To understand hospital admissions due to asthma flare ups, before and during the COVID-19 pandemic
Asthma is a common chronic lung disease associated with cough and wheeze, caused by excessive lung inflammation and allergy. Asthma patients are vulnerable to viral infections, leading to flare-up of symptoms such as cough and breathlessness. These flare up of symptoms are called exacerbations. Viral lung infections are the most common cause of exacerbations and hospital admission in this patient group.
Patients with the severest form of COVID-19 develop lung complications and lung failure and those with pre-existing chronic diseases are most at risk of poor outcomes.
There was significant concern among Respiratory healthcare professionals and patients, that COVID-19 would have devastating effects for those with asthma. Many asthma patients report shielding throughout the pandemic and there is anecdotal evidence that people missed hospital appointments and avoided coming to hospital, even when they were unwell. However, there is little objective information to assess the impact of COVID-19 on asthma hospital admissions and hospital care.
This project will look at routinely collected health data of patients admitted before (2019) and during the COVID-19 pandemic to determine:
- Whether there was a month by month reduction in asthma admissions comparing the COVID-19 pandemic (2020) and the same time period in 2019.
- Whether there are differences in the characteristics of patients with asthma admitted to hospital during the pandemic compared to the previous year. This includes their age, ethnicity, whether they come from poorer areas in the community (based on social deprivation scores linked to postcodes) and how bad their lung disease was before the admission.
- Whether there are differences in the severity of exacerbations in asthma patients admitted to hospital across the two time periods, i.e. how long people were in hospital for, whether they needed oxygen or breathing support via a breathing tube and ventilators, and survival.
- What number of patients with asthma attended routine outpatient appointments in 2020 (face to face or by phone/video conference) compared to 2019.
This project will help determine whether asthma care pathways need to change while the vaccine programme is being rolled out.
A number of asthma patients from the asthma clinic have agreed to work with the researchers to help with this project, including producing accessible information and discussing results.
This project was supported unanimously by the PIONEER Data Trust Committee.
Mohammed Almeshari, University of Birmingham; Dr Ben Sutton, University Hospital Birmingham NHS Foundation Trust