INTRODUCTION
Since the coronavirus disease 2019 (COVID-19) was first reported in
Wuhan, China, in December 2019, the disease caused by SARS-CoV2 virus
has rapidly spread worldwide resulting in declaration of a pandemic by
the World Health Organization (WHO) on March 2020, becoming one of the
most important challenges humans are facing nowadays. [1,2] Its
clinical manifestations characteristically vary from asymptomatic cases,
to mild and severe cases, mainly affecting the respiratory tract.
People with asthma are usually at greater risk of more severe outcomes
due to virus infections. However, recent reports reveal that the
prevalence of COVID-19 in asthma patients is lower than expected.
[3]
It seems that COVID-19 has less direct impact on children and
adolescents than on adults. Only about 1% of the entire COVID-19
population are children, being pediatric asthma patients
underrepresented in this population. [4] Symptoms tend to be less
severe, varying from asymptomatic, to mild-moderate cases. There is no
gender difference, and all ages appear to be susceptible to the disease.
[5]
Several hypotheses have been proposed to explain this fact: reduced
angiotensin converting enzyme 2 (ACE2) gene expression, less often
comorbidities associated, less potent PAMP activation, suboptimal and
Th2-skewed cytokine production, resulting in a hypo-inflammatory immune
response, and an extensive vaccination program, leading all to a
beneficial immune response towards SARS-CoV-2 infection. [1,5]
Until now, no one has considered if both individual and social behavior
of patients before the pandemic could have influenced this low
prevalence.
The main purpose of this study is to analyze lifestyle before the
pandemic in severe pediatric asthma patients in treatment with
monoclonal antibody (MAB), belonging to Castellon’s University General
Hospital Health’s Department (Castellon, Spain), and investigate the
prevalence of COVID-19 in these patients in order to see if their
lifestyle may have influenced the probability of being infected by
COVID-19 or not. Secondly, we wanted to study the behavioral of these
patients, and determine the level of asthma control during the pandemic.