Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China.
Department of Statistics, University of Wisconsin-Madison, Madison, Wisconsin; and.
Ann Am Thorac Soc. 2021 Oct;18(10):1624-1633. doi: 10.1513/AnnalsATS.202010-1247OC.
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. 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. 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. 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%). 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.
建议哮喘患者避免冠状病毒病（COVID-19）并在 COVID-19 大流行期间遵守药物治疗。呼吸道感染是哮喘加重的常见原因。目前尚无证据表明 COVID-19 与哮喘加重之间存在联系，特别是在普遍戴口罩和积极保持社交距离以显著控制感染的地方。
评估 2020 年 1 月至 4 月香港因哮喘加重而住院的人数，以参考过去 5 年的住院情况。从临床数据分析和报告系统中检索哮喘加重的住院记录。纳入年龄在 18 岁或以上、有已知哮喘病史并因哮喘加重而住院的患者。使用对数线性模型对计数进行建模，以年份和口罩使用情况为协变量，并进一步分析环境温度和住院时间。使用 Fisher 确切检验比较两个时期的死亡率和机械通气情况。纳入心肌梗死、缺血性卒中和胃溃疡的住院人数作为对照。
与 2015-2019 年每月平均住院人数相比，2020 年哮喘加重的住院人数显著减少 53.2%（95%置信区间[CI]，50.4-55.8%），与对照诊断相比，减少幅度更大。随着温度每升高 1°C（1.8°F），哮喘加重的住院人数减少 2.0%（95%CI，1.8-2.2%），随着口罩使用率增加 1%，住院人数减少 0.8%（95%CI，0.8-0.9%）。
2020 年初，哮喘加重的住院人数显著减少，住院时间相似。这是在 COVID-19 大流行期间香港普遍实施戴口罩和保持社交距离的情况下观察到的。我们提出，普遍戴口罩和保持社交距离减少了呼吸道病毒感染，导致哮喘加重的住院人数减少。
