Discussion
Main findings
The emotional impact of the COVID 19 pandemic on CYP with severe asthma appears significant. Our questionnaires have highlighted that accessing appropriate healthcare services, social distancing measures and school work as particularly detrimental on emotional wellbeing. In turn these influences appeared to manifest as physical symptoms including reported worsening asthma control.
Interpretation
The role of stress and anxiety on asthma control is well described5. The emotional impact of COVID 19 on children is beginning to emerge and themes identified using this questionnaire have been reflected in other reports. As access to support networks at school and within the wider community of family and friends have been disrupted, stressors have accumulated and become amplified. Uncertainty about the future including worries about health, cancellation of exams, applications to college and financial security have all been reported as contributing to the experience of anxiety. The charity, Young Minds, identified 83% of CYP as having experienced a worsening of their mental health6. Furthermore, specific concerns regarding accessing healthcare became apparent early on in the course of the pandemic with a sharp decline in paediatric emergency department attendances recorded, and concerns raised regarding delayed presentation of severe illness7.
Limitations
We acknowledge several important limitations to this study. The sample size is small with a low response rate and the patients identified were all from the same tertiary regional clinic. It is possible the results may have differed in different parts of the UK. In addition there was no measurement of adherence or asthma control test score.