Objective: The drastic decrease in pediatric asthma exacerbations at the beginning of the COVID-19 pandemic was assumed to be secondary to public health mitigation measures. However, this association has not been formally evaluated. We examined the correlation between the incidence of pediatric asthma hospitalizations in Canada and the stringency index (SI), a measure of the severity of public health mitigation measures, during the first two years of the COVID-19 pandemic.
Design: Ecological study from March 1st, 2020 to March 31st, 2022. Hospitalization data were obtained from a pan-Canadian inpatient administrative database and the SI was obtained from the Centre of Excellence on the Canadian Federation. We included children aged 1-17 years who were hospitalized for asthma. The association between the monthly number of asthma-related hospitalizations and the monthly average SI was evaluated using the Pearson correlation coefficient and negative binomial regression models.
Results: A total of 11,842 children were hospitalized for asthma. The monthly number of asthma-related hospitalizations was highly correlated with the SI (r = -0.73; 95 % CI -0.87, -0.47) and was the strongest for the initial pandemic period (March-June 2020, r = -0.99; 95 % CI -0.99, -0.82). A surge of hospitalizations was observed starting in May 2021, which coincided with the relaxation of public health measures.
Conclusion: Using a pan-Canadian database, we demonstrated a strong negative correlation between the number of pediatric asthma-related hospitalizations and the stringency of public health mitigation measures. These findings are relevant for future epidemic and pandemic response strategies and resource allocation.
Keywords: Asthma; Covid-19; Pediatrics; Public health; Stringency.
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