Frequency of asthma exacerbation in children during the coronavirus disease pandemic with strict mitigative countermeasures

Abstract

Background: Strict countermeasures for coronavirus disease (COVID-19) were undertaken in China without knowing their influence on asthma.

Objective: To investigate the associations between the frequencies of asthma exacerbations and respiratory infections and air pollutants before and during the COVID-19 pandemic, which were direct consequences of countermeasures undertaken for the pandemic.

Methods: Asthma exacerbations and respiratory infections among hospitalized children in the permanent population of Guangzhou City, China, from February to June 2016-2019 (before the pandemic) to February to June 2020 (during the pandemic) were collected in this cross-sectional study in Guangzhou.

Results: The number of asthma exacerbation cases per month documented in the Guangzhou Women and Children's Hospital before (median: 13.5; range: 0-48) and during (median: 20; range: 0-34) the mitigative response to the COVID-19 pandemic was similar. The frequency of severe asthma exacerbation cases per month decreased, whereas that of mild asthma exacerbation cases per year increased (p = .004). The number of patients hospitalized with infectious respiratory diseases decreased from 146 (range: 90-172) per month before the pandemic to 42 (range: 33-57) per month during the pandemic (p = .004). Most pathogens and air pollutants decreased during the COVID-19 pandemic. The frequency of severe asthma exacerbations positively correlated to that of respiratory infections in children, but did not correlate to air pollutants.

Conclusion: Strict countermeasures undertaken for the pandemic were associated with a decreased the frequency of infectious respiratory diseases and severe asthma exacerbations among urban children.

Keywords: COVID-19; air pollution; asthma exacerbation; prevention; respiratory infection.