Katherine Caid MD , Megan Tate MD , Shahwar Yousuf MD , Lillian Jones BS , Robert D. Pesek MD , Akilah A. Jefferson MD, MSc , Tamara T. Perry MD , Daniel Liu MD , Grace Turner BA , Ashton Ingold BS , Susanna Hartzell BA , Bobby L. Boyanton Jr. MD , Kim Cobb MA, RRT-NPS, AE-C , Haley Long BS, RRT, A-EC , Suzanne House BA , Dana Frederick MS , Rachel A. Frenner MHA , Erin Hathorn MSHI , Jing Jin PhD , Scott Stewart MS , Joshua L. Kennedy MD
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Abstract
Background
The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in March 2020 led to the implementation of nonpharmaceutical interventions (NPIs) to curb its spread. Studies have shown that adult asthma exacerbations and viral infections decreased during NPI use. However, few studies have shown the effects of NPIs on pediatric asthma exacerbations and infections during and after the pandemic.
Objective
This study aimed to understand the impact of NPIs on asthma exacerbations and viral respiratory infections in pediatric patients at our institution from March 2018 to December 2022.
Methods
The medical record numbers of children with asthma exacerbations seen at our institution between March 2018 and December 2022 were analyzed. Subjects were categorized on the basis of timing of their exacerbation in relation to NPI enforcement. We used the results from clinical testing with the BioFire Respiratory Panel (BRP) to detect up to 22 respiratory pathogens and then correlated these results with asthma exacerbation severity.
Results
There were 5,758 asthma exacerbations recorded, with a 50% decline in average weekly exacerbations during NPI enforcement. Of the 70,682 BRP tests performed, 87% returned a positive result for at least 1 pathogen. Several viruses (respiratory syncytial virus, parainfluenza, and influenza) had a decrease in positivity rate with NPIs, whereas rhinovirus/enterovirus positivity rates were unchanged throughout the pandemic. Asthma exacerbations with a positive BRP result required higher clinical levels of care during the admission.
Conclusion
NPIs were associated with significantly reduced numbers of asthma exacerbations and respiratory viral infections. The post-NPI period saw a return to prepandemic levels of asthma exacerbations and an unusual surge in respiratory syncytial virus infections, emphasizing the need for continuous monitoring and adaptive strategies in the postpandemic landscape.
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