The Impact of the COVID-19 Pandemic in Adolescents with Asthma

Incidence of respiratory diseases associated with per- and polyfluoroalkyl substances (PFAS) in PM2.5: New evidence from a population-based survey of Pearl River Delta (PRD), China

Epidemiological studies have evinced that particulate matter (PM) is linked to respiratory diseases, but the relationship between the specific constituents of PM and respiratory diseases remains scarce. Here, we evaluated the relationship between PFAS in PM2.5 with respiratory diseases. In this study, from May 2016 to May 2018, we recruited 131,346 school-aged children and adolescents living in Pearl River Delta, Guangdong Province, China. Participants self-reported the respiratory diseases, including asthma, wheezing, phlegm, cough and rhinitis. Logistic regression and qg-comp models were used to analyze the relationship between PFAS exposure and respiratory diseases. We found several PFAS were significantly associated with higher prevalence of respiratory diseases. For instance, higher quintiles of PFSA exposure (Q2-Q4), as compared to Q1, were associated with greater odds of respiratory diseases: 1.35 (95 %CI: 1.23, 1.48) in Q2, 1.95 (95 %CI: 1.78, 2.14) in Q3 and 2.83 (95 %CI: 2.76, 3.11) in Q4. Furthermore, qg-comp model analysis revealed PFCA as the most important weight in respiratory diseases. Moreover, the effect estimates were higher in boys, older children (>12 years old) and overweight/obesity, indicating the vulnerability of these subpopulations. In summary, exposure to PFAS, a specific PM2.5 constituent, potentially increases the risk of respiratory diseases among school-aged children and adolescents.

Navigating the Challenges and Resilience in the Aftermath of the COVID-19 Pandemic in Adolescents with Chronic Diseases: A Scoping Review

BACKGROUND/OBJECTIVES

The COVID-19 pandemic has profoundly affected the lives of adolescents worldwide, especially those living with chronic diseases. This study aims to explore the impact of the COVID-19 pandemic on the daily lives of adolescents with chronic diseases.

METHODS

This is a scoping review that follows the guidelines proposed by JBI. Eligibility criteria include articles focusing on adolescents aged 10 to 19 during the COVID-19 pandemic, regardless of chronic diseases. Searches were performed in PUBMED, LILACS, CINAHL, SCOPUS, grey literature, and manual searches in March 2024.

RESULTS

This review is composed of 35 articles. The analysis revealed two main categories: (1) Adolescents facing social isolation, school closure, and new family interactions, striving to reinvent themselves, and (2) Chasing the best decision: following up the chronic disease while fighting the COVID-19 pandemic. These categories encompass subcategories highlighting changes in social and family interactions and lifestyle habits. The findings suggest a multifaceted interaction of factors influencing adolescents' well-being, including improved family bonding, heightened disease management, and increased stress and strains on resources.

CONCLUSIONS

This review emphasizes the importance of long-term follow-up and social inclusion efforts for adolescents with chronic diseases and their families, addressing their unique needs during public health crises.

Quality of life and its influencing factors on children with asthma in China: a comparative study before and during the COVID-19 pandemic

OBJECTIVE

This study compares the level of quality of life (QoL) and its influencing factors on children with asthma before and during the COVID-19 pandemic.

METHODS

The study carried out cross-sectional surveys on children with asthma and their parents in China before and during the epidemic. Data were collected using a demographic questionnaire, the Family Management Scale for Children with Asthma (FMSCA), and the Pediatric Asthma Quality of Life Questionnaire (PAQLQ). Participants from before the epidemic were matched by their propensity score in a 1:1 ratio with individuals from during the epidemic. The level of QoL of children with asthma was subsequently analyzed. Both univariate analysis and multiple linear regression were employed to identify the influencing factors.

RESULTS

Compared to their level before the epidemic, the total score of PAQLQ and its three dimensions decreased during the epidemic. Regression analysis revealed that before the epidemic, the total score of PAQLQ was significantly associated with follow-up visits, attendance of asthma lectures, and the total score of FMSCA (p < 0.05). During the epidemic, the total score of the PAQLQ was significantly associated with three dimensions of the FMSCA (future expectation, children identity, and views of condition), and two classifications of the family management styles (FMS) (enduring and accommodating) (p < 0.05).

CONCLUSION

The QoL of children with asthma deteriorated during the epidemic. Influencing factors changed during the epidemic, with more emphasis on the family environment. Future intervention strategies need to take into account the development of interactions between children and environmental forces.

Sarcopenia and Mortality in Critically Ill COVID-19 Patients

COVID-19 can manifest as either asymptomatic or progressing to a severe phase in some patients, which may require hospitalization. These patients may experience dyspnea and hypoxia, leading to the development of acute respiratory distress syndrome. Studies have reported an increased risk of severe sarcopenia in COVID-19 patients during and after recovery. This narrative review aimed to summarize and synthesize available studies on the association between sarcopenia and mortality in critically ill COVID-19 patients. A total of 22 studies conducted on hospitalized COVID-19 patients were included in this review. Of those, 17 studies reported a direct association, while 5 studies showed no association between sarcopenia and mortality in severe COVID-19 patients. It is important to maintain muscle quality and quantity in defense against COVID-19. The measurement of lean muscle mass should be included in the risk assessment of severely ill COVID-19 patients as part of the therapy plan.

Current Approaches in the Multimodal Management of Asthma in Adolescents-From Pharmacology to Personalized Therapy

Asthma and adolescence are two sensitive points and are difficult to manage when they coexist. The first is a chronic respiratory condition, with frequent onset in early childhood (between 3 and 5 years), which can improve or worsen with age. Adolescence is the period between childhood and adulthood (12-19 years), marked by various internal and external conflicts and a limited capacity to understand and accept any aspect that is delimited by the pattern of the social circle (of the entourage) frequented by the individual. Therefore, the clinician is faced with multiple attempts regarding the management of asthma encountered during the adolescent period, starting from the individualization of the therapy to the control of compliance (which depends equally on the adverse reactions, quality of life offered and support of the close circle) and the social integration of the subject, communication probably having a more important role in the monitoring and evolution of the condition than the preference for a certain therapeutic scheme. Current statistics draw attention to the increase in morbidity and mortality among children with bronchial asthma, an aspect demonstrated by the numerous hospitalizations recorded, due either to an escalation in the severity of this pathology or to faulty management. The purpose of this article is to review the delicate aspects in terms of controlling symptoms and maintaining a high quality of life among teenagers.

Impact of the COVID-19 on asthma control among children: A systematic review

In December 2019, the current outbreak of coronavirus disease 2019 (COVID-19) was reported in Wuhan, China. Asthmatic patients are thought to be more vulnerable to the more severe form of SARS-CoV-2 infection due to their weakened immune systems and increased risk of respiratory exacerbation when infected with respiratory viruses; however, there is little evidence to support this theory. The objective of this systematic review is to assess the impact of the COVID-19 lockdown during the pandemic on asthma management outcome measures among children and adolescents. To conduct the search, we used five bibliographic databases. The results were limited to those articles published between December 2019 and February 2022, selecting only articles published in English that included the study population (children aged 0-18 years). All study designs were considered. Independent assessments of the included studies' quality were made and reported. Among the 945 results of the bibliographic search, only 21 articles were found to fit our eligibility criteria We organized the results from the studies according to the effect of the lockdown at the start of the COVID-19 pandemic on common outcomes, including the Pediatric Emergency Department Visits, hospitalization rates of pediatric asthmatic patients during the pandemic, asthma control, asthma exacerbations, psychological effects on patients, and caregivers' concerns. The management of pediatric asthma improved more during the 2020 COVID-19 pandemic lockdown than in previous years.

Psychometric validation of the Chinese version of the Adolescent Asthma Self-Efficacy Questionnaire

Background

Self-efficacy was considered as a promising target for the self-management of symptoms for adolescents with asthma. The measurement of self-efficacy in adolescents with asthma requires effective self-report tools, which have not been met with at present. So, the aim of this study was to cross-culturally validate the Adolescent Asthma Self-Efficacy Questionnaire (AASEQ).

Methods

As many as 408 adolescents with asthma were invited to take up the psychometric properties test between July 2021 and June 2022. We conducted the confirmatory factor analysis (CFA) to determine the structure of the AASEQ. The relationship between the AASEQ and General Self-Efficacy Scale was tested to evaluate the construct validity. The reliability was evaluated by retest reliability, internal consistency, and interfactor correlation.

Results

The results of the present study showed that the confirmatory factor analysis indicated a significantly good fit for a four-factor model, which explained 62.697% of the total variance. The fit indices of the four-factor model were acceptable, and the standardized factor loading ranged from 0.631 to 0.880. The C-AASEQ showed an acceptable internal consistency (Cronbach's α = 0.810-0.927) and test-retest reliability (intraclass correlation coefficient = 0.64-0.89). Content validity index at the scale level was 0.96, and content validity index at the item level was 0.86 to 1.

Conclusion

The Chinese version of Adolescent Asthma Self-Efficacy Questionnaire showed consistently acceptable positive psychometric properties and can be used as an instrument to assess the self-efficacy of adolescents with asthma in China, as corroborated in the present study.

Management of patients with allergic diseases in the era of COVID-19

In the early days of the coronavirus disease 2019 (COVID-19) pandemic, allergic diseases, especially asthma, were considered to be risk factors for severe COVID-19 infection, hospitalization, and death. These concerns stemmed from the idea that individuals with allergic diseases are generally more susceptible to respiratory virus infections, which are major causes of exacerbation of allergic diseases. However, epidemiologic data with mechanistic studies showed that the associations between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and clinical outcomes of allergic diseases are complex and affected by diverse factors such as allergic disease severity, phenotypes, and control status with current medications. In addition, children generally have less severe clinical outcomes of COVID-19 than those of adults, which complicates the association between allergic diseases and COVID-19-related outcomes among them. The present review summarizes the potential association between allergic diseases and COVID-19-related outcomes and discusses the factors requiring consideration. The findings viewed herein will aid the management of allergic diseases in patients with SARS-CoV-2 infection and the establishment of medical polices for managing patients with allergic diseases.

Lung Function Tests, Quality of Life and Telemedicine: Three Windows on the Multifaceted World of Asthma in Adolescents

Asthma is a heterogeneous disease usually characterized by chronic airway inflammation and recognized as the most prevalent chronic illness among children. Despite this, the knowledge as to how asthma affects adolescents is still scarce. One of the main management problems of asthmatic adolescents is the poor adherence to pharmacological and non-pharmacological treatments. The assessment of respiratory function and the impact on quality of life are still two crucial challenges in the management of asthmatic adolescents. Additionally, the COVID-19 pandemic has prompted physicians to explore complementary management strategies including telemedicine technologies. This review aims to provide an update on the contribution of respiratory functional tests, how asthma affects quality of life of adolescents and, finally, how telemedicine contributes to the management of adolescent asthmatics during the COVID-19 pandemic.