Published online: August 19, 2020
The COVID-19 pandemic was accompanied by several public health measures designed to limit viral transmission. These included social distancing, mask-wearing, and closure of schools and workplaces. There was also a dramatic shift in how healthcare was delivered, with hospital systems favoring video and phone over in-person visits. In the month following the Philadelphia shutdown (March 17, 2020), the emergency department at Children’s Hospital of Philadelphia (CHOP) experienced a sharp decrease in asthma patients (Kenyon et al., J Allergy Clin Immunol Pract., 2020). This decrease in asthma visits occurred across all acuity levels, suggesting that a shift towards virtual care were not solely responsible, and that COVID-19-related public health measures may have also influenced asthma triggers and/or asthma activity.
A recent study published in The Journal of Allergy and Clinical Immunology: In Practice examined how pediatric asthma healthcare activity changed during the early stages of the COVID-19 pandemic, and whether COVID-19-related public health measures influenced common asthma triggers including other respiratory viruses and environmental pollutants. To do so, Taquechel and colleagues collected data on asthmatics in the CHOP care network and measured their asthma related visits and prescriptions before and after the Philadelphia shutdown. They correlated their findings with respiratory viral testing data and air pollution levels between January 17 and May 17, 2020, as well as historical values from 2015 through 2019.
In the 2 months following the Philadelphia shutdown, there was a 60% decrease in the total number of asthma-related visits at CHOP. In-person asthma visits decreased most substantially, while video telemedicine became the most common visit format (61% of all visits). There was likely also a reduction in asthma flares in the Philadelphia region as the study team observed an 83% decrease in systemic steroid prescriptions—a medication class that are reserved for asthma exacerbations. Finally, of the asthma triggers that were studied there was a significant reduction in the number of rhinovirus infections, the virus responsible for the common cold. In contrast, air pollution levels did not substantially change when compared to historical trends. Together, these findings suggest that the COVID-19 pandemic coincided with a decrease in asthma flares in Philadelphia, as supported by the decrease in asthma-related visits and systemic steroids. This phenomenon may be due in part to a decreased rate of rhinovirus cases in the city during the study time period.
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.