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ED Visits for Childhood Asthma Down During Pandemic

FRIDAY, June 26, 2020 -- There has been a dramatic decrease in pediatric asthma-related emergency department use during the COVID-19 pandemic compared to the four previous years, according to research published online June 6 in the Journal of Allergy and Clinical Immunology: In Practice.

Chén C. Kenyon, M.D., from the University of Pennsylvania in Philadelphia, and colleagues describe trends in emergency department utilization in the first four months of 2020 versus the previous years (2016 to 2019). Mean daily asthma emergency department visits in 2020 pre-COVID-19 (Jan. 1, 2020, to March 18, 2020) were also compared to the mean daily asthma emergency department visits for the month following the first positive case (March 19, 2020, to April 18, 2020).

The researchers found that before the first COVID-19-positive case, asthma visits ranged between 11 and 39 visits per day (mean, 24.3), a utilization level that largely fell within three standard deviations (SDs) of the daily average for the preceding four years. Following a city-wide stay-at-home order that included home-based schooling, daily asthma visits dropped below three SDs of the daily mean from the period 2016 to 2019 for the remainder of the study period (mean daily asthma visit rate of 5.8, a decrease of 18.5 visits/day) or 76 percent lower than pre-COVID utilization. Similar trends were seen for all levels of triage acuity. The percentage of children subsequently admitted to the hospital decreased from 31 percent in the pre-COVID interval to 22 percent in the subsequent month. Over the same time period, emergency department utilization for nonasthma respiratory diagnoses decreased by 75 percent overall.

"These data also raise additional questions about how the emergence of COVID-19 influenced caregiver and child behaviors around the care of asthma," the authors write. "For example, the extent to which better adherence to preventative medications or outreach to outpatient providers to access interventions by telemedicine earlier in the course of exacerbation influences asthma outcomes."

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Posted: June 2020