The effects of the COVID-19 lockdown on severe asthma in patients taking biologic therapy and air pollution in Riyadh.

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From: Annals of Thoracic Medicine(Vol. 16, Issue 4)
Publisher: Medknow Publications and Media Pvt. Ltd.
Document Type: Survey
Length: 3,734 words
Lexile Measure: 1530L

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Byline: Khan. Ayaz, Rajendram. Rajkumar, Al-Ghamdi. Basma, Al-Jahdaly. Emad, AL-Harbi. Abdullah, Hayyan. Hajar, Obaidi. Mohammad, Hamdan. AL-Jahdali

BACKGROUND: The curfews and lockdowns imposed during the COVID-19 pandemic may decreased the volume of traffic and reduced air pollution. In addition, social distancing measures may contribute to reducing infection and asthma exacerbation. OBJECTIVE: The objective of this study was to assess asthma control and asthma medication use among severe asthmatics on biologics before and after the COVID-19 pandemic. METHODS: This is a cross-sectional survey study of patients with severe asthma receiving biologic therapy at King Abdulaziz Medical City-Riyadh, Saudi Arabia. We looked at the effects of the COVID-19 lockdown on this cohort of severe asthmatics on biologic therapy from March till June 2020 over a period of 12 weeks. We investigated changes in patients' symptoms and asthma control using the asthma control test (ACT) score and other parameters including emergency department visits, hospitalizations, use of oral prednisolone, changes in inhaler therapy, frequency of bronchodilator use, and patient perception of their symptoms before and after the lockdown period. RESULTS: A total of 56, Female 39 (69%), mean age [+ or -] SD 47.4 [+ or -] 13.8 years. The duration of bronchial asthma since diagnosis ranged from 4 to 30 years. Most patients had been treated with omalizumab (47, 84%); the rest received mepolizumab (7, 12.5%) and dupilumab (2, 3.6%). All these patients had been on biologic therapy for 5 months, ranging from 5 to 120 months. Most of the patients (45, 80.4%) agreed that their symptoms of asthma had improved with biologic therapy. Most of the patients felt that overall asthma symptoms are better after curfew and lockdown 28 (50%). Less use of bronchodilators postcurfew was reported in 38% of the patients. Asthma control ([greater-than or equal to]20) using ACT score was significantly higher among patients in postcurfew and lockdown period compared to precurfew period 34 (61.7%) and 23 (41%) (P = 0.001), respectively. CONCLUSIONS: Asthma control was better postcurfew and lockdown. A decrease in air pollution and social distances may be a contributing factor.

Asthma is a chronic inflammatory condition of the airways that results in variable bronchial hyperresponsiveness and airflow limitations causing symptoms.[1] Recent data suggest that around 650 million people live with some degree of asthma symptoms worldwide.[2] Hospitalization and medications are the most important associated direct costs, while work and school absenteeism account for the greatest percentage of indirect costs.[3],[4]

During coronavirus disease 2019 (COVID 19 the world re evaluated every aspect of contemporary life taken for granted in 2019; nevertheless, an expected increase in exacerbations and death due to asthma did not materialize.[5]

The curfews and lockdowns imposed during the COVID-19 pandemic may have prevented transmission of other infections besides severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Furthermore, the decreased volume of traffic and social distancing measures (social distance may contribute to reducing infection but not air pollution) are likely to have reduced air pollution.

Air pollution from ozone (O[sub]3), sulfur dioxide (SO[sub]2), nitrogen dioxide (NO[sub]2), and...

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Gale Document Number: GALE|A680637885