Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA.
Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Rutgers University, Piscataway, NJ, USA.
Respir Res. 2023 Mar 10;24(1):72. doi: 10.1186/s12931-023-02377-7.
Prior studies have documented declines in pediatric asthma exacerbations and asthma-related health care utilization during the COVID-19 pandemic, but less is known about the incidence of asthma during the pandemic.
We conducted a retrospective cohort study of children under age 18 without a prior diagnosis of asthma within a large US commercial claims database. Incident asthma was defined using a combination of diagnosis codes, location of services, and medication dispensing. Crude quarterly rates of asthma diagnosis per 1000 children were calculated, and the incidence rate ratio and 95% confidence interval were estimated for newly diagnosed asthma during versus before the pandemic using negative binomial regression, adjusted for age, sex, region, and season.
Compared with 3 years prior to the pandemic, crude incident diagnosis rates of asthma decreased by 52% across the first four quarters of the US pandemic. The covariate-adjusted pandemic-associated incidence rate ratio was 0.47 (95% confidence interval 0.43, 0.51).
New diagnoses of childhood asthma in the US declined by half during the first year of the pandemic. These findings raise important questions whether pandemic-related changes in infectious or other triggers truly altered the incidence of childhood asthma beyond the well-described disruptions in healthcare access.
先前的研究记录了 COVID-19 大流行期间儿童哮喘恶化和与哮喘相关的医疗保健利用减少，但对大流行期间哮喘的发病率知之甚少。
我们在一个大型美国商业索赔数据库中对 18 岁以下没有先前哮喘诊断的儿童进行了回顾性队列研究。通过诊断代码、服务地点和药物配药的组合来定义哮喘的新发病例。计算每 1000 名儿童中哮喘诊断的粗季度发病率，并使用负二项回归对大流行期间与大流行前相比新诊断的哮喘进行发病率比和 95%置信区间的估计，调整年龄、性别、地区和季节。
与大流行前 3 年相比，美国大流行的前四个季度，哮喘的粗发病诊断率下降了 52%。调整后的大流行相关发病率比为 0.47（95%置信区间 0.43，0.51）。
美国儿童哮喘的新诊断在大流行的第一年下降了一半。这些发现提出了一个重要的问题，即大流行相关的感染或其他诱因的变化是否真的改变了儿童哮喘的发病率，而不仅仅是医疗保健获取方面的明显中断。
