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.

References

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