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Did Hospital Admissions Caused by Respiratory Infections and Asthma Decrease During the COVID-19 Pandemic?
Zeynep Reyhan Onay1, Deniz Mavi1, Yetkin Ayhan1
1Istanbul Medeniyet University Faculty of Medicine, Department of Pediatric Pulmonology, Istanbul, Turkey.
Insights
During the COVID-19 pandemic, pediatric emergency department visits for influenza and upper respiratory infections decreased significantly. However, admissions for lower respiratory infections, bronchiolitis, and asthma increased, potentially due to delayed care.
Area of Science:
- Pediatric medicine
- Infectious diseases
- Epidemiology
Background:
- The COVID-19 pandemic necessitated stringent public health measures, including isolation, impacting healthcare utilization.
- Changes in pediatric admissions for respiratory illnesses and asthma were observed during the pandemic.
- Understanding these shifts is crucial for managing pediatric respiratory health during public health crises.
Purpose of the Study:
- To quantitatively analyze changes in the frequency of pediatric respiratory infections and asthma admissions during the COVID-19 pandemic.
- To compare admission rates for specific conditions (influenza, URTI, LRTI, bronchiolitis, asthma) before and during the pandemic.
Main Methods:
- Analysis of electronic medical records for pediatric patients admitted to emergency departments, outpatient/inpatient clinics, and PICU.
- Data collected over a two-year period: one year pre-COVID and the first year of the pandemic.
- Included admissions for influenza, upper and lower respiratory tract infections (URTI, LRTI), acute bronchiolitis, and asthma.
Main Results:
- Overall pediatric admissions decreased significantly: ED (-73%), outpatient (-70%), hospitalizations (-41.5%), PICU (-42%).
- Admissions for influenza and URTI decreased markedly (p<0.0001).
- Admissions for LRTI, acute bronchiolitis, and asthma increased proportionally (p<0.0001 for LRTI and asthma, p=0.027 for bronchiolitis).
Conclusions:
- Reduced circulation of viruses causing acute bronchiolitis and asthma attacks contributed to fewer admissions for these conditions.
- Parents' reluctance to seek emergency care during the pandemic may have led to more severe lower respiratory tract infections.
- The pandemic altered pediatric respiratory illness admission patterns, highlighting the need for adaptive healthcare strategies.
Objective:
Despite maximum isolation measures taken during the coronavirus disease-2019 (COVID-19) pandemic, the workload of health institutions has increased. Consequently, changes in the number of admissions in clinics and emergency departments by disease groups have been observed. We aimed to quantitatively investigate the changes in the frequency of respiratory infections and asthma in the pediatric population during the COVID-19 pandemic.
Methods:
We analyzed electronic medical record data of patients who were admitted to the emergency department (ED), outpatient and inpatient clinics, and pediatric intensive care unit (PICU) because of influenza, upper and lower respiratory tract infections (URTI, LRTI), acute bronchiolitis, and asthma during the two-year period (one year pre-COVID period and first year of the pandemic).
Results:
There were 96,648 admissions in the pre-COVID period and 15,848 during the pandemic. We observed a decline in ED admissions (-73%), outpatient clinic visits (-70%), hospitalizations (-41.5%), and PICU admissions (-42%). While the admission rates of patients with influenza [from 4.26% to 0.37% (p=0.0001)] and URTI [from 81.54% to 75.62% (p=0.0001)] decreased, the ratio of the number of admissions to the total number of admissions due to LRTI [from 8.22% to 10.01% (p=0.0001)], acute bronchiolitis [from 2.76% to 3.07% (p=0.027)], and asthma [from 5.96% to 14% (p=0.0001)] increased.
Conclusions:
The decrease in viruses that cause acute bronchiolitis and asthma attacks lead to a reduction in admissions to ED of this patient group. The fact that parents preferred not to admit their child in ED during this period may have paved the way for the development of more severe LRTIs.
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