Childhood asthma diagnoses declined during the COVID-19 pandemic in the United States

• Correspondence
• Open Access
• 
  

• Daniel B. Horton, 
• Amanda L. Neikirk, 
• Yiling Yang, 
• Cecilia Huang, 
• Reynold A. Panettieri Jr, 
• Stephen Crystal, 
• Brian L. Strom & 
• Lauren E. Parlett 

Respiratory Research volume 24, Article number: 72 (2023) 

• details

Abstract

Background

Prior studies have documented declines in pediatric asthma exacerbations and asthma-related health care utilization during the COVID-19 pandemic, but less is known about the incidence of asthma during the pandemic.

Methods

We conducted a retrospective cohort study of children under age 18 without a prior diagnosis of asthma within a large US commercial claims database. Incident asthma was defined using a combination of diagnosis codes, location of services, and medication dispensing.

Crude quarterly rates of asthma diagnosis per 1000 children were calculated, and the incidence rate ratio and 95% confidence interval were estimated for newly diagnosed asthma during versus before the pandemic using negative binomial regression, adjusted for age, sex, region, and season.

Results

Compared with 3 years prior to the pandemic, crude incident diagnosis rates of asthma decreased by 52% across the first four quarters of the US pandemic. The covariate-adjusted pandemic-associated incidence rate ratio was 0.47 (95% confidence interval 0.43, 0.51).

Conclusions

New diagnoses of childhood asthma in the US declined by half during the first year of the pandemic. These findings raise important questions whether pandemic-related changes in infectious or other triggers truly altered the incidence of childhood asthma beyond the well-described disruptions in healthcare access.

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