COVID-19's Effect on Inpatient and Emergency Room Evaluation of Pediatric Asthma Patients in the First Year of the Pandemic

Background: Coronavirus disease 2019 (COVID-19) was declared a pandemic March 2020. Social distancing measures reduced person-to-person contact, which also limited common viral pathogen spread. Asthma is a chronic lung disease, and upper respiratory viruses are a known trigger. Reduced asthma exacerbations were noted at our children’s hospital during COVID-19, which prompted this study to assess how COVID-19 impacted these visits overall in comparison to the previous years. This study sought to assess the impact of the pandemic within the first year primarily, which may serve as a reference point for comparison in the years that follow given how COVID-19 has persisted within our population.

Methods: An IRB-approved retrospective chart review of pediatric patients was performed for individuals who were discharged from the hospital and emergency room from our local tertiary center with a diagnosis including “asthma,” “wheeze,” or “bronchospasm.” Patient data was provided and compared as total numbers in annual visits, and the ranges were sorted in yearly increments from March 2014 to March 2021. The final year was compared against the trends that had developed in the previous years for patient encounters to see what degree of impact the COVID-19 pandemic had on overall asthma visits at our hospital.

Results: A list of 43,740 patients was generated for patients discharged from the hospital/emergency room for asthma diagnoses. In looking at annual numbers starting March 2014, the following was revealed: 2014–2015, 9,405 patients; 2015–2016, 8,130 patients; 2015–2017, 5,087 patients; 2017– 2018, 5,195 patients; 2018–2019, 5,876 patients; 2019–2020, 6,299 patients; and 2020– 2021, 3,748 patients. 2020–2021 had the lowest number of patients with diagnoses including “asthma,” “wheeze,” or “bronchospasm.” Asthma visits were increasing since March 2016 prior to COVID-19. Total asthma hospitalizations/visits in 2020-2021 correlated with an overall 40.50% decrease from the previous year.

Conclusions: During the year after COVID-19 was declared a pandemic, our children’s hospital experienced the lowest volume of asthma visits compared to the previous six years. Factors including social distancing and masking precautions may have reduced the spread of common pathogens which induce asthma exacerbations. Patients may have also willingly avoided hospitals despite having symptoms. By seeing the trends within our hospital system within this first year of the pandemic, subsequent analyses in the years that follow will more broadly illustrate the impact COVID-19 has had on asthma exacerbations within our pediatric population.