Territory-Wide Study on Hospital Admissions for Asthma Exacerbations in the COVID-19 Pandemic.
Territory-Wide Study on Hospital Admissions for Asthma Exacerbations in the COVID-19 Pandemic.
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DOI：
10.1513/annalsats.202010-1247oc
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发表时间：
2021-10
影响因子：
8.3
通讯作者：
Ho PL
中科院分区：
文献类型：
--
作者：
Chan KF;Kwok WC;Ma TF;Hui CH;Tam TC;Wang JK;Ho JC;Lam DC;Sau-Man Ip M;Ho PL
依据：在COVID-19大流行期间，建议哮喘患者避免冠状病毒病（COVID-19）并遵守药物治疗。呼吸道感染是哮喘恶化的常见原因。目前还没有证据表明COVID-19与哮喘恶化之间存在联系，特别是在通过普遍掩蔽和积极的社交距离控制感染的地方。目的：参考过去5年的入院情况，评估2020年1月至4月香港哮喘急性发作的入院人数。方法：从临床数据分析和报告系统中检索哮喘急性发作的入院记录。纳入了18岁或以上、已知有哮喘发作史的患者。使用对数线性对计数进行建模，使用年份和设盲作为协变量，并对环境温度和住院时间进行进一步分析。Fisher精确检验用于比较两个时期之间的死亡率和机械通气。因心肌梗死、缺血性卒中和胃溃疡入院的患者作为对照。结果如下：与2015-2019年的月平均入院人数相比，2020年哮喘急性发作入院人数显着下降了53.2%（95%置信区间[CI]，50.4-55.8%），与对照诊断相比，下降幅度更大。温度每升高1°C（1.8°F），哮喘急性发作的入院率下降2.0%（95% CI，1.8-2.2%），掩蔽每增加1%，哮喘急性发作的入院率下降0.8%（95% CI，0.8-0.9%）。结论：2020年初，哮喘急性发作的住院人数显著减少，住院时间相似。在香港COVID-19大流行期间，这与普遍掩蔽和社交距离的做法同时出现。我们提出，普遍的掩蔽和社交距离减少了呼吸道病毒感染，从而减少了因哮喘急性发作而住院的人数。
Rationale: Patients with asthma were advised to avoid coronavirus disease (COVID-19) and comply with medication during the COVID-19 pandemic. Respiratory tract infection is a common cause of asthma exacerbations. There has not been evidence suggesting the link between COVID-19 and asthma exacerbation, especially in places with dramatic responses in infection control with universal masking and aggressive social distancing. Objectives: To assess the number for admissions of asthma exacerbations in January to April 2020 in Hong Kong with reference to admission in the past 5 years. Methods: Admission records of asthma exacerbations were retrieved from the Clinical Data Analysis and Reporting System. Patients aged 18 years or older with a known history of asthma admitted for asthma exacerbation were included. Log-linear was used to model count, with year and masking used as covariate and further analysis on ambient temperature and length of hospital stays. Fisher’s exact test was used to compare the mortality rate and mechanical ventilation between the periods. Admissions for myocardial infarction, ischemic stroke, and gastric ulcer were included as controls. Results: The number of admissions for asthma exacerbations significantly decreased by 53.2% (95% confidence interval [CI], 50.4–55.8%) in 2020 compared with monthly average admission in 2015–2019, with a higher magnitude of decrease compared with control diagnoses. Admissions for asthma exacerbations decreased by 2.0% (95% CI, 1.8–2.2%) with every 1°C (1.8°F) increase in temperature and by 0.8% with every 1% increase in masking (95% CI, 0.8–0.9%). Conclusions: Hospitalization number for asthma exacerbations significantly decreased in early 2020, with similar length of stay. This was observed with concomitant practice of universal masking and social distancing during the COVID-19 pandemic in Hong Kong. We proposed that universal masking and social distancing reduced respiratory viral infection, leading to fewer hospital admissions for asthma exacerbations.