» Articles » PMID: 35756853

Impact of COVID-19 Pandemic on Asthma Exacerbations: Retrospective Cohort Study of over 500,000 Patients in a National English Primary Care Database

Overview
Specialty Health Services
Date 2022 Jun 27
PMID 35756853
Authors
Affiliations
Soon will be listed here.
Abstract

Background: Several countries reported a substantial reduction in asthma exacerbations associated with COVID-19 pandemic-related restrictions. However, it is not known if these early reported declines were short-term and if these have rebounded to pre-pandemic levels following easing of lockdown restrictions.

Methods: We undertook a retrospective, cohort study of all asthma patients in a national primary care database of almost 10 million patients, Optimum Patient Care Database (OPCRD), identified from January 1, 2010, to December 31, 2015, using a previously validated algorithm. We subsequently followed the identified cohort of asthma patients from January 1, 2016, to October 3, 2021, and identified every asthma exacerbation episode with a validated algorithm. To quantify any pandemic-related change in exacerbations, we created a control time-series (mean of 2016-2019) and then compared the change in exacerbation rate in 2020-2021 over quarterly periods when compared with the control period (the pre-pandemic period). We undertook overall and stratified analyses by age group, sex, and English region.

Findings: We identified 100,362 asthma patients (502,669 patient-years) from across England who experienced at least one exacerbation episode (298,390 exacerbation episodes during the entire follow-up). Except for the first quarter of 2020, the exacerbation rates were substantially lower (>25%) during all quarters in 2020-2021 when compared with the rates during 2016-2019 (39.7% (95% Confidence Interval (CI): 34.6, 44.9) in quarter-2, 2020; 46.5% (95%CI: 36.7, 56.4) in quarter-3, 2020; 56.3% (95%CI: 48.7, 63.9) in quarter-4, 2020; 63.2% (95%CI: 53.9, 72.5) in quarter-1, 2021; 57.7% (95%CI: 52.9, 62.4) in quarter-2, 2021; 53.3% (95%CI: 43.8, 62.8) in quarter-3, 2021).

Interpretation: There was a substantial and persistent reduction in asthma exacerbations across England over the first 18 months after the first lockdown. This is unlikely to be adequately explained by changes in health-seeking behaviour, pandemic-related healthcare service disruption, or any air-quality improvements.

Funding: Asthma UK, Health Data Research UK (HDR UK), Medical Research Council (MRC), National Institute for Health Research (NIHR).

Citing Articles

Associations of aeroallergen testing with reduced oral corticosteroid bursts among adults with asthma.

Gleeson P, Morales K, Buckey T, Fadugba O, Apter A, Christie J J Allergy Clin Immunol Glob. 2024; 4(1):100348.

PMID: 39583037 PMC: 11585680. DOI: 10.1016/j.jacig.2024.100348.


Effects of nonpharmaceutical interventions during COVID-19 pandemic on pediatric asthma exacerbations and viral infections.

Caid K, Tate M, Yousuf S, Jones L, Pesek R, Jefferson A J Allergy Clin Immunol Glob. 2024; 3(4):100340.

PMID: 39498233 PMC: 11533078. DOI: 10.1016/j.jacig.2024.100340.


Patterns and trends in asthma incidence rates in main Asian and Western countries and their prediction to 2030.

Zheng Y, Lan L, Lu G, Gao Y Chin Med J Pulm Crit Care Med. 2024; 2(3):188-196.

PMID: 39403411 PMC: 11471091. DOI: 10.1016/j.pccm.2024.08.004.


Features of children with critical asthma hospitalized in a pediatric intensive care unit: Results from the ICU-3A study.

Eusebe C, Dauger S, Leger P, Houdouin V, Renolleau S, Amat F Pediatr Pulmonol. 2024; 60(1):e27322.

PMID: 39400483 PMC: 11733709. DOI: 10.1002/ppul.27322.


Temporal variation in the effectiveness of biologics in asthma: Effect modification by changing patient characteristics.

Nopsopon T, Brown A, Hahn G, Rank M, Huybrechts K, Akenroye A Respir Med. 2024; 234:107802.

PMID: 39260678 PMC: 11588503. DOI: 10.1016/j.rmed.2024.107802.


References
1.
Mansfield K, Mathur R, Tazare J, Henderson A, Mulick A, Carreira H . Indirect acute effects of the COVID-19 pandemic on physical and mental health in the UK: a population-based study. Lancet Digit Health. 2021; 3(4):e217-e230. PMC: 7985613. DOI: 10.1016/S2589-7500(21)00017-0. View

2.
Davies G, Alsallakh M, Sivakumaran S, Vasileiou E, Lyons R, Robertson C . Impact of COVID-19 lockdown on emergency asthma admissions and deaths: national interrupted time series analyses for Scotland and Wales. Thorax. 2021; 76(9):867-873. DOI: 10.1136/thoraxjnl-2020-216380. View

3.
Assaf S, Tarasevych S, Diamant Z, Hanania N . Asthma and severe acute respiratory syndrome coronavirus 2019: current evidence and knowledge gaps. Curr Opin Pulm Med. 2020; 27(1):45-53. DOI: 10.1097/MCP.0000000000000744. View

4.
Papadopoulos N, Mathioudakis A, Custovic A, Deschildre A, Phipatanakul W, Wong G . Childhood asthma outcomes during the COVID-19 pandemic: Findings from the PeARL multi-national cohort. Allergy. 2021; 76(6):1765-1775. PMC: 8013557. DOI: 10.1111/all.14787. View

5.
Payne R, Abel G, Simpson C . A retrospective cohort study assessing patient characteristics and the incidence of cardiovascular disease using linked routine primary and secondary care data. BMJ Open. 2012; 2(2):e000723. PMC: 3332248. DOI: 10.1136/bmjopen-2011-000723. View