Paediatric Healthcare Utilisation Trends From the Pre-Pandemic Period Through Two Years Post-COVID-19: Evidence From...

The COVID-19 pandemic was associated with a marked decline in respiratory infections and asthma exacerbations in children. Following the easing of restrictions, a rebound in respiratory morbidity was observed. However, the long-term impact on paediatric asthma remains unclear.

We conducted a retrospective study using data from the largest healthcare provider in Israel. Children aged 2-18 years with recurrent wheezing or clinician-diagnosed asthma were included. Healthcare utilisation between January 2019 and July 2023 was analysed.

A total of 209 954 children, mean age 6.8 years (56.9% male), were included. During winter 2020-2021, compared with winter 2019-2020, healthcare utilisation declined significantly for chest radiographs (CXR) (RR = 0.69), asthma medication dispensing (RR = 0.67), and emergency department (ED) visits (RR = 0.61). After restrictions were lifted, all outcomes rose sharply, peaking in summer 2021. By winter 2022-2023, rates of CXR (RR = 1.30), asthma medication dispensing (RR = 1.03), ED visits (RR = 1.04), and hospitalisations (RR = 1.30) remained significantly higher than pre-pandemic levels across all age groups.

Paediatric respiratory-related healthcare utilisation exceeded pre-pandemic levels during the first and second post-pandemic winters. These findings highlight the unpredictable, long-lasting, and indirect consequences of pandemic-era interventions on respiratory health.