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This article examines the incidence of healthcare utilization for allergic and respiratory infectious diseases in children with asthma before and during the COVID-19 pandemic. The study analyzed data from the Korean Childhood Asthma Study (KAS) cohort and the Health Insurance Review and Assessment Service (HIRA) from March 2016 to March 2021. The findings showed significant decreases in hospital visits for allergic and respiratory diseases during the pandemic, with sustained reductions observed for one year. The decline in healthcare utilization may be attributed to factors such as reduced exposure to triggers and apprehension about accessing healthcare services. Further research is needed to explore the long-term effects of the pandemic on healthcare utilization. [Extracted from the article]

Background and Objective: Preterm birth or fetal growth has been associated with reduced lung function and asthma during childhood in the general population. We aimed to elucidate whether prematurity or fetal growth has a significant influence on lung function or symptoms in children with stable asthma. Methods: We included children with stable asthma who participated in the Korean childhood Asthma Study cohort. Asthma symptoms were determined by asthma control test (ACT). Percent predicted values of pre‐ and post‐bronchodilator (BD) lung function including forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and forced expiratory flow at 25%–75% of FVC (FEF25%–75%) were measured. Lung function and symptoms were compared according to the history of preterm birth and birth weight (BW) for gestational age (GA). Results: The study population consisted of 566 children (age range: 5–18 years). There were no significant differences in lung function and ACT between preterm and term subjects. We observed no significant difference in ACT but significant differences were observed in pre‐ and post‐BD FEV1, pre‐ and post‐BD FVC, and post‐BD FEF25%–75% according to BW for GA in total subjects. Two‐way ANOVA revealed that BW for GA rather than prematurity was a significant determining factor for pre‐ and post‐BD lung function. After regression analysis, BW for GA was still a significant determining factor of pre‐ and post‐BD FEV1 and pre‐ and post‐BD FEF25%–75%. Conclusion: Fetal growth rather than prematurity appears to have a significant effect on lung function in children with stable asthma. [ABSTRACT FROM AUTHOR]

Background: Asthma exacerbation (AE) leads to social and economic costs and long‐term adverse outcomes. We aimed to predict exacerbation‐prone asthma (EPA) in children. Methods: The Korean childhood Asthma Study (KAS) is a prospective nationwide pediatric asthma cohort of children aged 5–15 years followed every 6 months. Patients with AE during the 6 months prior to all three visits, with AE prior to one or two visits, and without AE prior to any visit were defined as having EPA, exacerbation‐intermittent asthma (EIA), and exacerbation‐resistant asthma (ERA), respectively. Risk factors and prediction models of EPA were explored. Results: Of the 497 patients who completed three visits, 42%, 18%, and 15% had exacerbations prior to visits 1, 2, and 3 and 5%, 47%, and 48% had EPA, EIA, and ERA, respectively. Univariate and multivariable logistic regression revealed forced expiratory volume in 1 s (FEV1) z‐score, forced vital capacity (FVC) z‐score, white blood cell (WBC) count, and asthma control test (ACT) score as relevant EPA risk factors. The EPA prediction model comprised FVC z‐score, WBC count, ACT score, sex, and parental education level (area under the receiver operating characteristic curve [AUROC] 0.841 [95% confidence interval (CI): 0.728–0.954]). Conclusion: With appropriate management, AE decreases over time, but persistent AEs may occur. Apart from asthma control level, baseline lung function and WBC count predicted EPA. [ABSTRACT FROM AUTHOR]

Objective: Various numerical asthma control tools have been developed to distinguish different levels of symptom control. We aimed to examine whether the asthma control test (ACT) is reflective of objective findings such as lung function, fractional exhaled nitric oxide (FeNO) and laboratory data in patients with stable asthma. Methods: We included patients who were enrolled in the Korean Childhood Asthma Study. ACT, spirometry, blood tests and FeNO were performed in patients after stabilization of their asthma. We examined differences among spirometry parameters, blood tests and FeNO according to control status as determined by ACT and investigated for any significant correlations. Results: The study population consisted of 441 subjects. Spirometry showed that forced expiratory volume in one second (FEV1), forced expiratory flow between 25% and 75% of forced vital capacity and FEV1/forced vital capacity were all significantly higher in the controlled asthma group. Likewise, FeNO and percent-change in FEV1 were both significantly lower in the controlled asthma group. In blood tests, the eosinophil fraction was significantly lower in the controlled asthma group while white blood cell count was significantly higher in the controlled asthma group. Lastly, among the various factors analyzed, only provocative concentration of methacholine causing a 20% fall in FEV1 significantly correlated with ACT score. Conclusion: ACT is useful as part of the routine evaluation of asthmatic children and should be used as a complement to existing tools such as spirometry and FeNO measurement. [ABSTRACT FROM AUTHOR]

Background: Asthma is a syndrome composed of heterogeneous disease entities. Although it is agreed that proper asthma endo-typing and appropriate type-specific interventions are crucial in the management of asthma, little data are available regarding pediatric asthma.Methods: We designed a cluster-based, prospective, observational cohort study of asthmatic children in Korea (Korean childhood Asthma Study [KAS]). A total of 1000 Korean asthmatic children, aged from 5 to 15 years, will be enrolled at the allergy clinics of the 19 regional tertiary hospitals from August 2016 to December 2018. Physicians will verify the relevant histories of asthma and comorbid diseases, as well as airway lability from the results of spirometry and bronchial provocation tests. Questionnaires regarding subjects' baseline characteristics and their environment, self-rating of asthma control, and laboratory tests for allergy and airway inflammation will be collected at the time of enrollment. Follow-up data regarding asthma control, lung function, and environmental questionnaires will be collected at least every 6 months to assess outcome and exacerbation-related aggravating factors. In a subgroup of subjects, peak expiratory flow rate will be monitored by communication through a mobile application during the overall study period. Cluster analysis of the initial data will be used to classify Korean pediatric asthma patients into several clusters; the exacerbation and progression of asthma will be assessed and compared among these clusters. In a subgroup of patients, big data-based deep learning analysis will be applied to predict asthma exacerbation.Discussion: Based on the assumption that asthma is heterogeneous and each subject exhibits a different subset of risk factors for asthma exacerbation, as well as a different disease progression, the KAS aims to identify several asthma clusters and their essential determinants, which are more suitable for Korean asthmatic children. Thereafter we may suggest cluster-specific strategies by focusing on subjects' personalized aggravating factors during each exacerbation episode and by focusing on disease progression. The KAS will provide a good academic background with respect to each interventional strategy to achieve better asthma control and prognosis. [ABSTRACT FROM AUTHOR]