Impact of COVID-19 mitigation strategies on asthma hospitalizations in Brazil

Abstract

Background: In 2020, a unique social experience was provided by the pandemic of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2. Interventions to tackle the pandemic may affect the burden of other respiratory diseases.

Objective: This study aims to assess the impact of the COVID-19 mitigation strategies on hospitalizations for asthma in children aged between 1 and 14 years, adults aged between 20 and 59 years, and elderly older than 60 years.

Methods: Data from hospital admissions for asthma were obtained from the Department of Informatics of Brazilian Public Health System database in the period between January 2016 and December 2020 and analyzed by age groups. To evaluate the effect of containment measures on the incidence of asthma and respiratory system diseases (total), the absolute reduction and relative reduction were calculated by analyzing the subsets from 2016 to 2019 versus 2020.

Results: There was a significant reduction in the average incidence of hospitalizations in 2020, with numbers ranging from -59% (incidence rate ratio, 0.41 [0.37-0.45]) for age 1 to 14 years (prepandemic 1,393.2/100,000 vs pandemic 574.9/100.000), -37% (incidence rate ratio, 0.63 [0.49-0.80]) for age 20 to 59 years (prepandemic 160.2/100,000 vs pandemic 101.1/100,000), and -60% (incidence rate ratio, 0.40 [0.33-0.47]) for older than 60 years (prepandemic 460.6/100,000 vs pandemic 185.3/100,000).

Conclusions: Ashtma hospitalizations decreased in 2020, especially in the pediatric group and the older group during the COVID-19 pandemic, which may be associated with the reduction in the incidence of many respiratory viral infections.

Keywords: COVID-19; COVID-19, Coronavirus disease 2019; DATASUS, Informatics Department of the Unified Health System; ICD-10, International Classification of Diseases, 10th edition; IRR, Incidence rate ratio; asthma; hospitalization.

Fig 1

Monthly subsets’ distribution of incidence (no social distance period vs social distance period) of hospitalizations for asthma and respiratory system diseases in (A and D) children aged 1 to 14 years, (B and E) adults 20 to 59 years of age, and (C and F) elderly older than 60 years in Brazil.

Fig 2

Monthly distribution of incidence of hospitalizations for children with leukemia aged 1 to 14 years in Brazil (2016-2020). ICD-10 code C95.0, a noncommunicable disease.