Objective: Studies have revealed that people with asthma have a higher risk of anxiety during the COVID-19 pandemic. The relationship between internet addiction and anxiety has long been known, but to our knowledge, no studies have combined anxiety in asthmatic children and adolescents with internet use. This study investigated the relationship between anxiety levels and internet use in asthmatic children and adolescents during the late stage of the COVID-19 pandemic.

Method: A multicenter survey was conducted in February-March 2021, enrolling 78 asthmatic patients and 44 healthy controls. Anxiety was assessed with the State-Trait Anxiety Inventory for Children (STAI-C) for children aged 9-12 and with the State-Trait Anxiety Inventory (STAI) for adolescents aged 13-18. Internet use was assessed with the Internet Addiction Scale for Adolescents (IASA).

Results: Anxiety scores did not differ between patients and controls. The average time spent on the internet increased markedly (over three-fold) during the pandemic period compared to the pre-pandemic period (from 2.1±1.5 [0-6] hours per day to 6.9±3.5 [0-18] hours per day (p<0.001 in all participants). There was no difference in the IASA scores between the patients and controls. There was a correlation between the IASA and STAI state and trait (STAI [S] and STAI [T]) scores in the 13-18 year group (r=0.28, p=0.03, and r=0.34 p=0.01, respectively).

Conclusion: Problematic internet use has more impact on anxiety in adolescents than asthma during the late stage of the COVID-19 pandemic. We suggest that internet addiction should be kept in mind when evaluating anxiety in asthmatic adolescents during their follow-up.

Keywords: Anxiety, asthma, children, COVID-19 pandemic, internet addiction