Impact of COVID-19 pandemic on asthmasymptoms and management: a prospectiveanalysis of asthmatic children in Ecuador

ackground:Asthma affects up to 33% of children in Latin American settings. The ongoingCOVID-19 pandemic has had a significant impact on access to and use of health services. Weaimed to evaluate the impact of the COVID-19 lockdown on asthma exacerbations, medical facilityvisits, and use of asthma medications in children.Methods:We used data from a prospective cohort of 213 children aged 5–17 years in 3 Ecua-dorian cities and analysed the impact of the COVID-19 lockdown on asthma. Outcomes (asthmaexacerbations, emergency room [ER] visits, planned and unplanned outpatient visits, and use ofinhaled corticosteroids and Beta-2 agonists) were analysed using repeated Poisson counts (ie,number of events per participant before and during the COVID-19 lockdown).Results:During compared to before lockdown: a) the number of asthma exacerbations remainedconstant (IRR, 0.87; 95% CI: 0.72–1.05; p¼0.152); b) outpatient visits (IRR 0.26, 95% CI 0.14–0.47,p<0.001) declined 74% while ER visits declined 89% (IRR 0.11, 95% CI 0.04–0.32, p