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\begin{document}

\title{Childhood asthma outcomes during the COVID-19 pandemic: Findings from
the PeARL multi-national cohort}



\author[1]{Nikolaos Papadopoulos}%
\author[1]{Alexander  Mathioudakis}%
\author[2]{A Custovic}%
\author[3]{Antoine DESCHILDRE}%
\author[4]{Wanda Phipatanakul}%
\author[5]{Gary Wong}%
\author[6]{PARASKEVI XEPAPADAKI}%
\author[7]{Rola Abou Taam}%
\author[8]{Ioana Agache}%
\author[9]{Jose Castro-Rodriguez}%
\author[10]{Zhimin Chen}%
\author[11]{Pierrick Cros}%
\author[12]{Jean Christophe Dubus}%
\author[13]{Zeinab El-Sayed}%
\author[13]{Rasha   El-Owaidy}%
\author[14]{Wojciech Feleszko}%
\author[15]{Vincenzo Fierro}%
\author[15]{Alessandro Fiocchi}%
\author[16]{Luis Garcia-Marcos}%
\author[17]{Anne Eng Neo Goh}%
\author[13]{Elham Hossny}%
\author[18]{Yunuen Huerta Villalobos}%
\author[19]{Tuomas Jartti}%
\author[20]{Pascal Le ROUX}%
\author[21]{Julia  Levina }%
\author[22]{Aída López-García}%
\author[23]{Angel Mazon}%
\author[24]{Mário Morais-Almeida}%
\author[25]{Clare Murray}%
\author[26]{Karthik Nagaraju}%
\author[27]{Major  Nagaraju}%
\author[28]{Elsy   Maureen Navarrete Rodriguez}%
\author[29]{Leyla Namazova-Baranova}%
\author[23]{Antonio Nieto}%
\author[30]{Cesar Fireth  Pozo Beltrán }%
\author[31]{Thanaporn  Ratchataswan }%
\author[32]{Daniele Rivero-Yeverino}%
\author[32]{Erendira Rodriguez-Zagal}%
\author[33]{Cyril  Schweitzer }%
\author[34]{Marleena  Tulkki }%
\author[14]{Katarzyna  Wasilczuk }%
\author[35]{Dan  XU}%
\affil[1]{The University of Manchester}%
\affil[2]{Imperial College London}%
\affil[3]{Institut Pasteur de Lille}%
\affil[4]{Children's Hospital, Boston}%
\affil[5]{Boston Children’s Hospital}%
\affil[6]{National and Kapodistrian University of Athens}%
\affil[7]{Hôpital universitaire Necker-Enfants malades}%
\affil[8]{Transylvania University, Brasov}%
\affil[9]{Pontificia Universidad Catolica de Chile}%
\affil[10]{Zhejiang University School of Medicine Children's Hospital}%
\affil[11]{CHRU de Brest}%
\affil[12]{Assistance Publique Hopitaux de Marseille}%
\affil[13]{Ain Shams University}%
\affil[14]{Medical University of Warsaw}%
\affil[15]{Bambino Gesu Pediatric Hospital}%
\affil[16]{University of Murcia}%
\affil[17]{KK Women's and Children's Hospital}%
\affil[18]{Hospital General Regional 1 Dr Carlos Mac Gregor Sanchez Navarro}%
\affil[19]{University of Oulu}%
\affil[20]{CH le Havre}%
\affil[21]{Russian Academy of Sciences}%
\affil[22]{Hospital Universitario de Puebla}%
\affil[23]{Children's Hospital La Fe}%
\affil[24]{CUF-Descobertas Hospital}%
\affil[25]{University of Manchester}%
\affil[26]{VN Allergy \& Asthma Research Centre}%
\affil[27]{Saveetha Medical College Department of General Medicine}%
\affil[28]{Hospital Infantil de Mexico Federico Gomez}%
\affil[29]{Russian National research medical university of MoH RF}%
\affil[30]{Hospital Juan María de Salvatierra}%
\affil[31]{Boston Children's Hospital}%
\affil[32]{Allergist}%
\affil[33]{CHRU de Nancy}%
\affil[34]{University of Turku}%
\affil[35]{Zhejiang University School of Medicine}%


\vspace{-1em}



  
  \date{May 26, 2024}


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\selectlanguage{english}
\begin{abstract}
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.%
\end{abstract}%



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