Rate of Hospitalization and Severity of Status Asthmaticus Among Children in Hong Kong Before, During and After the COVID-19 Pandemic

Abstract

<h2>Objectives</h2><p> The increase in respiratory infections post-COVID-19 pandemic, attributed to relaxed masking and social distancing, has raised concerns about a new pattern of severe asthma exacerbations in children. We compare admission rates, severity, and risk factors of status asthmaticus in children with reference to the past 3 years before, during, and after the COVID-19 pandemic.</p><p><br></p><p><strong>Study design</strong></p><p><br></p><p><br></p><p> This is a population-based cross-sectional analysis. Admission records were retrieved from the Clinical Data Analysis and Reporting System of the Hospital Authority in Hong Kong. Patients aged 2 to <18 years admitted for status asthmaticus between January 2017 to March 2024 were included.</p><p><br></p><h2>Main Results</h2><p> The incidence rate of pediatric status asthmaticus increased after the COVID-19 period compared to before COVID-19 (5.7 to 7.3 per 100,000 children aged 2 to <18 years), with a higher increase in children aged 2 to <6 years (10.1 to 20.6 per 100,000 children aged 2 to < 18 years). There was a higher percentage of status asthmaticus admissions among total pediatric asthma admissions after COVID-19 (0.83% vs 2.87%, <em>p</em><0.0001). Admissions are predicted to return to before COVID-19 levels by 2025.</p><p><br></p><h2>Conclusions</h2><p><br></p><p> Status asthmaticus increased after the COVID-19 pandemic, particularly in preschoolers. Public health measures during the pandemic may have prevented the children's immune systems from being educated with infection.</p>