Severe Asthma in a Tertiary Center Emergency Department: The Effect of the COVID-19 Pandemic
2Department of Pediatric Emergency Medicine, Soroka University Medical Center, Beer-Sheva, Israel
3Pediatric Pulmonary Unit, Soroka University Medical Center, Beer-Sheva, Israel
4Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel
5Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Background: Acute asthma exacerbations are a common reason for emergency department (ED) visits and hospitalizations in children. Since the introduction of COVID-19 outbreak and school closure in Israel on March 2020, we have noticed a trend of a decrease in pediatric ED visits and an increase in hospitalizations for asthma exacerbations.
Objective: To examine the patterns of ED visits for asthma exacerbations during the COVID-19 outbreak, in comparison to previous year.
Methods: A retrospective study comparing asthma related ED visits and hospitalizations among children aged 4-18 years, at Soroka university medical center, a tertiary center in south Israel. Three time periods were selected: 2020A (pre- lockdown, 1/2/20-14/3/20), 2020B (lockdown, 15/3/20-15/5/20) and 2020 C (post- lockdown, 16/5/20-30/6/20) and were compared to three parallel time periods in 2019. Data regarding demographics, visits` numbers and clinical severity parameters were collected.
Results: 512 children visited the ED for asthma exacerbation: 273 children during 2019 (124 in 2019A, 89 in 2019B and 60 in 2019C) and 239 children during 2020 (125 in 2020A, 51 in 2020B and 63 in 2020C). There were significantly fewer ED visits during the lockdown period, comparing to the parallel period in 2019, with higher hospitalization rate (47.1% vs 33.7%, p=0.05) and longer length of stay (LOS) (3.15 vs 1.9 days, p= 0.03).
Conclusion: lockdown period is associated with fewer ED visits for asthma exacerbation, probably due to reduced exposure to viral infections and environmental allergens. Visits during lockdown period were more severe, reflected by higher hospitalization rates and longer LOS.