Effect of the coronavirus disease 2019 pandemic on morbidity among children hospitalized for an asthma exacerbation

Background: Pediatric asthma exacerbations account for substantial morbidity, including emergency department (ED) visits and hospitalizations. Although the coronavirus disease 2019 (COVID-19) pandemic was associated with a decrease in pediatric asthma ED visits and hospitalizations, there is limited information on the clinical characteristics of children hospitalized with an asthma exacerbation during the pandemic. Objective: To investigate the clinical characteristics of children hospitalized with an asthma exacerbation during the pandemic as compared with those hospitalized during the same months in the year prior. Methods: A retrospective case-control study was conducted at the Children's National Hospital, Washington, DC, comparing demographic and clinical characteristics of all children, 2 to 18 years old, hospitalized for an asthma exacerbation between April to September 2020 (cases) and April to September 2019 (controls). Results: We identified 50 cases and 243 controls. Cases were significantly older than controls (9.8 4.3 years vs 6.7 3.8 years; P <.001), had significantly less eczema (16% vs 32.1%; P =.02) and food allergies (6% vs 18.5%; P =.03), and were more noncompliant with controller medications (46% vs 24.7%; P =.002) than controls. Magnesium sulfate was more frequently administered in the ED to the cases than to the controls (84% vs 63%; P =.004). Its use was associated with older age, African American race, and Hispanic ethnicity, but was independent of comorbid conditions. Conclusion: Patients hospitalized for asthma during the COVID-19 pandemic were older and have less atopy than those hospitalized prepandemic. A larger proportion received magnesium sulfate in the ED, suggesting patients had with more severe asthma presentation during the pandemic. (c) 2022 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.