Improvements in the use of health care for young people from urban minorities related to better asthma control

Source / Disclosures

Source:

Sun Y, et al. Advanced pediatric science for COVID-19. Presented at: International Conference of the American Thoracic Society; May 13-18, 2022; San Francisco (hybrid meeting).

Disclosures:
Sun does not report relevant financial disclosures.


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SAN FRANCISCO – In children from urban minorities with a high severity of asthma, improving health care use is associated with better asthma control, according to a study presented at the International Conference of the American Thoracic Society.

“Among children from urban minorities with a high severity of asthma, the use of health care, including hospitalizations, emergency department visits, emergency care and hospital visits, has decreased significantly as a result of the COVID-19 pandemic. During this time, despite improvements in asthma control symptoms, there was no change in spirometry results, suggesting that such changes did not affect lung function. Ye Song, MD, MPH, from the pediatrics department at the Children’s Hospital at Montefiore / Albert Einstein Medical College, Bronx, New York, told Healio.

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Sun and colleagues conducted a study to assess changes in the use of health care following orders to stay at home on COVID-19 among patients at the multidisciplinary asthma center at Montefiore Children’s Hospital in the Bronx, New York.

“We know that the COVID-19 pandemic has caused dramatic changes in access to and use of healthcare. “Various studies have found that the overall rate of asthma-related hospitalizations and emergency room visits has decreased,” Sun told Healio. “However, few have looked after children with poorly controlled, persistent asthma and little is known about how lung function has changed during this time.

The retrospective cohort study included 101 children and young adults aged 2 to 21 years (mean age 9.1 years; 53.5% men; 61.4% Hispanic; 27.7% black) with physician-diagnosed persistent asthma. All patients had at least one visit before and after the discontinuation of COVID-19, which occurred in this region from March to June 2020.

At baseline, 23.8% of patients had mild persistent asthma, 56.4% had moderate persistent asthma, and 19.8% had severe persistent asthma. The average duration between visits is 323.5 days.

Researchers observed a significant reduction in all pre- and post-discontinuation results with COVID-19, with an average reduction of 76% for hospitalization rates, 69% for ED visits, and 8% for oral steroid use.

These reductions are related to improved asthma control based on the result of the asthma control test or the NHLBI questionnaire (57% vs. 24% uncontrolled; P <.001).

Researchers have not reported a significant improvement in FEV1FEV1/ FVC ratios or FEF25%-75% before stopping COVID-19 compared to after stopping.

“Our findings were surprising because it suggests that the improvement in use during this time did not appear to affect lung function, which could potentially contribute to further exacerbations following the discontinuation of COVID,” The Sun told Healio.

Researchers plan to further investigate this to clarify the factors that contributed to the change in use during the shutdown, including sensitivity to allergens, weight change and exposure to viruses, the Sun said.

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