The impact of COVID-19 lockdown measures on the behaviour and morbidity of children with asthma: a narrative review

The spread of COVID-19 and the worldwide implementation of restrictive measures for the containment of SARS-CoV-2 led to drastic population behavioural changes. The aim of this review is to summarize the behavioural changes observed in asthmatic children during this period, present the concurrent changes in childhood asthma morbidity and discuss possible implications of these observations for public health and clinical practice in the post-COVID-19 era. Studies published from November 2021 to February 2022 were identified from PubMed® and Google Scholar databases using appropriate search terms. Numerous studies have assessed the morbidity of children with asthma during lockdown periods and associated these changes with reduced exposure to environmental triggers and respiratory viral infections, while a lockdown-independent increase in patient compliance to treatment was also observed. Within this context, asthmatic children demonstrated reduced asthma-related emergency department visits, less usage of systemic steroids and in general an improved disease control, with some data suggesting a positive association of asthma control and lockdown stringency. In summary, this narrative review examines the behavioural changes brought by lockdowns, their cumulative beneficial effect on paediatric asthmatic morbidity, and triggers a debate on how public health measures may be taken to benefit children with asthma in a post-COVID-19 era.