Abstract
Background: Acute asthma exacerbations are a common cause for
emergency department (ED) visits and hospitalizations in children. Since
the outbreak of COVID-19 and the education system closure/ total
lockdown in Israel on March 2020, we have noticed a decrease in
pediatric ED visits and an increase in hospitalizations of asthma
exacerbations.
Objective: to examine the patterns of ED visits for asthma
exacerbations during COVID-19 outbreak, in comparison to the previous
year.
Methods: a retrospective study comparing asthma related ED visits
and hospitalizations among children aged 2-18 years at a tertiary center
in southern Israel. Three time periods were selected: 2020A (pre-
lockdown, 2/1/20-3/14//20), 2020B (lockdown, 3/15/20-5/15/20) and 2020 C
(post- lockdown, 5/16/20-6/30/20) and compared to the three parallel
time periods in 2019. Data regarding demographics, number of ED visits
and clinical severity parameters were collected and analyzed.
Results: 512 children visited the ED for asthma exacerbation: 273
children during 2019 and 239 children during 2020, with significantly
fewer ED visits per day during the lockdown period (1.8 vs 1.43,
p<0.001), compared to the parallel period in 2019.
Significantly 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) were observed
during the lockdown.
Conclusion: lockdown is associated with fewer ED visits for
asthma exacerbation, probably due to; reduced exposure to viral
infections and environmental allergens, decreased availability of
primary physicians and families’ reluctance to arrive to the ED. ED
visits during lockdown were characterized by higher hospitalization rate
and longer LOS.