Annals of Thoracic Medicine Official publication of the Saudi Thoracic Society, affiliated to King Saud University
 
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ORIGINAL ARTICLE
Year : 2021  |  Volume : 16  |  Issue : 4  |  Page : 354-360

The effects of the COVID-19 lockdown on severe asthma in patients taking biologic therapy and air pollution in Riyadh


1 Department of Medicine, College of Medicine, King Saud University for Health Sciences; King Abdullah International Medical Research Centre; Department of Medicine, Pulmonary Division, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
2 Department of Medicine, College of Medicine, King Saud University for Health Sciences; King Abdullah International Medical Research Centre; Department of Medicine, Internal Medicine Division, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
3 Department of Medicine, Pulmonary Division, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
4 Department of Occupational and Environmental Medicine, College of Medicine, Umm AlQura University, Makkah, Saudi Arabia
5 Department of Medicine, College of Medicine, King Saud University for Health Sciences; Department of Medicine, Internal Medicine Division, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia

Correspondence Address:
Dr. Hamdan AL-Jahdali
McGill University. King Saud University for Health Sciences, Riyadh, Saudi Arabia.Pulmonary Division, Sleep Disorders Center, King Abdulaziz Medical City, Riyadh
Saudi Arabia
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DOI: 10.4103/atm.atm_559_20

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BACKGROUND: The curfews and lockdowns imposed during the COVID-19 pandemic may decreased the volume of traffic and reduced air pollution. In addition, social distancing measures may contribute to reducing infection and asthma exacerbation. OBJECTIVE: The objective of this study was to assess asthma control and asthma medication use among severe asthmatics on biologics before and after the COVID-19 pandemic. METHODS: This is a cross-sectional survey study of patients with severe asthma receiving biologic therapy at King Abdulaziz Medical City-Riyadh, Saudi Arabia. We looked at the effects of the COVID-19 lockdown on this cohort of severe asthmatics on biologic therapy from March till June 2020 over a period of 12 weeks. We investigated changes in patients' symptoms and asthma control using the asthma control test (ACT) score and other parameters including emergency department visits, hospitalizations, use of oral prednisolone, changes in inhaler therapy, frequency of bronchodilator use, and patient perception of their symptoms before and after the lockdown period. RESULTS: A total of 56, Female 39 (69%), mean age ± SD 47.4 ± 13.8 years. The duration of bronchial asthma since diagnosis ranged from 4 to 30 years. Most patients had been treated with omalizumab (47, 84%); the rest received mepolizumab (7, 12.5%) and dupilumab (2, 3.6%). All these patients had been on biologic therapy for 5 months, ranging from 5 to 120 months. Most of the patients (45, 80.4%) agreed that their symptoms of asthma had improved with biologic therapy. Most of the patients felt that overall asthma symptoms are better after curfew and lockdown 28 (50%). Less use of bronchodilators postcurfew was reported in 38% of the patients. Asthma control (≥20) using ACT score was significantly higher among patients in postcurfew and lockdown period compared to precurfew period 34 (61.7%) and 23 (41%) (P = 0.001), respectively. CONCLUSIONS: Asthma control was better postcurfew and lockdown. A decrease in air pollution and social distances may be a contributing factor.


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