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COVID-19 Pandemic-Related Reductions in Pediatric Asthma Exacerbations Corresponded with an Overall Decrease in Respiratory Viral Infections
Journal article   Open access   Peer reviewed

COVID-19 Pandemic-Related Reductions in Pediatric Asthma Exacerbations Corresponded with an Overall Decrease in Respiratory Viral Infections

Samir Sayed, Avantika R Diwadkar, Jesse W Dudley, Janielle O'Brien, Donald Dvorin, Chén C Kenyon, Blanca E Himes, David A Hill and Sarah E Henrickson
The journal of allergy and clinical immunology in practice (Cambridge, MA), v 10(1), pp 91-99.e12
01 Jan 2022
DOI: https://doi.org/10.1016/j.jaip.2021.10.067
PMID: 34785388
Featured in Collection :   UN Sustainable Development Goals @ Drexel
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https://doi.org/10.1016/j.jaip.2021.10.067View
Published, Version of Record (VoR) Open

Abstract

Asthma - epidemiology Child COVID-19 Humans Pandemics Respiratory Tract Infections - epidemiology SARS-CoV-2 Virus Diseases - epidemiology
Respiratory viruses, air pollutants, and aeroallergens are all implicated in worsening pediatric asthma symptoms, but their relative contributions to asthma exacerbations are poorly understood. A significant decrease in asthma exacerbations has been observed during the coronavirus disease 2019 pandemic, providing a unique opportunity to study how major asthma triggers correlate with asthma activity. To determine whether changes in respiratory viruses, air pollutants, and/or aeroallergens during the coronavirus disease 2019 pandemic were concomitant with decreased asthma exacerbations. Health care utilization and respiratory viral testing data between January 1, 2015, and December 31, 2020, were extracted from the Children's Hospital of Philadelphia Care Network's electronic health record. Air pollution and allergen data were extracted from US Environmental Protection Agency public databases and a National Allergy Bureau-certified station, respectively. Pandemic data (2020) were compared with historical data. Recovery of in-person asthma encounters during phased reopening (June 6 to November 15, 2020) was uneven: primary care well and specialty encounters reached 94% and 74% of prepandemic levels, respectively, whereas primary care sick and hospital encounters reached 21% and 40% of prepandemic levels, respectively. During the pandemic, influenza A and influenza B decreased to negligible frequency when compared with prepandemic cases, whereas respiratory syncytial virus and rhinovirus infections decreased to low (though nonnegligible) prepandemic levels, as well. No changes in air pollution or aeroallergen levels relative to historical observations were noted. Our results suggest that viral respiratory infections are a primary driver of pediatric asthma exacerbations. These findings have broad relevance to both clinical practice and the development of health policies aimed at reducing asthma morbidity.

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36 citations in Web of Science
31 citations in Scopus

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Web of Science research areas
Allergy
Immunology
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