Level of asthma control in children and adolescents before and during the COVID-19 pandemic.

Background: During the COVID-19 pandemic, national lockdowns were implemented worldwide. Asthma control was reported to have improved. However, some patients lost follow-up from the clinic because they intended to avoid crowds at the hospital.

Objective: To evaluate the level of asthma control during the COVID-19 pandemic and explore factors influencing asthma outcomes.

Methods: Subjects 8-18 years old from our previous study in 2019 were recruited. The data during the pandemic period were collected between June 2021 - May 2023. The level of asthma control was compared before and during the pandemic. We also evaluated inhaled corticosteroid (ICS) adherence and factors related to poor asthma control during the COVID-19 pandemic.

Results: One hundred and three subjects were enrolled. Asthma control levels remained relatively stable during the pandemic. However, an asthma exacerbation was significantly decreased from 36 (36.3%) in 2019 to 19 (19.2%)and 15 (15.1%) in 2021 and 2022 (p = 0.012, p < 0.001), respectively. Spirometry results demonstrated improved pre-bronchodilator FEV1 (89.91 ± 11.02 vs. 101.91 ± 14.11, p < 0.001). The factors related to the poor asthma outcome were not wearing a face mask (aOR = 8.52, 95%CI 1.26-57.79) and previously poor-controlled by the ACT score (aOR = 2.55, 95%CI 1.41-4.63). The median adherence rate during the pandemic was 85%. The main reasons for poor adherence were hectic lifestyle and misunderstandings of disease.

Conclusion: Asthma exacerbation was significantly decreased during the lockdown. Not wearing a face mask and previously poorly controlled by the ACT score are related to poor asthma outcomes.