338 - Impact of COVID-19 Infection on Pediatric Acute Asthma Disease

Poster Number: 338
Publication Number: 338.204

Matthias M. Manuel, University of Texas Southwestern Medical School, Dallas, TX, United States; Mohamed Badawy, University of Texas Southwestern Medical School, Dallas, TX, United States; Sriharsha Kambala, Children's Health, Dallas, TX, United States

Background: The SARS-CoV-2 (COVID-19) is a multi-systemic disease process that primarily affects that lungs. Like other respiratory viruses, it not known if SARS-CoV-2 infection constitutes a risk for severe acute disease process in children with chronic lung diseases like asthma.

Objective: Primarily, we evaluated and compared acute asthma severity, using asthma severity scores, hospital admission rate, and hospital length-of-stay (LOS) for asthma patients with or without COVID-19 infection. Secondarily we evaluated trend in acute asthma visit comparing pre-COVID (April 2019 - March 2020) to COVID (April 2020 - September 2021) times.

Design/Methods: We reviewed records of patients ≤18 years with established history of asthma who visited the pediatric-ED of a tertiary-care-hospital from April 2019 – September 2021 for acute asthma exacerbation and were tested for SARS-COV-2 viral infection with antigen or PCR testing during their ED stay.  Acute asthma severity scores, use of parenteral medication for acute asthma treatment in the ED, and admission or hospitalization were used as surrogates for severe acute asthma disease. We performed appropriate descriptive and univariate analyses using SAS-9.4®

Results: Of 5261 acute asthma visits, 4558 (86.6%) were pre-COVID visits and 703 (13.6%) visits occurred during the COVID pandemic. Of the 703 acute asthma visits occurring during the pandemic, mean age was 8.9 years, 62.6% were males, 50.1% self-identified as non-Hispanic Black, and 54 (7.7%) tested positive for COVID-19. Although the pandemic was associated with a significant decrease (84.5%) in acute asthma visits (p < 0.0001), there was no statistically significant difference in acute asthma severity score (p=0.207), overall disease severity (p=0.125), admission rate (p=0.139), or total hospital LOS (p=0.237) between patients with or without COVID-19 infection. Conclusion(s): The COVID-19 pandemic resulted in a significant decrease in acute asthma visits to the PED. However, acute asthma severity, admission rate, and hospital length-of-stay were not significantly different between asthma patients with or without COVID-19 infection.