Pediatric asthma control during the COVID-19 pandemic: A systematic review and meta-analysis.

Abstract

BackgroundWith the onset of the coronavirus disease 2019 (COVID‐19) pandemic, many experts expected that asthma‐associated morbidity because of severe acute respiratory syndrome coronavirus 2 infection would dramatically increase. However, some studies suggested that there was no apparent increasing in asthma‐related morbidity in children with asthma, it is even possible children may have improved outcomes. To understand the relationship between the COVID‐19 pandemic and asthma outcomes, we performed this article.MethodsWe searched PubMed, Embase, and Cochrane Library to find literature from December 2019 to June 2021 related to COVID‐19 and children's asthma control, among which results such as abstracts, comments, letters, reviews, and case reports were excluded. The level of asthma control during the COVID‐19 pandemic was synthesized and discussed by outcomes of asthma exacerbation, emergency room visit, asthma admission, and childhood asthma control test (c‐ACT).ResultsA total of 22,159 subjects were included in 10 studies. Random effect model was used to account for the data. Compared with the same period before the COVID‐19 pandemic, asthma exacerbation reduced (odds ratio [OR] = 0.26, 95% confidence interval [CI] = [0.14–0.48], Z = 4.32, p < 0.0001), the odds of emergency room visit decreased as well (OR = 0.11, 95% CI = [0.04–0.26], Z = 4.98, p < 0.00001). The outcome of asthma admission showed no significant difference (OR = 0.84, 95% CI = [0.32–2.20], Z = 0.36, p = 0.72). The outcome of c‐ACT scores were not analyzed because of the different manifestations used. Overall, c‐ACT scores reduced during the pandemic.ConclusionCompared to the same period before the COVID‐19 pandemic, the level of asthma control has been significantly improved. We need to understand the exact factors leading to these improvements and find methods to sustain it.