Pediatric Pulmonary Function Testing in COVID-19 Pandemic and Beyond. A Position Statement From the Hellenic Pediatric Respiratory Society.

Sotirios Fouzas,Fotios Kirvassilis,Harry Opsimos,Emmanouil Paraskakis,Dimos Gidaris,Michael B Anthracopoulos,Konstantinos Douros,Emmanouil I Alexopoulos,Markos Marangos,Ioannis Tsanakas,Nikolaos Karantaglis

doi:10.3389/fped.2021.673322

Abstract

As the COVID-19 pandemic is still evolving, guidelines on pulmonary function testing that may dynamically adapt to sudden epidemiologic changes are required. This paper presents the recommendations of the Hellenic Pediatric Respiratory Society (HPRS) on pulmonary function testing in children and adolescents during the COVID-19 era. Following an extensive review of the relevant literature, we recommend that pulmonary function tests should be carried out after careful evaluation of the epidemiologic load, structured clinical screening of all candidates, and application of special protective measures to minimize the risk of viral cross infection. These principles have been integrated into a dynamic action plan that may readily adapt to the phase of the pandemic.

Highlights

Pulmonary function testing is instrumental for the diagnosis and follow up of pediatric chronic respiratory disorders, including asthma, cystic fibrosis (CF), primary ciliary dyskinesia, and restrictive and interstitial lung diseases [1, 2]
The European Respiratory Society (ERS) and the American Thoracic Society (ATS) have issued special guidelines on infection control during pulmonary function testing, the current coronavirus disease 2019 (COVID-19) pandemic has raised additional concerns: the load of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the respiratory secretions of infected individuals is high [4], breathing maneuvers that lead to aerosol formation may favor its spread and increase the risk of cross contamination [5]
During the initial phase of COVID-19 pandemic, national and international health authorities advised against routine pulmonary function testing [6]

Summary

INTRODUCTION

Pulmonary function testing is instrumental for the diagnosis and follow up of pediatric chronic respiratory disorders, including asthma, cystic fibrosis (CF), primary ciliary dyskinesia, and restrictive and interstitial lung diseases [1, 2]. During the initial phase of COVID-19 pandemic, national and international health authorities advised against routine pulmonary function testing [6]. In this paper we briefly review the current national and international guidelines and we present the recommendations of the Hellenic Pediatric Respiratory Society (HPRS) on pulmonary function testing in children and adolescents during the COVID19 era and beyond. This position statement is based on the consensus of the authors, who are members of the HPRS and may be subject to changes as the pandemic evolves

REVIEW OF THE LITERATURE

Evaluation of the Epidemiologic Load

CONCLUSION