Evaluation of Asthma Control Status and Anxiety Level During the COVID-19 Pandemic in Children with Asthma

Year 2021, , 386 - 393, 23.09.2021

Betül Karaatmaca , Ahmet Selmanoğlu Tayfur Giniş , Esra Çöp , Gülser Şenses Dinç , Özden Şükran Üneri , Muge Toyran , Ersoy Civelek , Emine Dibek Mısırlıoğlu

https://doi.org/10.12956/tchd.956354

Abstract

Objective: We aimed to evaluate asthma control status, drug compliance and anxiety levels of children and their parents who were followed up with the diagnosis of asthma during the COVID-19 pandemic.

Material and Methods: Sixty-seven children aged between 8-12 years diagnosed with asthma and their parents were prospectively recruited to the study. A questionnaire including demographic features such as age, gender, asthma  medications and questions about COVID-19 prepared according to a 5-point Likert scale was conducted to the parents. Children completed the State-Trait Anxiety Inventories for Children (STAI-C) scales, and childhood asthma control test(c-ACT). Parents also fulfilled STAI scales.

Results: The mean age of the patients was 9.5±1.2 years, the median follow-up period for asthma (C-ACT) was 36 (21-66) months, and 45 (67.2%) were male. Most of the children were using their asthma medication regularly. Children’s STAI-C state and trait anxiety scores showed a statistically significant positive correlation with parents’ STAI state and trait anxiety scores. The anxiety levels of parents who thought that they would get the disease and that there would be no effective treatment and vaccine against COVID-19 were found to be higher.

Conclusion: During the pandemic period, regular asthma follow-up and drug compliance are very important controlling asthma symptoms in children. Considering the effects of the pandemic in children with asthma, psychosocial evaluations during outpatient controls may have positive effects on children’s mental health and disease control.

Astımlı Çocuklarda COVİD-19 Pandemisi Döneminde Astım Kontrolü ve Anksiyete Düzeyinin Değerlendirilmesi

Abstract

Amaç: Çalışmamızda astımlı çocuklarda ve ailelerinde yeni tip coronavirüs hastalığı (COVID-19) döneminde astım kontrol durumları, ilaç uyumları ve kaygı düzeylerinin değerlendirilmesi amaçlanmıştır.

Gereç ve Yöntemler: Çalışmaya en az altı aydır astım tanısıyla izlenen 8-12 yaş arası 67 çocuk ve ebeveynleri dahil edilmiştir. Ebeveynlere yaş, cinsiyet, astım ilaçları gibi demografik özellikleri ve 5’li Likert ölçeğine göre hazırlanmış COVID-19 ile ilgili soruları içeren anket yapılmıştır. Ayrıca çocukluk çağı astım kontrol anketi (AKT) ve kaygı düzeyini değerlendirmek için çocuklara Çocuklar İçin Durumluk-Sürekli Kaygı Envanteri (Ç-DSKE), ebeveynlere de Erişkinler için Durumluk-Sürekli Kaygı Envanteri (DSKE) uygulanmıştır.

Bulgular: Hastaların ortalama yaşı 9.5±1.2 yıl, astım takip süresi ortancası (çeyrekler arası aralık) 36 (21-66) aydı ve 45’i (%67.2) erkekti. Çocukların çoğu astım ilaçlarını düzenli kullanıyordu. Çocukların Ç-DSKE durumluk ve sürekli kaygı puanları, ebeveynlerin DSKE durumluk ve süreklik kaygı puanlarıyla istatistiksel olarak anlamlı pozitif yönde korelasyon gösteriyordu. Hastalığı geçireceğini, COVID-19’a karşı etkili tedavi ve aşı bulunamayacağını düşünen ebeveynlerin kaygı düzeyleri daha yüksek bulundu. Çocukların cinsiyeti, astım takip süreleri, astım kontrol durumları, düzenli takibe gelme ve astım ilacını düzenli kullanmasına göre gruplandırılarak karşılaştırıldığında yine çocuk Ç-DSKE ve ebeveynlerin DSKE skorları arasında fark yoktu.

Sonuç: Pandemi döneminde düzenli kontrol ve ilaç uyumu çocuklarda astım semptomlarının kontrol altına alınmasında son derece önemlidir. Astımlı çocuklarda pandeminin etkileri de göz önünde bulundurularak poliklinik kontrolleri sırasında psikososyal değerlendirilmelerinin yapılması çocukların ruh sağlığı ve hastalık kontrolü üzerinde olumlu etkileri olabilir.

Keywords

astım, COVID-19, çocuk, kaygı, pandemi

References

• 1. Dharmage SC, Perret JL, Custovic A. Epidemiology of asthma in children and adults. Frontiers in pediatrics 2019;7:246.
• 2. GINA. Global Initiative for Asthma (GINA): Global strategy for asthma management and prevention. Updated 2020: Available at: http://www. ginasthma.com.
• 3. Cloutier MM, Baptist AP, Blake KV, et al. 2020 Focused Updates to the Asthma Management Guidelines: A Report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group. Journal of Allergy and Clinical Immunology 2020;146:1217-70.
• 4. World Health Organization Current novel coronavirus (2019-nCoV) outbreak. 2020 https://www.who.int/health-topics/coronavirus.
• 5. Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. New England journal of medicine 2020.
• 6. Kaushik S, Aydin SI, Derespina KR, et al. Multisystem inflammatory syndrome in children associated with severe acute respiratory syndrome coronavirus 2 infection (MIS-C): a multi-institutional study from New York City. The Journal of pediatrics 2020;224:24-9.
• 7. Yasuhara J, Kuno T, Takagi H, Sumitomo N. Clinical characteristics of COVID‐19 in children: A systematic review. Pediatric pulmonology 2020;55:2565-75.
• 8. Grasselli G, Greco M, Zanella A, et al. Risk factors associated with mortality among patients with COVID-19 in intensive care units in Lombardy, Italy. JAMA internal medicine 2020;180:1345-55.
• 9. Satia I, Cusack R, Greene JM, O’Byrne PM, Killian KJ, Johnston N. Prevalence and contribution of respiratory viruses in the community to rates of emergency department visits and hospitalizations with respiratory tract infections, chronic obstructive pulmonary disease and asthma. PloS one 2020;15:e0228544.
• 10. Parri N, Lenge M, Buonsenso D. Children with Covid-19 in pediatric emergency departments in Italy. New England Journal of Medicine 2020;383:187-90.
• 11. Dong Y, Mo X, Hu Y, et al. Epidemiology of COVID-19 among children in China. Pediatrics 2020;145.
• 12. Williamson EJ, Walker AJ, Bhaskaran K, et al. Factors associated with COVID-19-related death using OpenSAFELY. Nature 2020;584:430-6.
• 13. Wang C, Pan R, Wan X, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. International journal of environmental research and public health 2020;17:1729.
• 14. Guessoum SB, Lachal J, Radjack R, et al. Adolescent psychiatric disorders during the COVID-19 pandemic and lockdown. Psychiatry research 2020:113264.
• 15. Kaplan A, Price D. Treatment adherence in adolescents with asthma. Journal of asthma and allergy 2020;13:39.
• 16. Matsunaga NY, Ribeiro MAGdO, Saad IAB, Morcillo AM, Ribeiro JD, Toro AADC. Evaluation of quality of life according to asthma control and asthma severity in children and adolescents. Jornal Brasileiro de Pneumologia 2015;41:502-8.
• 17. Ercan ES, Bilaç Ö, Özaslan TU, Ardic UA. Prevalence of psychiatric disorders among Turkish children: the effects of impairment and sociodemographic correlates. Child Psychiatry & Human Development 2016;47:35-42.
• 18. Ercan ES, Polanczyk G, Akyol Ardıc U, et al. The prevalence of childhood psychopathology in Turkey: a cross-sectional multicenter nationwide study (EPICPAT-T). Nordic journal of psychiatry 2019;73:132-40.
• 19. Sekerel B, Soyer O, Keskin O, et al. The reliability and validity of Turkish version of Childhood Asthma Control Test. Quality of Life Research 2012;21:685-90.
• 20. Liu AH, Zeiger R, Sorkness C, et al. Development and cross-sectional validation of the Childhood Asthma Control Test. Journal of Allergy and Clinical Immunology 2007;119:817-25. 21. Ozusta H. Turkish standardization, reliability and validity of State-Trait Anxiety Inventory for Children. Turk Psikoloji Dergisi 1995;10:32-43.
• 22. Spielberger CD, Reheiser EC. Measuring anxiety, anger, depression, and curiosity as emotional states and personality traits with the STAI, STAXI and STPI. 2004.
• 23. Spielberger C, Gorsuch R, Lushene R. State-trait anxiety inventory STAI (Form Y). Redwood City: Mind Garden 1983.
• 24. Öner N, LeCompte WA. Durumluk-sürekli kaygı envanteri el kitabı: Boğaziçi Üniversitesi Yayınları; 1985.
• 25. Costa DD, Pitrez PM, Barroso NF, Roncada C. Asthma control in the quality of life levels of asthmatic patients' caregivers: a systematic review with meta-analysis and meta-regression. Jornal de pediatria 2019;95:401-9.
• 26. Goodwin R, Robinson M, Sly P, et al. Severity and persistence of asthma and mental health: a birth cohort study. Psychological medicine 2013;43.
• 27. Li S, Wang Y, Xue J, Zhao N, Zhu T. The impact of COVID-19 epidemic declaration on psychological consequences: a study on active Weibo users. International journal of environmental research and public health 2020;17:2032.
• 28. Crane SJ, Ganesh R, Post JA, Jacobson NA. Telemedicine Consultations and Follow-up of Patients With COVID-19. Mayo Clinic Proceedings; 2020: Elsevier. p. S33-S4.
• 29. Zhang J-j, Dong X, Cao Y-y, et al. Clinical characteristics of 140 patients infected with SARS‐CoV‐2 in Wuhan, China. Allergy 2020;75:1730-41.
• 30. Guan W-j, Ni Z-y, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. New England journal of medicine 2020;382:1708-20.
• 31. Covid C, Team R, Covid C, et al. Coronavirus disease 2019 in children—United States, february 12–april 2, 2020. Morbidity and Mortality Weekly Report 2020;69:422.
• 32. Papadopoulos NG, Custovic A, Deschildre A, et al. Impact of COVID-19 on pediatric asthma: practice adjustments and disease burden. The Journal of Allergy and Clinical Immunology: In Practice 2020;8:2592-9. e3.
• 33. Bousquet J, Jutel M, Akdis CA, et al. ARIA‐EAACI statement on asthma and COVID‐19 (June 2, 2020). Allergy 2021;76:689-97.
• 34. Gülşah Ş, MISIRLIOĞLU ED. Astımlı Çocuklarda COVID-19 Etkisi. Türkiye Çocuk Hastalıkları Dergisi;15:251-5.
• 35. Morais-Almeida M, Aguiar R, Martin B, et al. COVID-19, asthma, and biologic therapies: what we need to know. World Allergy Organization Journal 2020:100126.
• 36. ERTUĞRUL A, BOSTANCI İ. Çocuklarda Ağır Astım, Biyolojik Tedaviler ve Covid-19 Pandemisinde Güncel Yaklaşımlar. Türkiye Çocuk Hastalıkları Dergisi:1-6.
• 37. Yucel E, Suleyman A, Hizli Demirkale Z, Guler N, Tamay ZU, Ozdemir C. ‘Stay at home’: Is it good or not for house dust mite sensitized children with respiratory allergies? Pediatric Allergy and Immunology 2021.
• 38. Licari A, Ciprandi R, Marseglia G, Ciprandi G. Anxiety and depression in adolescents with asthma and in their parents: a study in clinical practice. Monaldi Archives for Chest Disease 2019;89.
• 39. GÜNAYDIN NC, BAYKAL S. COVİD-19 Pandemi Döneminde Astım Tanılı Ergenlerde Anksiyete Düzeyinin Değerlendirilmesi. Namık Kemal Tıp Dergisi;8:296-302.
• 40. Letitre SL, de Groot EP, Draaisma E, Brand PL. Anxiety, depression and self-esteem in children with well-controlled asthma: case–control study. Archives of disease in childhood 2014;99:744-8.