Features of the treatment of children with mild asthma in the context of the COVID-19 pandemic

Abstract

Our society is still struggling with the spread of the SARS-Cov-2 virus, the cause of the development of the new coronavirus infection (COVID-19). Vaccine prophylaxis of this infection in children under 12 years old is not yet available in Russia. In many children, COVID-19 occurs against the background of concomitant pathology, including bronchial asthma (BA) as the most common chronic disease among children. BA treatment is successfully carried out by pediatricians due to modern clinical guidelines and the availability of medicines. This is one of the examples when the introduction of new methods of diagnosis and treatment made the disease controllable in most cases. Despite the obvious successes, the treatment of asthma is currently undergoing changes, and this applies specifically to mild asthma. When revising the guidelines in 2021–2022, GINA experts drew particular attention to the need for early prescription of anti-inflammatory therapy, mainly with low doses of ICS, regardless of whether asthma progresses with persistent or intermittent symptoms. Since children often suffer from ARVI and viral infections are the most frequent trigger of BA exacerbation in children, basic BA therapy in children is of particular importance, which can reduce the number of virus-induced exacerbations. Along with ICSs, generally recognized leaders in the basic therapy of BA, in the treatment of children with mild asthma with virus-induced exacerbations, montelukast, oral Cysteinyl Leukotriene Receptor Antagonist (LTRA), does not lose its importance. In recent years, additional properties have been described that allow pediatricians to use montelukast for mild asthma in children in the current context of the COVID-19 pandemic.