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Comparing Healthcare Utilization in Asthmatics During the Alpha, Delta and Omicron Variants of the COVID-19 Pandemic

AAAAI News Release

February 3, 2023

April Presnell, Media & Member Communications Manager
(414) 272-6071

A new study being presented at the 2023 AAAAI Annual Meeting suggests the Omicron wave may be associated with decreased healthcare utilization in asthmatics as compared to the Alpha variant.

Milwaukee, WI – Researchers have found prescription pattern and healthcare utilization changes during the different waves of COVID-19, specifically when it comes to corticosteroids, ER visits and hospitalizations for patients with asthma. These findings will be presented in full at the 2023 Annual Meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI).

The impact of different COVID-19 variants on patients with asthma is not well-known, though the Alpha variant did not appear to increase the disease burden of asthmatic patients. To see if that has remained the case, researchers compared the healthcare burden in asthma patients across three time periods, corresponding to the Alpha, Delta, and Omicron variants. “To do this, we compared prescriptions of systemic corticosteroids and antibiotic that are typically prescribed for respiratory infections, as well as rates of ER visits and hospitalizations,” Elizabeth A. Kudlaty, MD, primary author of the study explained. “Corticosteroid and antibiotic prescriptions are a surrogate for rates of upper or lower respiratory exacerbations in asthmatic patients, and healthcare utilization tells us how sick patients are getting with the different COVID-19 variants. By comparing ER visits and hospitalizations across the three time periods, we were able to evaluate the changing behavior of COVID-19 in asthmatics.”

A computer algorithm was used to evaluate the medical records of asthmatic patients with PCR-confirmed COVID-19 across three time periods associated with Alpha, Delta, and Omicron. Prescription rates of systemic corticosteroids and antibiotics in asthmatics during COVID-19 infection were compared to look for trends or changes.

In total, 2,424 Alpha, 2,136 Delta, and 8,338 Omicron COVID-19 cases were identified among asthmatic patients. Among them, 18.5% received systemic corticosteroid prescriptions during the Alpha wave, compared to 32.0% during the Delta wave and 28% during the Omicron wave. The proportion of patients treated with systemic corticosteroids was higher in the Delta and Omicron waves as compared to the Alpha wave. The lower rate of systemic corticosteroid prescriptions during the Alpha wave may reflect a combination of decrease rate of asthma exacerbations, as well as lower prescriptions due to the unknown impact of corticosteroids during the early days of the pandemic. Rates of ER visits by asthmatics were decreased from 31% during the Alpha wave to 21.1% in Delta and 18.4% during Omicron wave. Rates of hospitalization were decreased from 25% in Alpha to 17.6% in Delta and 11% during the Omicron wave. Just as during the Alpha variant, asthmatics were no more likely to be hospitalized compared to non-asthmatics for Omicron, suggesting that asthmatics do not have higher severity of disease compared to non-asthmatics.

“COVID-19 initially was not associated with asthma exacerbations, but we’re seeing an increase with the Omicron and Delta variants as suggested by the higher rates of systemic corticosteroids, even as the overall clinical course seems to be milder as evidenced by decrease in ER visits and hospitalizations,” said Dr. Kudlaty. “It is essential that healthcare providers keep this in mind when they’re seeing patients and providing treatment.”

Visit to learn more about COVID-19. Research presented at the AAAAI Annual Meeting, February 24-27 in San Antonio, Texas, is published in an online supplement to The Journal of Allergy and Clinical Immunology.

The American Academy of Allergy, Asthma & Immunology (AAAAI) is the leading membership organization of more than 7,100 allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic and immunologic diseases. The AAAAI is the go-to resource for patients living with allergies, asthma and immune deficiency disorders. Established in 1943, the AAAAI has more than 7,100 members in the United States, Canada and 72 other countries. The AAAAI’s Find an Allergist/Immunologist service is a trusted resource to help you find a specialist close to home.