Looking at the article topics in the May 2021 issue of Contemporary Pediatrics, there is a small but promising sense of comfort that we as a nation may finally be beating the COVID-19 pandemic. For the first time in 15 months, there are no major articles on COVID-19. The U.S. Food and Drug Administration’s press release on May 10, 2021 and the Centers for Disease Control and Prevention on May 13, 2021 of the Emergency Use Consent (EUA) for the Pfizer / BioNTech COVID-19 vaccine for adolescents 12 to 15 years of age provides further assurance for beating the COVID-19 pandemic. All pediatric caregivers and many parents have eagerly awaited the EUA for the Pfizer / BioNTech vaccine. The data from the randomized control study (RCT) for 12- to 15-year-old participants is so powerful: 100% efficacy for the children enrolled in the study. Now is the time for all pediatric caregivers to talk to their parents about immunizing their children.
Asthma Presentation in Children and Adolescents During the COVID-19 Pandemic
At the outset of the pandemic, it was feared that children and adolescents with a confirmed diagnosis of intermittent or persistent (mild, moderate, or severe) asthma were at high risk of contracting COVID-19 and poor outcomes. However, we now know that children and adolescents diagnosed with asthma did not experience increased wheezing or asthma exacerbations during the COVID-19 pandemic. After reviewing data from children and adults infected with COVID-19 during the first outbreak in China, a large epidemiological study did not include asthma as a risk factor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or an increased risk of serious COVID-19 disease or death.1 In addition, the pathology of SARS-CoV-2 infection shows that the virus’s spike protein binds to the angiotensin converting enzymes (ACE) 2 receptors and that children have lower ACE 2 receptors than adults, so children have limited infection and / or less severe infection
Can we better control childhood / adolescent asthma after a pandemic?
In the article Asthma: Everything You Need to Know, Ms. Zimlich describes the many drugs for asthma treatment that may be included in the upcoming 2007 Asthma Guidelines update. Thoughtful and Evidence-Based Treatment for Children and Adolescents with Asthma is critical to their health and well-being, including their ability to be like other children, to run and play freely, and to breathe effortlessly.
The COVID-19 pandemic has provided new insights into many aspects of primary care, but especially for children and adolescents with a mild to moderate asthma diagnosis. Evidence of less disease burden for people diagnosed with asthma during the pandemic raises 2 important questions: 1). Were the pathophysiological effects of the COVID-19 virus spike protein and reduced binding capacity (lower ACE 2 receptors) in children and adolescents the main reason for a reduction in the burden of asthma? and 2). Was the main reason for reduced disease burden strongly correlated with ‘staying at home’, wearing a mask, social distancing, and the cleanliness of the school and home environments – all primary prevention strategies?
If the answer to question 2 is yes, then primary care for people with asthma should focus on primary prevention strategies such as primary care. To determine the ‘next standard’ for asthma treatment, it may be prudent to conduct practice quality improvement (QI) projects to assess the status of the child or adolescent’s pre-pandemic symptoms and management of his or her status during the pandemic until then. improve management for the ‘next standard’. Pediatric nurses are uniquely prepared in primary care and many are prepared in QI initiatives to lead practice-based initiatives and solve problems to better manage care for people with asthma through both pediatric and family-centered care management strategies. Parents and their children and adolescents should be active participants in identifying triggers, controlling the triggers before and during the pandemic, changes in control of their personal environment (s) before and after the pandemic, and perhaps behavioral therapies to reduce stress. Reduce. clearly understand the ‘next standard’ for asthma treatment without undue reliance on drugs. In addition, we are looking forward to new asthma practice guidelines that take into account the importance of pandemic outcomes for people diagnosed with asthma.
1. Lu X, et al .; SARS-CoV-2 infection in children. N Engl J Med. 2020; 382 (17): 1663-1665. doi: 10.1056 / NEJMc2005073.
2. Chatziparasidis, G. & Kantar, A. Lung. 2021; 1-6. doi: 10.1007 / s00408-021-00419-9.