Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Thorax. 2023 Aug;78(8):752-759. doi: 10.1136/thorax-2022-219591. Epub 2022 Nov 23.
The imposition of restrictions on social mixing early in the COVID-19 pandemic was followed by a reduction in asthma exacerbations in multiple settings internationally. Temporal trends in social mixing, incident acute respiratory infections (ARI) and asthma exacerbations following relaxation of COVID-19 restrictions have not yet been described.
We conducted a population-based longitudinal study in 2312 UK adults with asthma between November 2020 and April 2022. Details of face covering use, social mixing, incident ARI and severe asthma exacerbations were collected via monthly online questionnaires. Temporal changes in these parameters were visualised using Poisson generalised additive models. Multilevel logistic regression was used to test for associations between incident ARI and risk of asthma exacerbations, adjusting for potential confounders.
Relaxation of COVID-19 restrictions from April 2021 coincided with reduced face covering use (p<0.001), increased frequency of indoor visits to public places and other households (p<0.001) and rising incidence of COVID-19 (p<0.001), non-COVID-19 ARI (p<0.001) and severe asthma exacerbations (p=0.007). Incident non-COVID-19 ARI associated independently with increased risk of asthma exacerbation (adjusted OR 5.75, 95% CI 4.75 to 6.97) as did incident COVID-19, both prior to emergence of the omicron variant of SARS-CoV-2 (5.89, 3.45 to 10.04) and subsequently (5.69, 3.89 to 8.31).
Relaxation of COVID-19 restrictions coincided with decreased face covering use, increased social mixing and a rebound in ARI and asthma exacerbations. Associations between incident ARI and risk of severe asthma exacerbation were similar for non-COVID-19 ARI and COVID-19, both before and after emergence of the SARS-CoV-2 omicron variant.
NCT04330599.
在 COVID-19 大流行早期实施社交限制后，国际上多个地区的哮喘恶化情况有所减少。但 COVID-19 限制放松后社交混合、新发急性呼吸道感染（ARI）和哮喘恶化的时间趋势尚未被描述。
我们在 2020 年 11 月至 2022 年 4 月期间，对 2312 名英国哮喘成年人进行了一项基于人群的纵向研究。通过每月在线问卷收集面部覆盖物使用、社交混合、新发 ARI 和严重哮喘恶化的详细信息。使用泊松广义加性模型可视化这些参数的时间变化。使用多水平逻辑回归检验新发 ARI 与哮喘恶化风险之间的关联，并调整潜在混杂因素。
2021 年 4 月 COVID-19 限制放宽，与此同时，面部覆盖物使用减少（p<0.001），室内前往公共场所和其他家庭的频率增加（p<0.001），COVID-19（p<0.001）、非 COVID-19 ARI（p<0.001）和严重哮喘恶化（p=0.007）的发病率上升。新发非 COVID-19 ARI 与哮喘恶化风险独立相关（调整后的比值比 5.75，95%置信区间 4.75 至 6.97），新发 COVID-19 也是如此，包括在 SARS-CoV-2 奥密克戎变异株出现之前（5.89，3.45 至 10.04）和之后（5.69，3.89 至 8.31）。
COVID-19 限制放宽，面部覆盖物使用减少，社交混合增加，ARI 和哮喘恶化反弹。新发 ARI 与严重哮喘恶化风险之间的关联，在非 COVID-19 ARI 和 COVID-19 之间相似，无论 SARS-CoV-2 奥密克戎变异株出现与否。
NCT04330599。
