COVID 19 Risk With Asthma

Good News (Mostly) for Asthma Patients During Pandemic

COVID 19 has not shown the risk to asthma sufferers that many experts anticipated.  The role of biologic use and risk may still be unclear.  However, COVID 19 is a mucosal respiratory virus and can likely trigger a viral asthma exacerbation especially for those that are uncontrolled.  This is why it's important to work with your asthma specialist to optimize control especially in the problem seasons.  These include:
1) Having a written asthma action plan with clear recommendations for flare ups
2) Regular follow up with asthma specialist to monitor asthma control
3) Becoming familiar with symptoms of poor control, including frequent SABA use and exercise intolerance

Two studies presented at the European Respiratory Society (ERS) virtual meeting should reassure asthma patients and their physicians about their risks from COVID-19.

On the one hand, "no evidence of excess deaths was directly attributed to asthma" in a study of Scottish data on hospital admissions and death certificates during the first COVID-19 wave in early 2020, said Steven Smith, MRCP, of Gartnavel General Hospital in Glasgow.

And on the other, analysis of asthma patients receiving biologic drugs in Greek clinics showed no overall increase in COVID infection rates relative to the general population through April of this year, reported Andriana Papaioannou, MD, PhD, of Attikon University Hospital in Athens.

These encouraging results come against a backdrop of worry about how patients with preexisting respiratory disease, who may also be taking immune-modulating drugs, would fare during the pandemic.

There were two concerning blips in the Greek data, however. Papaioannou's group found that, among the 26 biologic-treated patients who did come down with COVID-19, nine needed hospitalization -- a considerably higher proportion than among COVID patients in the general Greek population, she said.

Read article here.

Sleepless in Lockdown

The impact of lockdown on sleep patterns of children and adolescents with ADHD

Among the consequences of COVID 19 lockdowns and extended virtual learning, a deterioration in sleep-wake patterns especially among at risk children was anticipated and now confirmed in this Italian study surveying parents with children with ADHD.   Children an adolescents were more likely to have delayed sleep time, anxiety, awakenings, and daytime sleepiness. Unfortunately, many of the maladaptive sleep patterns may take longer to reverse and require a concerted sleep strategy.

ABSTRACT

STUDY OBJECTIVES:

The current study examined the impact of home confinement (lockdown) because of the COVID-19 pandemic on the sleep patterns of children and adolescents with attention-deficit hyperactivity disorder (ADHD).

METHODS:

Nine hundred ninety-two parents of children and adolescents with ADHD filled out an anonymous online survey through the ADHD family association website. The survey investigated the sleep patterns and disturbances (using a modified version of the Sleep Disturbance Scale for Children) and screen exposure time before and during lockdown.

RESULTS:

During lockdown, 59.3% of children and 69.4% of adolescents with ADHD reported a change of bedtime, with a significant increase in patients with ADHD who went to sleep at 11 pm or later. Sleep duration, in contrast, resulted in 2 opposing processes with more children and adolescents sleeping either less than 6 hours/night or 10–11 hours/night. Among children and adolescents, respectively, 19.9% and 22% slept less than they did before lockdown, whereas 21.4% and 27.4% slept for more hours. Bedtime delay and decreased sleep duration were associated with an increase in screen time exposure. Moreover, patients with ADHD reported an increase in sleep disturbances when compared to their previous condition, mainly including difficulties falling asleep, anxiety at bedtime, night awakenings, nightmares, and daytime sleepiness.

CONCLUSIONS:

Lockdown impacted sleep-wake rhythms by strengthening the maladaptive sleep patterns reported in usual-life conditions in children and adolescents with ADHD.

CITATION:

Bruni O, Giallonardo M, Sacco R, Ferri R, Melegari MG. The impact of lockdown on sleep patterns of children and adolescents with ADHD. J Clin Sleep Med. 2021;17(9):1759–1765

Read abstract here.