OBJECTIVE: To determine asthma control during the SARS-CoV-2 pandemic in a minority pediatric population at a community hospital. BACKGROUND: During the pandemic, exposure to allergens and infectious agents has decreased during the pandemic due to heightened hygiene measures and primarily virtual visits. We examined the effect of the pandemic on pediatric asthma control. DESIGN/METHODS: Our study included 104 asthmatic children, 3-18 years of age. The mean age of patients was 9.7 ± 3.8. Subjects were assessed during the time period of March-August 2019 and 2020. Outcome variables included: rescue albuterol and systemic steroid use, physician visits (PMDv), emergency department visits (EDv), hospitalizations (H) for asthma exacerbation, pulmonology clinic visits, change in and adherence to controller therapy, spacer technique and BMI. RESULTS: During the pandemic, the majority of pulmonology clinic visits were via telemedicine. There was a significant difference in appropriate spacer technique and change in controller regimen, with improved technique and decreased requirement for step up controller therapy, during the pandemic There was no significant difference in BMI, adherence to controller therapy or the number of pulmonology visits. Additionally, there was an improvement in asthma control during the pandemic with less use of rescue albuterol, systemic steroids, H, EDv or PMDv for acute exacerbation. CONCLUSIONS: Overall, we found that asthma control has improved during the SARS-CoV-2 pandemic in terms of: reduced albuterol and systemic steroid use and decreased asthma exacerbations. The recent addition of telemedicine to patient care has not negatively affected asthma control in children.

Background: Surgical management of symptomatic neonates with Tetralogy of Fallot (TOF) is controversial. Either primary surgical repair (EPSR) in neonates with TOF or a staged palliation with initial palliative intervention (PI). Aim: Compare outcomes of neonates with TOF who had EPSR and those who had PI. Materials and Methods: The study utilized the US National Inpatient Sample dataset for the years 2000 to 2018. Patients with EPSR and those with PI (aortic to pulmonary shunt or cardiac catheter palliative intervention) identified. Results: A total of 29,292 neonates with TOF were identified; of them 1726 neonates had EPSR, 4363 had PI. Hospital mortality was similar in both groups (PI 7.4% vs EPSR 8.0%, p = 0.41). Patient in the PI group had more comorbidities; chromosomal anomalies (PI 13.2% vs. ESPR 7.8%,  p < 0.001), prematurity (PI 15.1% vs. EPSR 10.4%,  p < 0.001), and low birth weight < 2500 grams (PI 15.4% vs. EPSR 10.3%,  p < 0.001). Median length of stay and median cost of hospitalization were significantly higher in the EPSR (25 days vs. 19 days, and $312,405 vs. $191,863, respectively,  p < 0.001). Conclusion: EPSR had similar mortality to PI but comes with a higher resource utilization and complications. If we include the cumulative morbidity and resource utilization associated with a two staged repair, EPSR could be proven as a better strategy in symptomatic neonates with TOF. A prospective superiority study on symptomatic neonates with TOF randomized to either ESPR or PI is needed to further answer this question.