@article{2999866,
    title = "Childhood asthma outcomes during the COVID-19 pandemic: Findings from the PeARL multi-national cohort",
    author = "Papadopoulos, N.G. and Mathioudakis, A.G. and Custovic, A. and Deschildre, A. and Phipatanakul, W. and Wong, G. and Xepapadaki, P. and Abou-Taam, R. and Agache, I. and Castro-Rodriguez, J.A. and Chen, Z. and Cros, P. and Dubus, J.-C. and El-Sayed, Z.A. and El-Owaidy, R. and Feleszko, W. and Fierro, V. and Fiocchi, A. and Garcia-Marcos, L. and Goh, A. and Hossny, E.M. and Huerta Villalobos, Y.R. and Jartti, T. and Le Roux, P. and Levina, J. and López García, A.I. and Ramos, Á.M. and Morais-Almeida, M. and Murray, C. and Nagaraju, K. and Nagaraju, M.K. and Navarrete Rodriguez, E.M. and Namazova-Baranova, L. and Nieto Garcia, A. and Pozo Beltrán, C.F. and Ratchataswan, T. and Rivero Yeverino, D. and Rodríguez Zagal, E. and Schweitzer, C.E. and Tulkki, M. and Wasilczuk, K. and Xu, D. and Alekseeva, A. and Almeida, B. and Andre, M. and Arimova, P. and Blonde, A. and Cunningham, A. and Da Mota, S. and Efendieva, K. and Kalugina, V. and Kiefer, S. and Klein, A. and López, C.G.C. and López, J.J.R. and Moratellti, C. and Fuentes Pérez, M. and Simermann, M. and Tapia, J.S.P. and Tatopoulos, A. and Vishneva, E. and Volkov, Κ. and Bacharier, L. and Bonini, M. and Craig, T. and Diamant, Z. and Ducharme, F.M. and Gern, J.E. and Grigg, J. and Hamelmann, E.H. and Hedlin, G. and Jartti, T. and Kalayci, O. and Kaplan, A. and Konradsen, J. and Kuna, P. and Lau, S. and Le Souef, P. and Lemanske, R.F. and Makela, M.J. and Matricardi, P.M. and Gómez, R.-M. and Miligkos, M. and Pitrez, P.M.C. and Price, D. and Pohunek, P. and Roberts, G.C. and Sheikh, A. and Tsiligianni, I. and Turner, S. and Valiulis, A. and Winders, T. and Yusuf, O.M. and Zar, H. and PeARL collaborators, on behalf of the PeARL Think Tank",
    journal = "Allergy: European Journal of Allergy and Clinical Immunology",
    year = "2021",
    volume = "76",
    number = "6",
    pages = "1765-1775",
    publisher = "John Wiley and Sons Inc",
    doi = "10.1111/all.14787",
    keywords = "influenza vaccine, adolescent;  Article;  asthma;  bronchodilatation;  child;  clinical outcome;  cohort analysis;  controlled study;  coronavirus disease 2019;  disease control;  disease severity;  emergency health service;  female;  fever;  forced expiratory volume;  hospital admission;  hospitalization;  human;  infection risk;  lower respiratory tract infection;  lung function;  major clinical study;  male;  minimal clinically important difference;  pandemic;  patient compliance;  peak expiratory flow;  pediatric ward;  upper respiratory tract infection;  asthma;  pandemic;  preschool child, Adolescent;  Asthma;  Child;  Child, Preschool;  COVID-19;  Hospitalization;  Humans;  Pandemics;  SARS-CoV-2",
    abstract = "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. Conclusion: 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. © 2021 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd."
}