Asthma admission among children in Hong Kong during the first year of the COVID‐19 pandemic

Abstract

Background: Multiple nonpharmaceutical interventions (NPIs) had been introduced in Hong Kong during coronavirus disease 2019 (COVID-19) pandemic. The impact on asthma admission, which was closely related to viral infection, was of concern.Objective: The study aimed to identify the impact of NPIs on pediatric asthma admissions and their association with respiratory viruses. Methods:We conducted a retrospective observational study to compare the difference in pediatric asthma hospital admission rates between pre-COVID-19 and COVID-19 periods. Information on demographics, nasopharyngeal specimen results, ventilatory support, intensive care admission, hospital stay duration, asthma control therapy, and previous admission episodes was collected. Weather parameters including temperature, rainfall, humidity, and air quality data that was reflected by the air quality health index were recorded.Results: A total of 1808 pediatric asthma admissions were recorded during the pre-COVID-19 period while there were 62 admissions during COVID-19 period, among which 54 admissions from the pre-COVID-19 period and 4 admissions from COVID-19 period were excluded. Weekly pediatric asthma admissions per total pediatric admissions during COVID-19 was one-third of that during the pre-COVID-19 period (0.3% vs. 0.9%, p < 0.001). During COVID-19 period, a significantly lower percentage of respiratory virus isolates was noted (58.6% vs. 72.6%, p = 0.019). Poisson regression analysis showed that the COVID-19 period (odds ratio[OR] = 0.202, 95% confidence interval [CI,; p ≤ 0.001), summer vacation period (OR = 0.512, 95% CI [0.43-0.62]; p ≤ 0.001), and humidity (OR = 0.99, 95% CI [0.98-1.00]; p = 0.004) were independent protective factors for asthma admission.Conclusions: There was a significant reduction in pediatric asthma hospitalizations and respiratory virus isolates in the first year of COVID-19 pandemic in Hong Kong with the implementation of NPIs. Rhinovirus remained the key respiratory virus

The effects of the COVID‐19 pandemic on PICU admissions for severe asthma exacerbations: A single‐center experience

“…Among the detected viral agents, rhinovirus was the most commonly detected virus. This finding was the same as the results that were found in a similar study in Hong Kong, from the beginning of 2015 to the end of 2020 36 …”

Impacts of ambient air quality on acute asthma hospital admissions during the COVID-19 pandemic in Oxford City, UK: a time-series study

“…The findings presented in our study regarding the consistently positive association between NO 2 and PM 2.5 and asthma exacerbations rates are consistent with the existing evidence 43–52. The identified lockdown impact is also broadly consistent with a large-scale analysis of emergency admissions in Scotland and Wales which showed a 36% reduction in asthma-related hospitalisations for all ages population during the first 18 weeks of 2020,31 however, the fixed-effect meta-analysis model limited wider generalisability.…”

“…The findings presented in our study regarding the consistently positive association between NO 2 and PM 2.5 and asthma exacerbations rates are consistent with the existing evidence. [43][44][45][46][47][48][49][50][51][52] The identified lockdown impact is also broadly consistent with a large-scale analysis of emergency admissions in Scotland and Wales which showed Open access a 36% reduction in asthma-related hospitalisations for all population during the first 18 weeks of 2020, 31 however, the fixed-effect meta-analysis model limited wider generalisability. Davies et al proposed multiple possible theories for their observations, including reductions in NO 2 and PM 2.5 that were a national trend, however, unfortunately they were unable to substantiate this proposition as they did not collect concurrent air quality data.…”

Relationship between meteorological and environmental factors and acute exacerbation for pediatric bronchial asthma: Comparative study before and after COVID-19 in Suzhou

“…HRV is another pathogen linked to asthma exacerbations and asthmatic respiratory infections in children. During the COVID-19 outbreak in Hong Kong (44), a large number of rhinoviruses were still detected in viral biopositive specimens, a finding that was consistent with our results. Liang et al (45) showed that the use of surgical masks could significantly reduce influenza transmission through droplet infection but not HRV transmission.…”