Modifiable risk factors for asthma exacerbations during the COVID-19 pandemic: a population-based repeated cross-sectional study using the Research and Surveillance Centre primary care database.
Mukherjee M., Okusi C., Jamie G., Byford R., Ferreira F., Agarwal U., Weatherill D., Fletcher M., Quint JK., Romel Bhuia M., de Lusignan S., Sheikh SA.
BackgroundThere were substantial reductions in asthma exacerbations during the COVID-19 pandemic for reasons that remain poorly understood. We investigated changes in modifiable risk factors which might help explain the reductions in asthma exacerbations.MethodsMultilevel generalised linear mixed models were fitted to examine changes in modifiable risk factors for asthma exacerbations during 2020-2022, compared to pre-pandemic year (2019), using observational, routine data from general practices in the Oxford-Royal College of General Practitioners Research and Surveillance Centre. Asthma exacerbations were defined as any of GP recorded: asthma exacerbations, prescriptions of prednisolone, accident and emergency department attendance or hospitalisation for asthma. Modifiable risk factors of interest were ownership of asthma self-management plan, asthma annual review, inhaled-corticosteroid (ICS) prescriptions, influenza vaccinations and respiratory-tract-infections (RTI).FindingsCompared with 2019 (n = 550,995), in 2020 (n = 565,956) and 2022 (n = 562,167) (p InterpretationWe have identified changes in modifiable risk factors for asthma exacerbation that need to be maintained in the post-pandemic era.FundingAsthma UK Centre for Applied Research and Health Data Research UK.