Impact of COVID-19 national lockdown on asthma exacerbations: interrupted time-series analysis of English primary care data.
Impact of COVID-19 national lockdown on asthma exacerbations: interrupted time-series analysis of English primary care data.
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DOI：
10.1136/thoraxjnl-2020-216512
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发表时间：
2021-09
期刊：
影响因子：
10
通讯作者：
Sheikh A
中科院分区：
文献类型：
--
作者：
Shah SA;Quint JK;Nwaru BI;Sheikh A
COVID-19和随后的全国封锁对哮喘急性发作的影响尚不清楚。我们对哮喘队列进行了中断时间序列（2020年3月23日锁定为中断点）分析，该队列使用来自国家级初级保健数据库（最佳患者护理数据库）的经验证算法进行识别。我们得出了每周的哮喘急性发作率，并比较了2020年1月至8月与2019冠状病毒病前时期以及2016年1月至8月至2019年期间的急性发作率。急性发作定义为哮喘相关住院（包括意外和急诊访视），或口服皮质类固醇的急性病程伴呼吸系统检查证据，如初级保健所记录。我们使用了广义最小二乘建模方法，并按年龄、性别、英国地区和医疗环境对分析进行分层。在9949387例患者的数据库中，有100165例哮喘患者在2016-2020年期间至少发生过一次急性发作。在278996次急性加重发作中，49938次（17.9%）需要住院访视。比较封锁前和封锁后，我们观察到所有患者的急性发作率水平在统计学上显著降低（-0.196次发作/人-年; p<0.001;每100名哮喘患者每年约有20次发作）。分层分析中的水平降低为：0.005-0.244（医疗保健环境，仅无住院/入院的患者具有显著性），0.210-0.277（性别），0.159-0.367（年龄），0.068-0.590（地区）。在大流行期间，因哮喘急性发作而到初级保健机构就诊的人数显著减少。在英格兰的所有年龄组、性别和大部分地区都观察到这种减少。
The impact of COVID-19 and ensuing national lockdown on asthma exacerbations is unclear. We conducted an interrupted time-series (lockdown on 23 March 2020 as point of interruption) analysis in asthma cohort identified using a validated algorithm from a national-level primary care database, the Optimum Patient Care Database. We derived asthma exacerbation rates for every week and compared exacerbation rates in the period: January to August 2020 with a pre-COVID-19 period and January to August 2016–2019. Exacerbations were defined as asthma-related hospital attendance/admission (including accident and emergency visit), or an acute course of oral corticosteroids with evidence of respiratory review, as recorded in primary care. We used a generalised least squares modelling approach and stratified the analyses by age, sex, English region and healthcare setting. From a database of 9 949 387 patients, there were 100 165 patients with asthma who experienced at least one exacerbation during 2016–2020. Of 278 996 exacerbation episodes, 49 938 (17.9%) required hospital visit. Comparing pre-lockdown to post-lockdown period, we observed a statistically significant reduction in the level (−0.196 episodes per person-year; p<0.001; almost 20 episodes for every 100 patients with asthma per year) of exacerbation rates across all patients. The reductions in level in stratified analyses were: 0.005–0.244 (healthcare setting, only those without hospital attendance/admission were significant), 0.210–0.277 (sex), 0.159–0.367 (age), 0.068–0.590 (region). There has been a significant reduction in attendance to primary care for asthma exacerbations during the pandemic. This reduction was observed in all age groups, both sexes and across most regions in England.
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影响因子：
8.9
作者：
Colice G;Chisholm A;Dima AL;Reddel HK;Burden A;Martin RJ;Brusselle G;Popov TA;von Ziegenweidt J;Price DB
通讯作者：
Price DB
DOI：
10.15585/mmwr.mm6915e3
发表时间：
2020-04-17
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Garg S;Kim L;Whitaker M;O'Halloran A;Cummings C;Holstein R;Prill M;Chai SJ;Kirley PD;Alden NB;Kawasaki B;Yousey-Hindes K;Niccolai L;Anderson EJ;Openo KP;Weigel A;Monroe ML;Ryan P;Henderson J;Kim S;Como-Sabetti K;Lynfield R;Sosin D;Torres S;Muse A;Bennett NM;Billing L;Sutton M;West N;Schaffner W;Talbot HK;Aquino C;George A;Budd A;Brammer L;Langley G;Hall AJ;Fry A
通讯作者：
Fry A
影响因子：
14.2
作者：
Ivanova, Jasmina I.;Bergman, Rachel;McLaurin, Kimmie
通讯作者：
McLaurin, Kimmie
影响因子：
2.9
作者：
Nissen, Francis;Morales, Daniel R.;Quint, Jennifer K.
通讯作者：
Quint, Jennifer K.
影响因子：
9.1
作者：
Kuruvilla ME;Lee FE;Lee GB
通讯作者：
Lee GB