Allergy and Clinical Immunology, 2020. 146(2): p. 307-314. e4.
  7. Wang, Y., The association between COVID‐19 and asthma: a systematic review and meta‐analysis. 2020.
  8. Wang Y, Chen J, Chen W, Liu L, Dong M, Ji J, Hu D, Zhang N, Does asthma increase the mortality of patients with COVID-19?: a systematic review and meta-analysis. International Archives of Allergy and Immunology, 2021. 182(1): p. 76-82.
  9. Mahdavinia M, Foster KJ, Jauregui E, Moore D, Adnan D, Andy-Nweye AB, Khan S, Bishehsari F, Asthma prolongs intubation in COVID-19. The Journal of Allergy and Clinical Immunology: In Practice, 2020. 8(7): p. 2388-2391.
  10. Abrams EM, Sinha I, Fernandes RM, Hawcutt DB, Pediatric asthma and COVID‐19: The known, the unknown, and the controversial. Pediatric pulmonology, 2020. 55(12): p. 3573-3578.
  11. Hussein MH, Toraih EA, Attia AS, Burley N, Zhang AD, Roos J, Houghton A, Aniemeka N, Omar M, Aboueisha M, Shama MA, Duchesne J, Kandil E, Asthma in COVID-19 patients: An extra chain fitting around the neck? Respiratory medicine, 2020. 175: p. 106205.
  12. Izquierdo JL, Almonacid C, González Y, Rio-Bermudez CD, Ancochea J, Cárdenas R, Lumbreras S, Soriano JB, The impact of COVID-19 on patients with asthma. European Respiratory Journal, 2021. 57(3).
  13. Morais-Almeida M, Barbosa MT, Sousa CS, Aguiar R, Bousquet J, Update on asthma prevalence in severe COVID-19 patients. Allergy, 2020.
  14. Qamar MA, Sajid MI, Dhillon RA, Irfan O, Abaidullah S, Who is at a Higher Risk? A brief review of Recent Evidence on comorbidities in children infected with COVID-19. J Ayub Med Coll Abbottabad, 2020. 32(Suppl 1) (4): p. S695-s700.
  15. Beken B, Ozturk GK, Aygun FD, Aydogmus C, Akar HH, Asthma and allergic diseases are not risk factors for hospitalization in children with coronavirus disease 2019. Ann Allergy Asthma Immunol, 2021. 126(5): p. 569-575.
  16. Chatzy Parasidis, G. and A. Kantar, COVID-19 in Children with Asthma. Lung, 2021. 199(1): p. 7-12.
  17. Farzan S, Rai S, Cerise J, Bernstein S, Coscia G, Hirsch JS, Jeanty J, Makaryus M, McGeechan S, McInerney A, Quizon A, Santiago MT, Asthma and COVID-19: An early inpatient and outpatient experience at a US children's hospital. Pediatr Pulmonol, 2021.
  18. Floyd GC, Dudley JW, Xiao R, Feudtner C, Taquechel K, Miller K, Henrickson SE, Hill DA, Kenyon CC, Prevalence of asthma in hospitalized and non-hospitalized children with COVID-19. J Allergy Clin Immunol Pract, 2021. 9(5): p. 2077-2079.e2.
  19. Graff K, Smith C, Silveira L, Jung S, Curran-Hays S, Jarjour J, Carpenter L, Pickard K, Mattiucci M, Fresia J, McFarland EJ, Dominguez SR, Abuogi L, Risk Factors for Severe COVID-19 in Children. Pediatr Infect Dis J, 2021. 40(4): p. e137-e145.
  20. Rabha AC, Fernandes FR, Solé D, Bacharier LB, Wandalsen GF, Asthma is associated with lower respiratory tract involvement and worse clinical score in children with COVID-19. Pediatr Allergy Immunol, 2021.
  21. Roland D, Teo KW, Bandi S, Lo D, Gaillard EA, COVID-19 is not a driver of clinically significant viral wheeze and asthma. Arch Dis Child, 2021. 106(4): p. e22.
  22. Timberlake DT, Narayanan D, Ogbogu PU, Raveendran R, Porter K, Scherzer R, Prince B, Grayson MH, Severity of COVID-19 in hospitalized patients with and without atopic disease. World Allergy Organ J, 2021. 14(2): p. 100508.
  23. Gao YD, Ding M, Dong X, Zhang JJ, Azkur AK, Azkur D, Gan H, Sun YL, Fu W, Li W, Liang HL, Cao YY, Yan Q, Cao C, Gao HY, Brüggen MC, Veen WVD, Sokolowska M, Akdis M, Akdis CA, Risk factors for severe and critically ill COVID-19 patients: A review. Allergy, 2021. 76(2): p. 428-455.
  24. Wakabayashi M, Pawankar R, Narazaki H, Ueda T, Itabashi T, Coronavirus disease 2019 and asthma, allergic rhinitis: molecular mechanisms and host-environmental interactions. Curr Opin Allergy Clin Immunol, 2021. 21(1): p. 1-7.
Journal of Pediatric Perspectives
Volume 11, Issue 2
February 2023
Pages 17405-17415

Files

Share

How to cite

Statistics