Nikolaos Papadopoulos

and 41 more

Background: The interplay between COVID-19 pandemic and asthma in children is still unclear. We evaluated the impact of COVID-19 on childhood asthma outcomes. Methods: The PeARL multinational cohort included 1,054 children with asthma and 505 non-asthmatic children aged between 4-18 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 to 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.

Yun Zhu

and 18 more

Background Community-acquired pneumonia (CAP) is one of the leading causes of morbidity and mortality in the children worldwide. In this study, we aim to describe the aetiology of viral infection of pediatric community-acquired pneumonia in mainland China. Methods During Nov. 2014 and Jun. 2016, the prospective study was conducted at thirteen hospitals. The hospitalized children under 18 years old who met the criteria for CAP were enrolled. The throat swabs or nasopharyngeal aspirates were collected from cases and screened the eighteen respiratory viruses using multiplex PCR assay. Results Viral pathogens were present in 56.6% (1539/2721) of enrolled cases, with the detection rate of single virus in 39.8% cases and multiple viruses in 16.8% cases. The most frequently detected virus was RSV (15.2%, 413/2721). The highest detection rate of virus was in < 6 m age group (70.7%). RSV, HMPV, HPIVs and Flu B showed the similar prevalence pattern both in northern and south China, but HPIVs, Flu A, HBoV, HAdV and HCoVs showed the distinct circulating patterns in northern and south China. HEV/HRV (27.6%, 27/98), HBoV (18.4%, 18/98), RSV (16.3%, 16/98) and HMPV (14.3%, 14/98) were the most commonly detected virus in severe pneumonia children with signal virus infection. Conclusions In conclusion, viral pathogens are frequently detected in pediatric CAP cases and may therefore play a vital role in the aetiology of CAP. RSV was the most important virus in hospitalized children with CAP in mainland China.