BACKGROUND: It is unclear whether asthma may affect susceptibility or severity of coronavirus disease 2019 (COVID-19) in children and how pediatric asthma services worldwide have responded to the pandemic. OBJECTIVE: To describe the impact of the COVID-19 pandemic on pediatric asthma services and on disease burden in their patients. METHODS: An online survey was sent to members of the Pediatric Asthma in Real Life think tank and the World Allergy Organization Pediatric Asthma Committee. It included questions on service provision, disease burden, and the clinical course of confirmed cases of COVID-19 infection among children with asthma. RESULTS: Ninety-one respondents, caring for an estimated population of more than 133,000 children with asthma, completed the survey. COVID-19 significantly impacted pediatric asthma services: 39% ceased physical appointments, 47% stopped accepting new patients, and 75% limited patients' visits. Consultations were almost halved to a median of 20 (interquartile range, 10-25) patients per week. Virtual clinics and helplines were launched in most centers. Better than expected disease control was reported in 20% (10%-40%) of patients, whereas control was negatively affected in only 10% (7.5%-12.5%). Adherence also appeared to increase. Only 15 confirmed cases of COVID-19 were reported among the population; the estimated incidence is not apparently different from the reports of general pediatric cohorts. CONCLUSIONS: Children with asthma do not appear to be disproportionately affected by COVID-19. Outcomes may even have improved, possibly through increased adherence and/or reduced exposures. Clinical services have rapidly responded to the pandemic by limiting and replacing physical appointments with virtual encounters.

Allergy and Clinical Immunology Transylvania University Brasov Romania

Allergy and Respiratory Research Group Centre for Population Health Sciences University of Edinburgh Edinburgh United Kingdom

Allergy Center CUF Descobertas Hospital Lisbon Portugal

Allergy Department 2nd Paediatric Clinic National and Kapodistrian University of Athens Athens Greece

Allergy Department Bambino Gesù Children's Hospital Rome Italy

Astrid Lindgren Children's Hospital Karolinska University Hospital Stockholm Sweden; Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden

Charité Universitätsmedizin Berlin Pediatric Pulmonology Immunology and Intensive Care Medicine Berlin Germany

Children's Center Bethel EvKB University Bielefeld Bielefeld Germany

Children's Hospital Boston Pediatric Allergy and Immunology Boston Mass

Clinic of Children's Diseases Institute of Clinical Medicine Medical Faculty of Vilnius University Vilnius Lithuania

Department of Allergy and Immunology Penn State University State College Pa

Department of Allergy Helsinki University Central Hospital Helsinki Finland

Department of Cardiovascular and Thoracic Sciences Università Cattolica del Sacro Cuore Fondazione Policlinico Universitario A Gemelli IRCCS Rome Italy; National Heart and Lung Institute Imperial College London London United Kingdom

Department of Internal Medicine Asthma and Allergy Medical University of Lodz Lodz Poland

Department of Internal Medicine Rush Medical College Chicago Ill

Department of Paediatrics Imperial College London London United Kingdom

Department of Pediatric Respiratory Diseases and Allergy The Medical University of Warsaw Warsaw Poland

Department of Pediatrics and Adolescent Medicine Turku University Hospital and University of Turku Turku Finland

Department of Pediatrics and Child Health MRC Unit on Child and Adolescent Health Red Cross War Memorial Children's Hospital University of Cape Town Cape Town South Africa

Department of Pediatrics and Medicine University of Wisconsin School of Medicine and Public Health Madison Wis

Department of Pediatrics Faculty of Medicine The Chinese University of Hong Kong Sha Tin Hong Kong

Department of Pediatrics University of Montréal Department of Social and Preventive Medicine University of Montréal Montréal QC Canada

Departments of Pediatrics and Medicine University of Wisconsin School of Medicine and Public Health Madison Wis

Division of Allergy Immunology and Pulmonary Medicine Department of Pediatrics Washington University St Louis Mo

Division of Infection Immunity and Respiratory Medicine School of Biological Sciences The University of Manchester Manchester United Kingdom

Division of Infection Immunity and Respiratory Medicine School of Biological Sciences The University of Manchester Manchester United Kingdom; Allergy Department 2nd Paediatric Clinic National and Kapodistrian University of Athens Athens Greece

Division of Infection Immunity and Respiratory Medicine School of Biological Sciences The University of Manchester Manchester United Kingdom; North West Lung Centre Wythenshawe Hospital Manchester University NHS Foundation Trust Manchester Academic Health Science Centre Manchester United Kingdom

Division of Pediatrics School of Medicine Pontificia Universidad Catolica de Chile Santiago Chile

Family Physician Airways Group of Canada Edmonton AB Canada

Paediatric Allergy and Respiratory Medicine within Medicine at the University of Southampton Southampton United Kingdom

Paediatric Allergy Centre for Allergy Research Karolinska Institutet Solna Sweden

Pediatric Allergy and Asthma Unit Hacettepe University School of Medicine Ankara Turkey

Pediatric Allergy and Immunology Unit Children's Hospital Ain Shams University Cairo Egypt

Pediatric Department Pirogov Russian National Research Medical University the Ministry of Health Moscow Russia

Pediatric Pulmonology and Allergy Department Hôpital Jeanne de Flandre Lille France

Pediatric Pulmonology and Allergy Unit Children's Hospital la Fe Valencia Spain

Pediatric Pulmonology Division Hospital Moinhos de Vento Porto Alegre Brazil

Pediatric Pulmonology Pediatric Department 2nd Faculty of Medicine Charles University Prague University Hospital Motol Prague Czech Republic

Pediatric Respiratory and Allergy Units Virgen de la Arrixaca Children's University Clinical Hospital University of Murcia Murcia Spain; Institute for Biomedical Research of Murcia IMIB Arrixaca and Network of Asthma and Adverse and Allergic Reactions Murcia Spain

Pulmonology Department Children's Hospital Zhejiang University School of Medicine Zhejiang China

Research and Education Ayre Foundation Salta Argentina; Allergy and Asthma Department Alas Medical Institute Salta Argentina

School of Paediatrics and Child Health Faculty of Medicine Dentistry and Health Sciences University of Western Australia Crawley WA Australia

Teaching and Research Department and Paediatric Allergy Department Hospital with Specialties Juan María de Salvatierra La Paz Baja California Sur México La Paz Mexico; Allergy and Immunology Department Hospital Infantil de Medico Federico Gomez Mexico City Mexico

VN Allergy and Asthma Research Centre Chennai Tamilnadu India

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