N , total number of qualified subjects for evaluation; n(%), frequency (percentage of frequency); 95% CI, 95% confidence
interval. M ±SD, average ± standard deviation.
Our survey found that, during the COVID-19 epidemic in Beijing, the
majority of our asthma patients (89.3%) had their disease controlled as
defined by GINA, which is higher than the results of general population
before the pandemic. A multi-center, retrospective, cross-sectional
study in China5 indicated that less than one-third
(28.7%) of the patients had controlled asthma, and the control rate in
Beijing was 31.4%. We speculate that this might be due to social
distancing and mandatory closure of places where aggregation may occur,
stepped-up public hygiene measures and the wearing of masks during the
COVID-19 epidemic, thereby reducing contact with allergens and viruses.
During the study period, a quarter of our patients experienced an
exacerbation of asthma, which is more than the general population before
the COVID-19 pandemic. A cross-section study in China showed that the
proportion of people with asthma experiencing an exacerbation in the
previous year before the study was 15.5%(4). The patients enrolled in
our study had a higher rate of asthma exacerbation but lower rates of ED
visit and hospitalization. It is not surprising to see that one-third of
them worried about the risk of exposure to SARS-CoV-2 in the hospital,
although most patients regarded their symptoms as not severe and could
be relieved by self-management with medications.
In our survey, the majority of the patients used ICS plus LABA as
maintenance therapy, which is consistent with guideline
recommendations1,2,4. Indeed, there is no evidence
regarding whether currently available asthma and allergy treatments,
including corticosteroids and bronchodilators, increase the
susceptibility to or severity of COVID-191. On the
contrary, it may be more likely that a patient with asthma would have an
exacerbation from other causes, including seasonal pollen exposure or a
virus other than SARS-CoV-2 if they stopped regular use of indicated
controller therapy. An exacerbation may drive asthmatic patients to seek
medical treatment, which would put them at increased risk of being
exposed to SARS-CoV-2 during the current pandemic4.
The use of telehealth in asthma treatment in recommended within a
risk-stratified context of the SARS-CoV-2 pandemic4.
However, in our interview, only a few patients used online consultation
during the COVID-19 pandemic. Patients with mild-to-moderate or
well-controlled asthma were encouraged to use digital medicine
services6. Outpatient service should be prioritized
for patients who have poorly controlled asthma, have worsening asthma
symptoms, or who have required dose escalations of their asthma
medications in the past several months’ time4.
In conclusion, our survey revealed the status of asthma control,
exacerbations, self-management and healthcare utilization during the
COVID-19 epidemic in Beijing, which supports the recommendation that
patients continue taking their prescribed asthma medications as usual
and maintain good asthma control during the ongoing pandemic. For
containment of viral transmission, social distancing is being
encouraged, but measures should be taken to mitigate the negative impact
on asthma.
Chun Chang a M.D.
Linlin Zhang a B.S.
Fawu Dong a B.S.
Ying Liang a M.D.
Yahong Chen a M.D.
Ying Shang a B.S.
Mairipaiti Abulikemu a B.S.
Yongchang Sun a M.D.
From aDepartment of Respiratory and Critical Care
Medicine, Peking University Third Hospital, Beijing, China.
Correspondence
Department of Respiratory and Critical Care Medicine, Peking University
Third Hospital, Beijing, China.
North Garden Rd. 49.
Haidian District, Beijing, 100191, China
E-mail: suny@bjmu.edu.cn
Acknowledgments
This study was supported by the National Natural Science Foundation of
China. [No. 81970028]
Conflict of interest
The authors declare that they have no relevant conflicts of interest.
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