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Impact of COVID-19 lockdown on emergency asthma admissions and deaths: national interrupted time series analyses for Scotland and Wales.
Thorax. 2021 09; 76(9):867-873.T

Abstract

BACKGROUND

The COVID-19 pandemic's impact on people with asthma is poorly understood. We hypothesised that lockdown restrictions were associated with reductions in severe asthma exacerbations requiring emergency asthma admissions and/or leading to death.

METHODS

Using data from Public Health Scotland and the Secure Anonymised Information Linkage Databank in Wales, we compared weekly counts of emergency admissions and deaths due to asthma over the first 18 weeks in 2020 with the national averages over 2015-2019. We modelled the impact of instigating lockdown on these outcomes using interrupted time-series analysis. Using fixed-effect meta-analysis, we derived pooled estimates of the overall changes in trends across the two nations. We also investigated trends in asthma-related primary care prescribing and emergency department (ED) attendances in Wales.

RESULTS

Lockdown was associated with a 36% pooled reduction in emergency admissions for asthma (incidence rate ratio, IRR: 0.64, 95% CI: 0.49 to 0.83, p value 0.001) across both countries. There was no significant change in asthma deaths (pooled IRR: 0.57, 95% CI: 0.17 to 1.94, p value 0.37). ED asthma attendances in Wales declined during lockdown (IRR: 0.85, 95% CI: 0.73 to 0.99, p value 0.03). A large spike of 121% more inhaled corticosteroids and 133% more oral corticosteroid prescriptions was seen in Wales in the week before lockdown.

CONCLUSIONS

National lockdowns were associated with substantial reductions in severe asthma exacerbations leading to hospital admission across both Scotland and Wales, with no corresponding increase in asthma deaths.

Authors+Show Affiliations

Population Data Science, Swansea University Medical School, Swansea, UK.Population Data Science, Swansea University Medical School, Swansea, UK M.A.Alsallakh@Swansea.ac.uk.Population Data Science, Swansea University Medical School, Swansea, UK.Usher Institute, University of Edinburgh, Edinburgh, UK.Population Data Science, Swansea University Medical School, Swansea, UK.Health Protection Scotland, Public Health Scotland, Glasgow, UK.Usher Institute, University of Edinburgh, Edinburgh, UK.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33782079

Citation

Davies, Gwyneth A., et al. "Impact of COVID-19 Lockdown On Emergency Asthma Admissions and Deaths: National Interrupted Time Series Analyses for Scotland and Wales." Thorax, vol. 76, no. 9, 2021, pp. 867-873.
Davies GA, Alsallakh MA, Sivakumaran S, et al. Impact of COVID-19 lockdown on emergency asthma admissions and deaths: national interrupted time series analyses for Scotland and Wales. Thorax. 2021;76(9):867-873.
Davies, G. A., Alsallakh, M. A., Sivakumaran, S., Vasileiou, E., Lyons, R. A., Robertson, C., & Sheikh, A. (2021). Impact of COVID-19 lockdown on emergency asthma admissions and deaths: national interrupted time series analyses for Scotland and Wales. Thorax, 76(9), 867-873. https://doi.org/10.1136/thoraxjnl-2020-216380
Davies GA, et al. Impact of COVID-19 Lockdown On Emergency Asthma Admissions and Deaths: National Interrupted Time Series Analyses for Scotland and Wales. Thorax. 2021;76(9):867-873. PubMed PMID: 33782079.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of COVID-19 lockdown on emergency asthma admissions and deaths: national interrupted time series analyses for Scotland and Wales. AU - Davies,Gwyneth A, AU - Alsallakh,Mohammad A, AU - Sivakumaran,Shanya, AU - Vasileiou,Eleftheria, AU - Lyons,Ronan A, AU - Robertson,Chris, AU - Sheikh,Aziz, AU - ,, Y1 - 2021/03/29/ PY - 2020/10/13/received PY - 2021/01/30/revised PY - 2021/02/01/accepted PY - 2021/3/31/pubmed PY - 2021/8/31/medline PY - 2021/3/30/entrez KW - COVID-19 KW - asthma KW - asthma epidemiology SP - 867 EP - 873 JF - Thorax JO - Thorax VL - 76 IS - 9 N2 - BACKGROUND: The COVID-19 pandemic's impact on people with asthma is poorly understood. We hypothesised that lockdown restrictions were associated with reductions in severe asthma exacerbations requiring emergency asthma admissions and/or leading to death. METHODS: Using data from Public Health Scotland and the Secure Anonymised Information Linkage Databank in Wales, we compared weekly counts of emergency admissions and deaths due to asthma over the first 18 weeks in 2020 with the national averages over 2015-2019. We modelled the impact of instigating lockdown on these outcomes using interrupted time-series analysis. Using fixed-effect meta-analysis, we derived pooled estimates of the overall changes in trends across the two nations. We also investigated trends in asthma-related primary care prescribing and emergency department (ED) attendances in Wales. RESULTS: Lockdown was associated with a 36% pooled reduction in emergency admissions for asthma (incidence rate ratio, IRR: 0.64, 95% CI: 0.49 to 0.83, p value 0.001) across both countries. There was no significant change in asthma deaths (pooled IRR: 0.57, 95% CI: 0.17 to 1.94, p value 0.37). ED asthma attendances in Wales declined during lockdown (IRR: 0.85, 95% CI: 0.73 to 0.99, p value 0.03). A large spike of 121% more inhaled corticosteroids and 133% more oral corticosteroid prescriptions was seen in Wales in the week before lockdown. CONCLUSIONS: National lockdowns were associated with substantial reductions in severe asthma exacerbations leading to hospital admission across both Scotland and Wales, with no corresponding increase in asthma deaths. SN - 1468-3296 UR - https://www.unboundmedicine.com/medline/citation/33782079/Impact_of_COVID_19_lockdown_on_emergency_asthma_admissions_and_deaths:_national_interrupted_time_series_analyses_for_Scotland_and_Wales_ L2 - https://thorax.bmj.com/lookup/pmidlookup?view=long&pmid=33782079 DB - PRIME DP - Unbound Medicine ER -