Published: 29 March 2021
Authors: Syed A Shah, Jennifer K Quint, Bright I Nwaru, Aziz Sheikh
Source: This abstract has been sourced from NZ Respiratory Research Review Issue 194
Background The impact of COVID-19 and ensuing national lockdown on asthma exacerbations is unclear.
Methods We conducted an interrupted time-series (lockdown on 23 March 2020 as point of interruption) analysis in asthma cohort identified using a validated algorithm from a national-level primary care database, the Optimum Patient Care Database. We derived asthma exacerbation rates for every week and compared exacerbation rates in the period: January to August 2020 with a pre-COVID-19 period and January to August 2016–2019. Exacerbations were defined as asthma-related hospital attendance/admission (including accident and emergency visit), or an acute course of oral corticosteroids with evidence of respiratory review, as recorded in primary care. We used a generalised least squares modelling approach and stratified the analyses by age, sex, English region and healthcare setting.
Results From a database of 9 949 387 patients, there were 100 165 patients with asthma who experienced at least one exacerbation during 2016–2020. Of 278 996 exacerbation episodes, 49 938 (17.9%) required hospital visit. Comparing pre-lockdown to post-lockdown period, we observed a statistically significant reduction in the level (−0.196 episodes per person-year; p<0.001; almost 20 episodes for every 100 patients with asthma per year) of exacerbation rates across all patients. The reductions in level in stratified analyses were: 0.005–0.244 (healthcare setting, only those without hospital attendance/admission were significant), 0.210–0.277 (sex), 0.159–0.367 (age), 0.068–0.590 (region).
Conclusions There has been a significant reduction in attendance to primary care for asthma exacerbations during the pandemic. This reduction was observed in all age groups, both sexes and across most regions in England.
Link to abstract