Pediatric asthma symptom control during lockdown for the COVID-19 pandemic in Spring 2020: A prospective community-based study in Cyprus and Greece
Panayiotis Kouis PhD
Respiratory Physiology Laboratory, Medical School, University of Cyprus, Nicosia, Cyprus
Contribution: Data curation (equal), Formal analysis (equal), Methodology (equal), Project administration (equal), Software (equal), Visualization (equal), Writing - original draft (equal)
Search for more papers by this authorEleni Michaelidou MD, PhD
Medical School, University of Crete, Heraklion, Greece
Contribution: Data curation (equal), Formal analysis (equal), Methodology (equal), Visualization (equal), Writing - review & editing (equal)
Search for more papers by this authorParaskevi Kinni MSc
Respiratory Physiology Laboratory, Medical School, University of Cyprus, Nicosia, Cyprus
Contribution: Data curation (equal), Formal analysis (supporting), Visualization (equal), Writing - review & editing (equal)
Search for more papers by this authorAntonis Michanikou MSc
Respiratory Physiology Laboratory, Medical School, University of Cyprus, Nicosia, Cyprus
Contribution: Data curation (supporting), Software (equal), Visualization (equal), Writing - review & editing (equal)
Search for more papers by this authorPinelopi Anagnostopoulou MD, PhD
Respiratory Physiology Laboratory, Medical School, University of Cyprus, Nicosia, Cyprus
Institute of Anatomy, University of Bern, Bern, Switzerland
Contribution: Data curation (supporting), Formal analysis (equal), Writing - review & editing (equal)
Search for more papers by this authorHelen Dimitriou PhD
Medical School, University of Crete, Heraklion, Greece
Contribution: Data curation (supporting), Project administration (supporting), Writing - review & editing (equal)
Search for more papers by this authorKostas Karanicolas MSc
Respiratory Physiology Laboratory, Medical School, University of Cyprus, Nicosia, Cyprus
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorAndreas M. Matthaiou MD
Respiratory Physiology Laboratory, Medical School, University of Cyprus, Nicosia, Cyprus
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorSouzana Achilleos PhD
Cyprus International Institute for Environmental & Public Health, Cyprus University of Technology, Limassol, Cyprus
Contribution: Software (equal), Writing - review & editing (equal)
Search for more papers by this authorStefania I. Papatheodorou MD, PhD
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
Contribution: Methodology (equal), Writing - review & editing (equal)
Search for more papers by this authorPetros Koutrakis PhD
Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
Contribution: Methodology (equal), Writing - review & editing (equal)
Search for more papers by this authorNicos Middleton PhD
Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
Contribution: Formal analysis (equal), Visualization (equal), Writing - review & editing (equal)
Search for more papers by this authorEmmanouil Galanakis MD, PhD
Medical School, University of Crete, Heraklion, Greece
Contribution: Methodology (equal), Supervision (equal), Writing - review & editing (equal)
Search for more papers by this authorCorresponding Author
Panayiotis K. Yiallouros MD, PhD
Respiratory Physiology Laboratory, Medical School, University of Cyprus, Nicosia, Cyprus
Correspondence Panayiotis Yiallouros, MD, PhD, Shacolas Educational Center of Clinical Medicine, Palaios Dromos Lefkosias-Lemesou 215/6, 2029 Aglantzia, Cyprus.
Email: [email protected]
Contribution: Conceptualization (lead), Funding acquisition (lead), Methodology (equal), Supervision (equal), Writing - review & editing (equal)
Search for more papers by this authorPanayiotis Kouis PhD
Respiratory Physiology Laboratory, Medical School, University of Cyprus, Nicosia, Cyprus
Contribution: Data curation (equal), Formal analysis (equal), Methodology (equal), Project administration (equal), Software (equal), Visualization (equal), Writing - original draft (equal)
Search for more papers by this authorEleni Michaelidou MD, PhD
Medical School, University of Crete, Heraklion, Greece
Contribution: Data curation (equal), Formal analysis (equal), Methodology (equal), Visualization (equal), Writing - review & editing (equal)
Search for more papers by this authorParaskevi Kinni MSc
Respiratory Physiology Laboratory, Medical School, University of Cyprus, Nicosia, Cyprus
Contribution: Data curation (equal), Formal analysis (supporting), Visualization (equal), Writing - review & editing (equal)
Search for more papers by this authorAntonis Michanikou MSc
Respiratory Physiology Laboratory, Medical School, University of Cyprus, Nicosia, Cyprus
Contribution: Data curation (supporting), Software (equal), Visualization (equal), Writing - review & editing (equal)
Search for more papers by this authorPinelopi Anagnostopoulou MD, PhD
Respiratory Physiology Laboratory, Medical School, University of Cyprus, Nicosia, Cyprus
Institute of Anatomy, University of Bern, Bern, Switzerland
Contribution: Data curation (supporting), Formal analysis (equal), Writing - review & editing (equal)
Search for more papers by this authorHelen Dimitriou PhD
Medical School, University of Crete, Heraklion, Greece
Contribution: Data curation (supporting), Project administration (supporting), Writing - review & editing (equal)
Search for more papers by this authorKostas Karanicolas MSc
Respiratory Physiology Laboratory, Medical School, University of Cyprus, Nicosia, Cyprus
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorAndreas M. Matthaiou MD
Respiratory Physiology Laboratory, Medical School, University of Cyprus, Nicosia, Cyprus
Contribution: Data curation (equal), Writing - review & editing (equal)
Search for more papers by this authorSouzana Achilleos PhD
Cyprus International Institute for Environmental & Public Health, Cyprus University of Technology, Limassol, Cyprus
Contribution: Software (equal), Writing - review & editing (equal)
Search for more papers by this authorStefania I. Papatheodorou MD, PhD
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
Contribution: Methodology (equal), Writing - review & editing (equal)
Search for more papers by this authorPetros Koutrakis PhD
Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
Contribution: Methodology (equal), Writing - review & editing (equal)
Search for more papers by this authorNicos Middleton PhD
Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
Contribution: Formal analysis (equal), Visualization (equal), Writing - review & editing (equal)
Search for more papers by this authorEmmanouil Galanakis MD, PhD
Medical School, University of Crete, Heraklion, Greece
Contribution: Methodology (equal), Supervision (equal), Writing - review & editing (equal)
Search for more papers by this authorCorresponding Author
Panayiotis K. Yiallouros MD, PhD
Respiratory Physiology Laboratory, Medical School, University of Cyprus, Nicosia, Cyprus
Correspondence Panayiotis Yiallouros, MD, PhD, Shacolas Educational Center of Clinical Medicine, Palaios Dromos Lefkosias-Lemesou 215/6, 2029 Aglantzia, Cyprus.
Email: [email protected]
Contribution: Conceptualization (lead), Funding acquisition (lead), Methodology (equal), Supervision (equal), Writing - review & editing (equal)
Search for more papers by this authorThis research was primarily done at Respiratory Physiology Laboratory, Medical School University of Cyprus, Nicosia, Cyprus.
Abstract
Objectives
To prospectively quantify at the community level changes in asthma symptom control and other morbidity indices, among asthmatic schoolchildren in response to coronavirus disease 2019 (COVID-19) lockdown measures.
Methods
In Spring 2019 and Spring 2020, we prospectively assessed monthly changes in pediatric asthma control test (c-ACT), asthma medication usage, infections and unscheduled visits for asthma among schoolchildren with active asthma in Cyprus and Greece. We compared asthma symptom control and other morbidity indices before and during lockdown measures, while participants’ time spent at home was objectively assessed by wearable sensors.
Results
A total of 119 asthmatic children participated in the study during Spring 2020. Compared to a mean baseline (pre-COVID-19 lockdown) c-ACT score of 22.70, adjusted mean increases of 2.58 (95% confidence interval [CI]: 1.91, 3.26, p < 0.001) and 3.57 (95% CI: 2.88, 4.27, p < 0.001) in the 2nd and 3rd monthly assessments were observed after implementation of lockdown measures. A mean increase in c-ACT score of 0.32 (95% CI: 0.17, 0.47, p < 0.001) was noted per 10% increase in the time spent at home. Improvement was more profound in children with severe asthma, while significant reductions in infections, asthma medication usage and unscheduled visits for asthma were also observed. During Spring 2019, 39 children participated in the study in the absence of lockdown measures and no changes in c-ACT or other indices of disease severity were observed.
Conclusions
Clinically meaningful improvements in asthma symptom control, among asthmatic schoolchildren were observed during the COVID-19 lockdown measures in Spring 2020. Improvements were independently associated with time spent at home and were more profound in the children with severe asthma.
CONFLICT OF INTERESTS
The authors declare that there are no conflict of interests.
Open Research
DATA AVAILABILITY STATEMENT
The study dataset is available from the corresponding author upon reasonable request.
Supporting Information
| Filename | Description |
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| ppul25765-sup-0001-R1_Submit_Online_Supplement.docx409 KB | Supporting information. |
| ppul25765-sup-0003-R1_Submit_Online_Supplement.docx409 KB | Supporting information. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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