Division of Global and Community Health, University of South Carolina School of Medicine Greenville, Greenville, South Carolina, USA.
Office of Scholarship and Research, Columbia University School of Nursing, New York, New York, USA.
Pediatr Allergy Immunol Pulmonol. 2023 Mar;36(1):23-28. doi: 10.1089/ped.2022.0143. Epub 2023 Feb 15.
Asthma and COVID-19 have overlapping symptoms. During the 2019-2022 pandemic, pediatric asthma control appears to have improved, with some researchers theorizing that that is due to changes in asthma self-management. This study examined adolescents' views regarding how the pandemic impacted their asthma severity and self-management. Differences by urbanicity, sex, and race/ethnicity were explored. We utilized baseline data from adolescents with poorly controlled asthma ( = 183) who were participating in 1 of 2 school-based clinical trials-1 in rural schools and 1 in urban schools-testing the impact of interventions to improve asthma control. Adolescents reported if they believed their asthma severity remained the same, improved, or worsened during the pandemic, and if it changed, how it changed. They also reported if and how they modified their asthma management since the pandemic. We used multinomial logistic regression and binary logistic regression to assess the relationship between demographic factors and changes in asthma severity during the pandemic, and if adolescents altered their asthma management. Adolescents' mean age was 15.9 years; most lived in rural communities (65.6%) and identified as female (66.7%). About half (56.2%) self-identified as black, 13.1% as Hispanic, and 10.4% as another race/ethnicity. Most (68.4%) reported that their asthma severity remained unchanged; 26.0% reported it worsened. Nearly 30% reported they altered how they managed their asthma, with most (80%) reporting additional efforts. Compared with asthma remaining the same, females had a higher relative risk than males of reporting that their asthma worsened [adjusted relative risk ratio = 3.65, 95% confidence interval (CI) = 1.34-9.90, < 0.05]. Urban youth had greater odds (adjusted odds ratio = 5.4, 95% CI = 2.0-14.5, < 0.001) of reporting they changed their asthma self-management compared with rural peers. This study demonstrates that during the 2019-2022 pandemic, adolescents generally believed their asthma severity stayed consistent and many took additional self-management efforts.
哮喘和 COVID-19 有重叠的症状。在 2019-2022 年大流行期间，儿科哮喘控制似乎有所改善，一些研究人员推测这是由于哮喘自我管理的变化。本研究调查了青少年对大流行如何影响他们哮喘严重程度和自我管理的看法。探讨了城乡差异、性别和种族/族裔差异。 我们利用了来自患有控制不佳的哮喘的青少年（ = 183）的基线数据，他们正在参加 2 项基于学校的临床试验中的 1 项-1 项在农村学校进行，1 项在城市学校进行-测试改善哮喘控制的干预措施的影响。青少年报告他们是否认为他们的哮喘严重程度在大流行期间保持不变、改善或恶化，如果发生变化，如何变化。他们还报告了他们自大流行以来是否以及如何改变他们的哮喘管理。我们使用多项逻辑回归和二项逻辑回归来评估人口统计学因素与大流行期间哮喘严重程度变化之间的关系，以及青少年是否改变了他们的哮喘管理。 青少年的平均年龄为 15.9 岁；大多数人居住在农村社区（65.6%），并自认为是女性（66.7%）。大约一半（56.2%）自我认定为黑人，13.1%为西班牙裔，10.4%为其他种族/族裔。大多数（68.4%）报告他们的哮喘严重程度保持不变；26.0%报告恶化。近 30%的人报告说他们改变了管理哮喘的方式，其中大多数（80%）报告了更多的努力。与哮喘保持不变相比，女性报告哮喘恶化的相对风险高于男性[调整后的相对风险比 = 3.65，95%置信区间（CI） = 1.34-9.90， < 0.05]。与农村同龄人相比，城市青年报告改变哮喘自我管理的可能性更大（调整后的优势比 = 5.4，95%置信区间（CI） = 2.0-14.5， < 0.001）。 本研究表明，在 2019-2022 年大流行期间，青少年普遍认为他们的哮喘严重程度保持一致，许多人采取了额外的自我管理措施。
