Declining Pediatric Emergency Department Visits for Asthma and COVID-19 Shut-downs

Researchers Simoneau et al from Boston Children’s Hospital just published in the Annals of the American Thoracic Society their research on the impact of COVID-19 on emergency department utilization for asthma. After adjusting for year, weeks and time period (pre- or post- shutdown), they found a significantly decreased incidence of ED visits after the COVID-19-related shut-down in 2020 compared to 2018 and 2019. While the reasons for this significant decrease are unclear, the authors suggest several potential contributors to this decrease, including “increased adherence to asthma medications, avoidance of the healthcare setting due to fear of contracting COVID-19, improved air quality due to work-from-home implementation, decreased participation in sports and exercise, decreased exposure to outdoor aero-allergens, and decreased viral exposure due to school/daycare closure. Interestingly, rather than a gradual decline, which would be more indicative of improved medication adherence, there was a dramatic decline, suggestive of a sudden change in exposure, which occurred in conjunction with the stay at home order and school closure.” The authors note that their research only looked at data for their own hospital and additional research is needed to assess whether this dynamic is similar elsewhere. They note that this could provide an important opportunity to identify factors that can be controlled in the future to improve asthma management.

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