University of Oulu

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. and (2021), Childhood asthma outcomes during the COVID-19 pandemic: Findings from the PeARL multi-national cohort. Allergy, 76: 1765-1775.

Childhood asthma outcomes during the COVID-19 pandemic : findings from the PeARL multinational cohort

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Author: Papadopoulos, Nikolaos G.1,2; Mathioudakis, Alexander G.1,3; Custovic, Adnan4;
Organizations: 1Univ Manchester, Sch Biol Sci, Div Infect Immun & Resp Med, Manchester, Lancs, England.
2Natl & Kapodistrian Univ Athens, Allergy Dept, Paediat Clin 2, Athens, Greece.
3Manchester Univ NHS Fdn Trust, Manchester Acad Hlth Sci Ctr, Wythenshawe Hosp, North West Lung Ctr, Manchester, Lancs, England.
4Imperial Coll London, London, England.
5Univ Lille, Ctr Infect & Immun Lille, Inst Pasteur Lille, CNRS,INSERM,Unit 1019,UMR 8204, Lille, France.
6Boston Childrens Hosp, Dept Allergy & Immunol, Boston, MA USA.
7Chinese Univ Hong Kong, Dept Pediat, Fac Med, Sha Tin, Hong Kong, Peoples R China.
8Hosp Necker Enfants Malades, Pediat Pulmonol & Allergy Dept, Paris, France.
9Transylvania Univ, Allergy & Clin Immunol, Brasov, Romania.
10Pontificia Univ Catolica Chile, Sch Med, Dept Pediat Pulmonol, Santiago, Chile.
11Zhejiang Univ, Childrens Hosp, Natl Clin Res Ctr Child Hlth, Dept Pulmonol,Sch Med, Hangzhou, Peoples R China.
12Univ Hosp Morvan, Dept Pediat, Brest, France.
13Ctr Ressources & Competences Mucoviscidose Pneumo, Ventilat, Malad Resp Rares Enfant CHU Timone Enfants, Marseille, France.
14Ain Shams Univ, Childrens Hosp, Pediat Allergy & Immunol Unit, Cairo, Egypt.
15Med Univ Warsaw, Dept Pediat Pneumonol & Allergy, Warsaw, Poland.
16Bambino Gesu Childrens Hosp IRCCS, Allergy Dept, Rome, Italy.
17Univ Murcia, Virgen Arrixaca Childrens Univ Clin Hosp, Pediat Resp & Allergy Units, Murcia, Spain.
18IMIB Arrixaca, Inst Biomed Res Murcia, Murcia, Spain.
19Network Asthma & Adverse & Allerg React ARADyAL, Murcia, Spain.
20Rush Med Coll, Dept Internal Med, Chicago, IL 60612 USA.
21Hosp Gen Reg 1 Dr Carlos Mac Gregor Sanchez Navar, Mexico City, DF, Mexico.
22Oulu Univ Hosp, Dept Pediat & Adolescent Med, Oulu, Finland.
23Univ Oulu, Oulu, Finland.
24Grp Hosp Le Havre, Dept Pediat, Le Havre, France.
25Russian Acad Sci, Pediat & Child Hlth Res Inst, Cent Clin Hosp, Moscow, Russia.
26Univ Hosp Puebla, Allergy & Clin Immunol Serv, Puebla, Mexico.
27Childrens Hosp La Fe, Pediat Pulmonol & Allergy Unit, Valencia, Spain.
28CUF Descobertas Hosp, Allergy Ctr, Lisbon, Portugal.
29VN Allergy & Asthma Res Ctr, Chennai, Tamil Nadu, India.
30Saveetha Med Coll, Dept Allergy & Clin Immunol, Chennai, Tamil Nadu, India.
31Hosp Infantil Mexico Dr Federico Gomez, Pediat Allergy & Clin Immunol Serv, Mexico City, DF, Mexico.
32Pirogov Russian Natl Res Med Univ, Minist Hlth Russian Federat, Moscow, Russia.
33Hosp Specialties Juan Maria Salvatierra, Teaching & Res Dept, La Paz, Mexico.
34Hosp Specialties Juan Maria Salvatierra, Paediat Allergy Dept, La Paz, Mexico.
35Hosp Infantil Medico Federico Gomez, Allergy & Immunol Dept, Mexico City, DF, Mexico.
36Hosp Univ Puebla, Allergy & Clin Immunol Dept, Puebla, Mexico.
37CHRU Nancy, Hop Enfants, Vandoeuvre Les Nancy, France.
38Turku Univ Hosp, Dept Pediat & Adolescent Med, Turku, Finland.
39Univ Turku, Turku, Finland.
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.7 MB)
Persistent link:
Language: English
Published: John Wiley & Sons, 2021
Publish Date: 2022-03-30


Background: The interplay between COVID-19 pandemic and asthma in children is still unclear. We evaluated the impact of COVID-19 pandemic on childhood asthma outcomes.

Methods: The PeARL multinational cohort included 1,054 children with asthma and 505 non-asthmatic children aged between 4 and 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 with 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.

Conclusions: 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.

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Series: Allergy
ISSN: 0105-4538
ISSN-E: 1398-9995
ISSN-L: 0105-4538
Volume: 76
Issue: 6
Pages: 1765 - 1775
DOI: 10.1111/all.14787
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
3123 Gynaecology and paediatrics
Funding: This study was supported by the Respiratory Effectiveness Group (REG). REG has received support from AstraZeneca, Novartis, and Sanofi for continued work on PeARL. AGM was supported by the National Institute of Health Research Manchester Biomedical Research Centre (NIHR Manchester BRC). We thank Mrs Maria Kritikou for excellent administrative support of the study.
Copyright information: © 2021 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.