Asthma control, self-management
and healthcare access during the COVID-19 Epidemic in Beijing
Chun Chang a* M.D., Linlin Zhanga*B.S., Fawu Dong a* B.S., Ying
Liang a M.D., Yahong Chen a M.D.,
Ying Shang a B.S., Mairipaiti Abulikemua B.S.,
Yongchang Suna# M.D.
aDepartment of Respiratory and Critical Care Medicine,
Peking University Third Hospital, Beijing, China.
#, Corresponding to Yongchang Sun:
Department of Respiratory and Critical Care Medicine, Peking University
Third Hospital, Beijing, China.
North Garden Rd. 49.
Haidian District, Beijing, 100191, China
Tel: +86 010 139 1097 9132
Fax +86 108 226 6989
E-mail: suny@bjmu.edu.cn
* Chun Chang, Linlin Zhang and Fawu Dong contributed equally to this
work;
To the Editor:
The pandemic of COVID-19, caused by the pathogen SARS-CoV-2, has now
spread around the globe. Social distancing and restriction measures
during COVID-19 pandemic may have impacts on asthma control and
management in terms of medication availability and healthcare access.
International societies responded quickly by releasing guidance on the
management of asthma during the COVID-19 pandemic1-4.
However, these temporary guidelines were based largely on previous
asthma guidelines and expert consensus, because evidence from related
studies was lacking. Therefore, we investigated the status of asthma
control, self-management, medications and healthcare utilization of
asthma patients during the COVID-19 epidemic in Beijing, aiming to
provide data for guideline recommendations on asthma managements during
the emergency.
Patients with asthma, selected randomly from our hospital database, were
interviewed by phone call. Detailed description of items in the
questionnaire is available in this article’s online supplementary
material.
We contacted 286 patients, of whom 178 (62.2%) responded with valid
results. Sociodemographic data and clinical characteristics of the
patients before the COVID-19 pandemic are provided as online
supplements. During the COVID-19 epidemic in Beijing (January 25, 2020
to April 25, 2020), the majority
(74.2%, 132/178) of the patients felt that their symptoms had not
changed as compared with usual times, while 18.0% (32/178) felt better,
and 7.9% (14/178) felt worse. The
mean ACT score of the 178 patients was 22.76 ± 3.06 (ranging from 8 to
25) in the last 4 weeks before the survey. According to the criteria of
ACT scoring from GINA, asthma was classified as well-controlled in
89.3%, not well-controlled in 6.2%, and very poorly controlled in
4.5% of the patients. During this period, only 24.7% (44/178) of the
patients had ever visited a hospital or clinic for asthma, of whom 11
patients had 2 visits, and 6 had ≥3 visits, totaling 74 visits. 14.9%
(11/74) of all medical visits were due to exacerbation of asthma, while
the remaining visits (63/74, 85.1%) were for regular prescription of
asthma medications. Only 6 patients (3.4%) sought consultation online.
(Table 1)
Notably, 25.6% (45/176) of the patients experienced aggravation of
asthma symptoms during the COVID-19 epidemic, but 75.6% (34/45) of them
did not see a doctor, because 67.6% (23/34) of the patients thought
that they did not need to go to the hospital and took more medications
by themselves, and the remaining 32.4% (11/34) worried about
cross-infection of COVID-19 in the hospital. No patient said that they
did not see a doctor because they could not arrange an appointment.
Eleven patients went to the hospital due to aggravation, 81.8% (9/11)
to the outpatient, while only 18.2% (2/11) to the Emergency Department
(ED).
Table 1 Asthma control and management during the COVID-19 epidemic in
Beijing