Age-dependent rebound in asthma exacerbations after COVID-19 lockdown.
Age-dependent rebound in asthma exacerbations after COVID-19 lockdown.
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DOI：
10.1016/j.jacig.2022.06.001
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发表时间：
2022-11
期刊：
影响因子：
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通讯作者：
Haspel, Jeffrey
中科院分区：
文献类型：
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作者：
Hazan, Guy;Fox, Carolyn;Mok, Huram;Haspel, Jeffrey
2019 年冠状病毒传染病 (COVID-19) 大流行初期制定的病毒缓解措施抑制了常见呼吸道病毒，并减少了阻塞性肺病恶化的数量。然而，许多地方在2021年开始放松这些预防措施，导致非新冠病毒死灰复燃。哮喘和慢性阻塞性肺疾病（COPD）活动如何应对病毒丰度的上升尚不清楚。我们的目的是研究在放松 COVID-19 限制期间病毒复发如何影响哮喘和慢性阻塞性肺病 (COPD) 恶化。我们分析了急诊科 (ED) 呼吸道病毒阳性、哮喘就诊和慢性阻塞性肺病 (COPD) 就诊的电子病历。我们比较了 COVID-19 限制之前的 52 周间隔（封锁前时期 [2019 年 3 月 22 日至 2020 年 3 月 19 日]）、限制颁布后的 52 周时期（封锁期 [2020 年 3 月 20 日至 2021 年 3 月 18 日]）以及此后的 52 周时期（封锁后时期 [2020 年 3 月 20 日至 2021 年 3 月 18 日]）。 2021 年 19 日至 2022 年 3 月 18 日]）。我们使用 MetaCYCLE 来分析数据中的季节性趋势。与封锁期间相比，封锁后时期的病毒阳性率增加了 400%。与封锁期间相比，与哮喘和慢性阻塞性肺病相关的急诊就诊人数分别增加了 37%，其中哮喘急诊就诊人数的反弹主要集中在 20 岁以下的人群中。有趣的是，封锁期结束后，5 岁以下儿童的哮喘急诊就诊矫枉过正，与封锁前相比增加了 81%。哮喘和慢性阻塞性肺病恶化的季节性节律在封锁期间受到抑制，并在封锁后恢复。一旦常见呼吸道病毒复发，COVID-19 预防措施会产生意想不到的效果，导致儿童早期哮喘活动加剧。这些结果可能对未来在幼儿中使用病毒缓解策略产生影响。
Virus mitigation measures enacted early in the coronavirus infectious disease 2019 (COVID-19) pandemic suppressed common respiratory viruses and reduced the number of obstructive lung disease exacerbations. However, many localities began to ease these precautions in the year 2021, leading to a resurgence of non-COVID viruses. How asthma and chronic obstructive pulmonary disease (COPD) activity responded to this upswing in viral abundance is unclear. Our aim was to examine how viral resurgence during the relaxation of COVID-19 restrictions affected asthma and COPD exacerbations. We analyzed electronic medical records for emergency department (ED) respiratory virus positivity, asthma visits, and COPD visits. We compared the 52-week interval before the COVID-19 restrictions (the pre-lockdown period [March 22, 2019–March 19, 2020]), the 52-week period immediately following enactment of the restrictions (the lockdown period [March 20, 2020–March 18, 2021]), and the 52-week period thereafter (the post-lockdown period [March 19, 2021–March 18, 2022]). We used MetaCYCLE to analyze seasonal trends in our data. The post-lockdown period was marked by a 400% increase in viral positivity compared with during the lockdown period. Asthma- and COPD-related ED visits each rose 37% compared with during the lockdown, with the rebound in asthma ED visits concentrated in individuals younger than 20 years. Interestingly, after the lockdown period, asthma ED visits overcorrected in children younger than 5 years, rising 81% compared with before the lockdown. Seasonal rhythms in asthma and COPD exacerbations were suppressed during the lockdown and recovered after the lockdown. COVID-19 precautions had the unexpected effect of magnifying early-childhood asthma activity once common respiratory viruses recurred. These results may have implications for the future use of virus mitigation strategies in young children.