Effect of the coronavirus disease 2019 pandemic on morbidity among children hospitalized for an asthma exacerbation

• Published in: Annals of allergy, asthma, & immunology Vol. 129; no. 2; pp. 194 - 198.e1
• Main Authors: Alabdulkarim, Nada, Gai, Jiaxiang, Bost, James, Pillai, Dinesh K., Teach, Stephen J., Rastogi, Deepa
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2022; American College of Allergy, Asthma & Immunology. Published by Elsevier Inc
• Subjects: Adolescent; Asthma - drug therapy; Asthma - epidemiology; Case-Control Studies; Child; Child, Preschool; COVID-19 - epidemiology; Emergency Service, Hospital; Hospitalization; Humans; Magnesium Sulfate - therapeutic use; Morbidity; Original; Pandemics; Retrospective Studies
• ISSN: 1081-1206; 1534-4436; 1534-4436
• DOI: 10.1016/j.anai.2022.03.033

Pediatric asthma exacerbations account for substantial morbidity, including emergency department (ED) visits and hospitalizations. Although the coronavirus disease 2019 (COVID-19) pandemic was associated with a decrease in pediatric asthma ED visits and hospitalizations, there is limited information on the clinical characteristics of children hospitalized with an asthma exacerbation during the pandemic. To investigate the clinical characteristics of children hospitalized with an asthma exacerbation during the pandemic as compared with those hospitalized during the same months in the year prior. A retrospective case-control study was conducted at the Children's National Hospital, Washington, DC, comparing demographic and clinical characteristics of all children, 2 to 18 years old, hospitalized for an asthma exacerbation between April to September 2020 (cases) and April to September 2019 (controls). We identified 50 cases and 243 controls. Cases were significantly older than controls (9.8 ± 4.3 years vs 6.7 ± 3.8 years; P < .001), had significantly less eczema (16% vs 32.1%; P = .02) and food allergies (6% vs 18.5%; P = .03), and were more noncompliant with controller medications (46% vs 24.7%; P = .002) than controls. Magnesium sulfate was more frequently administered in the ED to the cases than to the controls (84% vs 63%; P = .004). Its use was associated with older age, African American race, and Hispanic ethnicity, but was independent of comorbid conditions. Patients hospitalized for asthma during the COVID-19 pandemic were older and have less atopy than those hospitalized prepandemic. A larger proportion received magnesium sulfate in the ED, suggesting patients had with more severe asthma presentation during the pandemic.