COVID-19 大流行前后小儿哮喘加重因素分析

IF 3.9 2区 医学 Q2 ALLERGY World Allergy Organization Journal Pub Date : 2024-09-01 DOI:10.1016/j.waojou.2024.100961
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引用次数: 0

摘要

目的 2019 年冠状病毒病(COVID-19)大流行期间,由于社会疏远,现有呼吸道病毒和空气污染物的发病率已经消失或下降。因此,2020 年的哮喘加重并没有增加。本研究旨在分析 COVID-19 爆发前后儿童和青少年哮喘患者在急诊科(ED)就诊的情况,并研究呼吸道病毒感染和空气污染物的影响。方法本研究纳入了 2018 年、2019 年和 2020 年 2 月至 12 月期间在全国 419 家急诊科就诊的 2-18 岁儿童和青少年哮喘患者。利用全国急诊科信息系统,纳入了在急诊科病史、出院诊断史和通过急诊科住院后出院诊断中被诊断为哮喘的患者,即J45或J46(国际疾病分类,第10版)。结果在COVID-19大流行前,每月平均有673名来访患者(95%置信区间[CI],474-872),而在COVID-19大流行期间,每月平均有176名来访患者(95%置信区间[CI],113-239),减少了73.8%(p <0.001)。而在 COVID-19 大流行期间,仅在秋季出现高峰。结论呼吸道病毒感染与儿童和青少年的哮喘恶化密切相关。在这项研究中,空气污染并不是哮喘恶化导致急诊就诊的主要因素。尽管呼吸道病毒的发病率在下降,但因哮喘恶化而到急诊室就诊的人数却呈下降趋势。这一现象可能表明,哮喘恶化是由于花粉或气温和气压波动等其他原因造成的。
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Analysis of exacerbating factors of pediatric asthma before and after the COVID-19 pandemic

Purpose

The incidence of the existing respiratory virus and air pollutants had disappeared or decreased due to social distancing during the coronavirus disease 2019 (COVID-19) pandemic. Therefore, there was no increase in asthma exacerbations in 2020. This study aimed to analyze the emergency department (ED) visits of children and adolescent patients with asthma before and after the COVID-19 outbreak and examine the effects of respiratory virus infection and air pollutants.

Methods

This study included pediatric and adolescent patients with asthma aged 2–18 years who visited 419 EDs nationwide during February to December in 2018, 2019, and 2020. The patients who were diagnosed with asthma, ie, J45 or J46 (International Classification of Diseases, 10th revision) in the ED medical history, diagnosis history at discharge, and diagnosis at discharge after hospitalization through the ED were included using the National Emergency Department Information System. Data were analyzed by dividing the period as follows: pre-COVID-19 (from February to December 2018 and 2019) and COVID-19 pandemic (from February to December 2020).

Results

The monthly average of 673 visiting patients (95% confidence interval [CI], 474–872) during the pre-COVID-19 period decreased to 176 (95% CI, 113–239) during the COVID-19 pandemic, which is a 73.8% decrease (p < 0.001).

In the pre-COVID-19 period, peaks were observed in spring and autumn. Meanwhile, during the COVID-19 pandemic, a peak was observed only during autumn. During the COVID-19 pandemic, no relationship was found between the rhinovirus infection and asthma exacerbations (p < 0.001).

Conclusions

Respiratory virus infections are strongly associated with asthma exacerbations in children and adolescents. In this study, air pollution is not a major factor for ER visits due to asthma exacerbations. Even though the prevalence of respiratory viruses is decreasing, ED visits due to worsening asthma are trending in the fall. This phenomenon may indicate that asthma has worsened due to other causes such as pollen or fluctuations in temperature and air pressure.

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来源期刊
World Allergy Organization Journal
World Allergy Organization Journal Immunology and Microbiology-Immunology
CiteScore
9.10
自引率
5.90%
发文量
91
审稿时长
9 weeks
期刊介绍: The official pubication of the World Allergy Organization, the World Allergy Organization Journal (WAOjournal) publishes original mechanistic, translational, and clinical research on the topics of allergy, asthma, anaphylaxis, and clincial immunology, as well as reviews, guidelines, and position papers that contribute to the improvement of patient care. WAOjournal publishes research on the growth of allergy prevalence within the scope of single countries, country comparisons, and practical global issues and regulations, or threats to the allergy specialty. The Journal invites the submissions of all authors interested in publishing on current global problems in allergy, asthma, anaphylaxis, and immunology. Of particular interest are the immunological consequences of climate change and the subsequent systematic transformations in food habits and their consequences for the allergy/immunology discipline.
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