309 - A Comparison of Children Hospitalized for Asthma Before and During the COVID-19 Pandemic

Poster Number: 309
Publication Number: 309.322

Joanne M. Nazif, The Children's Hospital at Montefiore, Scarsdale, NY, United States; Ellen J. Silver, Albert Einstein College of Medicine, Bronx, NY, United States; Elissa Gross, The Children's Hospital at Montefiore, Bronx, NY, United States

Background: Little is known about the impact of the COVID-19 pandemic on hospitalization of children with asthma. Prior to the pandemic, the Bronx, NY, had the highest prevalence and morbidity of pediatric asthma in the nation. Following the start of the pandemic, there was a noticeable decrease in pediatric asthma admissions to our tertiary care hospital in the Bronx. 

Objective: The objective of this study was to investigate if there were differences in the demographics or clinical characteristics of children admitted for asthma in the year following pandemic start compared with the year prior.

Design/Methods: We performed a retrospective chart review of children ages 2 to 18 years admitted to the Children’s Hospital at Montefiore for status asthmaticus, defined by ICD-10 admission codes and excluding patients with medical conditions that could impact breathing, such as neuromuscular diseases or anatomic airway abnormalities. Demographic characteristics including age, weight, and height were extracted as well as asthma classification, controller medications, need for intravenous (IV) magnesium and intensive (ICU) care, and length of stay (LOS). Patients admitted during the 12 months prior to the start of the pandemic (March 2019-Feb 2020) were compared with those admitted during the following 12 months using ANOVA and chi-square tests.
 

Results: In the year prior to the pandemic, 667 children were admitted for asthma, compared with 177 children in the year after pandemic start. While gender, race/ethnicity, asthma classification, controller use, and LOS were all similar between the 2 groups (see table), age and insurance differed significantly; children admitted during the pandemic were older and more likely to have public insurance. Proportionally more children during the pandemic required IV magnesium and ICU care. Additionally, more admitted children were under- or overweight during the pandemic. 131 of the 177 children hospitalized for asthma after pandemic start were tested for COVID, with low positivity rate (n=6, 0.05%).  Of these, 2 required ICU care, and 4 required IV magnesium.Conclusion(s): After pandemic onset, there was a substantial decrease in the number of children hospitalized for asthma in the Bronx, with some notable patient differences. Those who were admitted during the pandemic were sicker and more likely to be either overweight/obese or underweight. Despite these differences, the LOS remained similar. Further investigation is needed to determine the cause of these changes and whether the differences persist as the pandemic continues.
Comparison of asthma admissions before and after pandemic start