Infectious Disease

Sharp decline in pediatric ED visits for bronchial asthma throughout COVID-19 shutdown

December 07, 2020

2 min read

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Simoneau does not report any relevant financial information. In the study you will find all relevant financial information from all other authors.

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Pediatric ED visits for asthma in Massachusetts fell 80% this year during the COVID-19 surge and spring lockdown, researchers reported in the Annals of the American Thoracic Society.

The retrospective cohort study evaluated medical records of people aged 2 to 22 who attended Boston Children’s Hospital ED and who were treated with at least one asthma drug from January to May 2018, 2019, and 2020. Massachusetts Schools and Childcare Facilities Closed until March 15 and March 18, respectively, and a stay at home order went into effect on March 24 to help contain the spread of COVID-19.

From January to May there were 2,543 asthma ED visits for all three years. According to the results, there were significantly fewer asthma ED visits in 2020 compared to 2018 and 2019 (630 versus 955 and 958, respectively).

The percentage of asthma exacerbations in children requiring hospitalization was not significantly higher in 2020 compared to 2018 (53.2% vs 51.3%), but was higher than in 2019 (53.2% vs 43.5%).

After COVID-19 shutdown in 2020, the incidence of asthma ED visits was significantly decreased compared to 2018 (incidence rate rate) [IRR] = 0.21; 95% CI, 0.11-0.37; P <0.0001) and 2019 (IRR = 0.18; 95% CI, 0.1-0.32; P <0.0001) after adjusting for years, weeks and before or after the shutdown, but not between 2018 and 2019 (P = 0.625)), the researchers reported.

Pediatric asthma ED visit rates were similar for the week of March 15-21 for all three years, but pediatric asthma ED visit rates decreased 80% in the following week compared to 2018 (IRR = 0 , 2; 95% CI, 0.14-0.28)) and 82% compared to 2019 (IRR = 0.18; 95% CI, 0.13-0.25). That decline continued through May 23, with a decline of 82% and 87%, respectively, compared to 2018 and 2019, respectively, the researchers wrote.

“Our main finding was the dramatic, sudden drop in ED visits soon after school finished and the home stay regulation came into effect,” said Dr. Tregony Simoneau, Assistant Professor of Pediatrics at Boston Children’s Hospital, in a press release. “How this decline was sustained over several months is remarkable.”

Consistent with overall results, rates of ED asthma visits in Hispanic (n = 420) and non-Hispanic (n = 1,799) pediatric patients after COVID-19 were significantly lower in 2020 compared to 2018 and 2019.

“[I]For future studies, it will be important to specifically assess the racial / ethnic differences in health care utilization, ”the researchers wrote. “This phenomenon offers lessons and different areas for future study of this complex problem and serves as a framework for future prevention of asthma exacerbations in children.”

Reference:

Press release.

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