Impact of lockdowns on paediatric asthma hospital presentations over three waves of COVID-19 pandemic

Homaira, Nusrat; Hu, Nan; Owens, Louisa; Chan, Mei Yen; Gray, Melinda; Britton, Philip N; Selvadurai, Hiran; Lingam, Raghu; Jaffé, Adam

doi:10.1186/s13223-022-00691-1

Cited by 10 publications

(8 citation statements)

References 10 publications

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“…During autumn 2020, when many COVID-19 restrictions in Brussels were still in place [22,23], no decrease in the number of wheezing episodes (as compared to 2019) was observed despite a reduction in overall outpatient attendance. This nding contrasts with other studies that all documented a decrease in wheezing episodes with the onset of the COVID-19 pandemic and its lockdown measures in 2020 [24][25][26][27]. However, most of the studies report on the annual incidence [25,26] or incidence during strict lockdown periods [24,27] which makes comparison di cult.…”

Section: Discussionmentioning

confidence: 71%

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Wheezing Episodes in Children Before and After the Onset of the COVID-19 Pandemic in Brussels

Delporte,

Bruwaene,

Bruffaerts

et al. 2024

Preprint

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Purpose: Studies have demonstrated important changes in the seasonality of pediatric respiratory illnesses since the onset of the COVID-19 pandemic. The aim of this study was to describe the epidemiology of childhood wheezing episodes before and after the start of the COVID-19 pandemic in relation to their potentially associated environmental triggers. Methods: Files of all children treated with salbutamol for a wheezing episode in September and October 2019, 2020 and 2021 were retrospectively reviewed. Infection epidemiology, daily concentrations of air pollutants (NO2, O3, PM10 and PM2.5) and fungal spores were collected over the same time period. Results: In 2021, 298 episodes of wheezing were observed compared to 111 in 2020 and 86 in 2019 (p<0.001). Compared to 2019, children with wheezing in 2021 were significantly older (p<0.001), less likely to have a history of recurrent wheezing (p<0.001) and required less hospitalization (p=0.034). Adenovirus and SARS-CoV-2 were more prevalent in 2021 as compared to 2019 (p<0.001). The concentration of PM10, PM2.5 and O3 was higher in 2021, as compared to both 2019 and 2020 (p<0.001) while the concentration of NO2 and airborne spores was lower in 2021 compared to 2019 (p<0.0001). Conclusion: A threefold increase in wheezing episodes was observed in the autumn post-COVID (2021) compared to pre-COVID (2019) together with a significant increase in some viruses and most air pollutants. We hypothesize that this abnormal surge may be related to the release of restrictions with rapid spread of viruses in children who were exposed to high levels of air pollution.

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Section: Discussionmentioning

confidence: 71%

“…This nding contrasts with other studies that all documented a decrease in wheezing episodes with the onset of the COVID-19 pandemic and its lockdown measures in 2020 [24][25][26][27]. However, most of the studies report on the annual incidence [25,26] or incidence during strict lockdown periods [24,27] which makes comparison di cult.…”

Section: Discussionmentioning

confidence: 71%

Wheezing Episodes in Children Before and After the Onset of the COVID-19 Pandemic in Brussels

Delporte,

Bruwaene,

Bruffaerts

et al. 2024

Preprint

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“…Previous study from our group also found a significant reduction of 50–70% in asthma hospital presentations during the lockdown periods in NSW. 36 In a separate meta-analysis of 35 studies, the authors found that adoption of non-pharmaceutical public health interventions was associated with a 4.68% decrease in daily cases, 4.80% decrease in daily deaths, 1.90% decrease in the COVID-19 reproduction number and 16.5% decrease in COVID-19 daily ICU admission. 37 …”

Section: Discussionmentioning

confidence: 99%

Asthma and Susceptibility to COVID-19 in Australian Children During Alpha, Delta and Omicron Waves of the COVID-19 Pandemic

Chan,

Owens,

Gray

et al. 2023

JAA

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Purpose Earlier coronavirus-19 (COVID-19) pandemic reports did not implicate increased disease burden in asthmatics while subsequent findings have been inconsistent. To date, the impact of COVID-19 on childhood asthma remains undetermined and is further complicated with ongoing emergence of new variants. This study aimed to investigate association between asthma and COVID-19 for children in New South Wales (NSW), Australia and compare its differences across four major outbreaks from alpha, delta and omicron variants/subvariants. Methods This is a retrospective cross-sectional study of all children aged ≤17 years old who sought care for COVID-19 at Sydney Children’s Hospitals Network (SCHN) between 1 January 2020 and 31 May 2022. Results Of the 18,932 children with polymerase chain reaction (PCR) confirmed COVID-19 who attended SCHN, 60% received their care during delta wave, and 5.41% (n = 913) had prior diagnosis of asthma. Among children with COVID-19, the odds of having asthma were lower during alpha (aOR = 0.43; 95% CI, 0.19–0.83) and delta wave (aOR = 0.84; 95% CI, 0.73–0.96), but were higher during omicron wave (aOR = 1.56; 95% CI, 1.23–1.95). Length of hospital stay (LOS) for asthmatic children were increased by 0.55 days and 1.17 days during delta and the second omicron wave, respectively. Intensive care and mechanical ventilation requirements were not significantly different between asthmatic and non-asthmatic children. Eleven deaths were reported but none had asthma. Conclusion Although children with asthma were more susceptible to COVID-19 infections during omicron waves compared to that of alpha or delta waves, they were not at greater risk of COVID-19 severity at any stage of the outbreak regardless of the predominant SARS-CoV-2 variants/subvariants.

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“…Furthermore, the advantages arising from the pandemic, such as improved air quality and increased parental supervision, may have contributed to protecting children from diseases and adverse health conditions. A number of studies around the world have discussed the decline in hospital admissions among children [ 41 – 49 ].…”

Section: Discussionmentioning

confidence: 99%

Non-COVID-19 hospitalization and mortality during the COVID-19 pandemic in Iran: a longitudinal assessment of 41 million people in 2019–2022

Razimoghadam,

Yaseri,

Rezaee

et al. 2024

BMC Public Health

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Background During a COVID-19 pandemic, it is imperative to investigate the outcomes of all non-COVID-19 diseases. This study determines hospital admissions and mortality rates related to non-COVID-19 diseases during the COVID-19 pandemic among 41 million Iranians. Method This nationwide retrospective study used data from the Iran Health Insurance Organization. From September 23, 2019, to Feb 19, 2022, there were four study periods: pre-pandemic (Sept 23-Feb 19, 2020), first peak (Mar 20-Apr 19, 2020), first year (Feb 20, 2020-Feb 18, 2021), and the second year (Feb 19, 2021-Feb 19, 2022) following the pandemic. Cause-specific hospital admission and in-hospital mortality are the main outcomes analyzed based on age and sex. Negative binomial regression was used to estimate the monthly adjusted Incidence Rate Ratio (IRR) to compare hospital admission rates in aggregated data. A logistic regression was used to estimate the monthly adjusted in-hospital mortality Odds Ratio (OR) for different pandemic periods. Results During the study there were 6,522,114 non-COVID-19 hospital admissions and 139,679 deaths. Prior to the COVID-19 outbreak, the standardized hospital admission rate per million person-month was 7115.19, which decreased to 2856.35 during the first peak (IRR 0.40, [0.25–0.64]). In-hospital mortality also increased from 20.20 to 31.99 (OR 2.05, [1.97–2.13]). All age and sex groups had decreased admission rates, except for females at productive ages. Two years after the COVID-19 outbreak, the non-COVID-19 hospital admission rate (IRR 1.25, [1.13–1.40]) and mortality rate (OR 1.05, [1.04–1.07]) increased compared to the rates before the pandemic. The respiratory disease admission rate decreased in the first (IRR 0.23, [0.17–0.31]) and second years (IRR 0.35, [0.26–0.47] compared to the rate before the pandemic. There was a significant reduction in hospitalizations for pneumonia (IRR 0.30, [0.21–0.42]), influenza (IRR 0.04, [0.03–0.06]) and COPD (IRR 0.39, [0.23–0.65]) during the second year. There was a significant and continuous rise in the hematological admission rate during the study, reaching 186.99 per million person-month in the second year, reflecting an IRR of 2.84 [2.42–3.33] compared to the pre-pandemic period. The mortality rates of mental disorders (OR 2.15, [1.65–2.78]) and musculoskeletal (OR 1.48, [1.20–1.82), nervous system (OR 1.42, [1.26–1.60]), metabolic (OR 1.99, [1.80–2.19]) and circulatory diseases (OR 1.35, [1.31–1.39]) increased in the second year compare to pre-pandemic. Myocardial infarction (OR 1.33, [1.19–1.49]), heart failure (OR 1.59, [1.35–1.87]) and stroke (OR 1.35, [1.24–1.47]) showed an increase in mortality rates without changes in hospitalization. Conclusions In the era of COVID-19, the changes seem to have had a long-term effect on non-COVID-19 diseases. Countries should prepare for similar crises in the future to ensure medical services are not suspended.

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Impact of lockdowns on paediatric asthma hospital presentations over three waves of COVID-19 pandemic

Cited by 10 publications

References 10 publications

Wheezing Episodes in Children Before and After the Onset of the COVID-19 Pandemic in Brussels

Wheezing Episodes in Children Before and After the Onset of the COVID-19 Pandemic in Brussels

Asthma and Susceptibility to COVID-19 in Australian Children During Alpha, Delta and Omicron Waves of the COVID-19 Pandemic

Non-COVID-19 hospitalization and mortality during the COVID-19 pandemic in Iran: a longitudinal assessment of 41 million people in 2019–2022

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