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The effect of the COVID-19 pandemic on pediatric intensive care admissions for severe acute asthma
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  • Sarah van den Berg,
  • Somaye Bazdar,
  • Niels Rutjes,
  • Lizan D. Bloemsma,
  • George S. Downward,
  • Letty A. De Weger,
  • Suzanne Terheggen-Lagro,
  • Yolanda van Wijck,
  • Anke-Hilse Maitland - van der Zee,
  • Berber Kapitein
Sarah van den Berg
Emma Kinderziekenhuis Amsterdam UMC
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Somaye Bazdar
Amsterdam UMC Locatie AMC

Corresponding Author:s.bazdar@amsterdamumc.nl

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Niels Rutjes
Emma Kinderziekenhuis Amsterdam UMC
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Lizan D. Bloemsma
Amsterdam UMC Locatie AMC
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George S. Downward
Universiteit Utrecht IRAS
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Letty A. De Weger
Leids Universitair Medisch Centrum Public Health en Eerstelijnsgeneeskunde
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Suzanne Terheggen-Lagro
Amsterdam UMC Locatie AMC
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Yolanda van Wijck
Amsterdam UMC Locatie AMC
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Anke-Hilse Maitland - van der Zee
Amsterdam UMC Locatie AMC
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Berber Kapitein
Emma Kinderziekenhuis Amsterdam UMC
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Abstract

Background – The incidence of pediatric asthma exacerbations during the COVID-19 pandemic has been evaluated; however, the incidence of severe acute asthma (SAA) requiring a Pediatric Intensive Care Unit (PICU) admission is unknown. Furthermore, we examined several factors which might influence this incidence, such as environmental triggers or changes in COVID-19 lockdown regulations. Methods – In this single-center, retrospective cohort study running from 2018 to 2021, all PICU admissions for SAA of children above two years of age at a tertiary hospital in the Netherlands were included. Information on potential asthma triggers during the pandemic, including viral infections, concentrations of ambient fine particulate matter (PM2.5) and pollen index were evaluated. Results – In total, 168 children were included in this study. While we observed a decrease in PICU admissions for SAA during lockdown periods, there was an increase in the admission rates in the periods without a lockdown, with the highest peak from August to November of 2021. This peak in the fall of 2021 did not align with pollen or ambient PM2.5 concentrations (r s=-0.04 for pollen and r s=0.23 for PM2.5). Discussion – COVID-19 lockdowns influenced the admission rates for SAA at the PICU both during and after the lockdowns in the Netherlands. We hypothesize that an increase in viral infections after lockdown periods was the reason for the altered incidence of SAA at the PICU in late 2021, rather than air pollution and pollen concentrations.