Pediatric Asthma Health Care Utilization, Viral Testing, and Air Pollution Changes During the COVID-19 Pandemic
Pediatric Asthma Health Care Utilization, Viral Testing, and Air Pollution Changes During the COVID-19 Pandemic
复制标题
DOI：
10.1016/j.jaip.2020.07.057
复制
发表时间：
2020-11-01
影响因子：
9.4
通讯作者：
Hill, David A.
中科院分区：
文献类型：
--
作者：
Taquechel, Kiara;Diwadkar, Avantika R.;Hill, David A.
背景：2019冠状病毒病（COVID-19）大流行导致美国日常生活、医疗保健利用和提供模式发生巨大变化。了解这些变化和相关公共卫生干预措施对哮喘护理的影响，对于确定对患者预后的影响和确定确保未来最佳卫生保健服务的措施非常重要。目的：我们试图确定在COVID-19大流行期间儿童哮喘相关医疗保健利用、呼吸道病毒检测和空气污染的变化。方法：提取2015年1月17日至2020年5月17日期间费城儿童医院电子病历中哮喘相关就诊情况和每周呼吸道病毒检测汇总数据，提取AirNow中4项标准空气污染物污染数据。评估了2020年3月17日（费城实施限制病毒传播的公共卫生干预措施的日期）前后遭遇特征、病毒检测模式和空气污染的变化，并将其与2015年至2019年的数据作为历史参考进行了比较。结果：2020年3月17日之后，现场哮喘就诊减少了87%（门诊）和84%（急诊+住院）。以前没有的视频远程医疗成为使用最多的哮喘就诊方式（占所有就诊的61%），电话就诊增加了19%。与此同时，与哮喘相关的全身类固醇处方和鼻病毒检测阳性的频率下降，尽管与历史趋势相比，空气污染水平没有实质性变化。结论：费城的COVID-19大流行伴随着儿科哮喘医疗服务模式的变化，包括入院人数减少和全身类固醇处方减少。鼻病毒感染的减少可能促成了这些模式。(C) 2020年美国过敏、哮喘与免疫学学会
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic caused dramatic changes in daily routines and health care utilization and delivery patterns in the United States. Understanding the influence of these changes and associated public health interventions on asthma care is important to determine effects on patient outcomes and identify measures that will ensure optimal future health care delivery.OBJECTIVE: We sought to identify changes in pediatric asthma-related health care utilization, respiratory viral testing, and air pollution during the COVID-19 pandemic.METHODS: For the time period January 17 to May 17, 2015 to 2020, asthma-related encounters and weekly summaries of respiratory viral testing data were extracted from Children's Hospital of Philadelphia electronic health records, and pollution data for 4 criteria air pollutants were extracted from AirNow. Changes in encounter characteristics, viral testing patterns, and air pollution before and after Mar 17, 2020, the date public health interventions to limit viral transmission were enacted in Philadelphia, were assessed and compared with data from 2015 to 2019 as a historical reference.RESULTS: After March 17, 2020, in-person asthma encounters decreased by 87% (outpatient) and 84% (emergency + inpatient). Video telemedicine, which was not previously available, became the most highly used asthma encounter modality (61% of all visits), and telephone encounters increased by 19%. Concurrently, asthma-related systemic steroid prescriptions and frequency of rhinovirus test positivity decreased, although air pollution levels did not substantially change, compared with historical trends.CONCLUSIONS: The COVID-19 pandemic in Philadelphia was accompanied by changes in pediatric asthma health care delivery patterns, including reduced admissions and systemic steroid prescriptions. Reduced rhinovirus infections may have contributed to these patterns. (C) 2020 American Academy of Allergy, Asthma & Immunology