Study Examines Asthma Exacerbations Before and After COVID-19 Pandemic Onset

Results of a recent study showed that asthma attacks have substantially decreased in Black and Hispanic/Latinx individuals with the onset of the COVID-19 pandemic.

The findings, which were published in the Journal of Allergy & Clinical Immunology: In Practice, demonstrated that asthma attacks decreased by more than 40% in this population. Data were collected as part of a trial in Black and Hispanic/Latinx patients with asthma that began prior to the pandemic.

Investigators from Brigham and Women’s Hospital aimed to determine whether the drop in asthma attacks was due to individuals avoiding emergency departments during the pandemic or due to better asthma control. The data analyzed was collected as part of the PREPARE Trial, which is examining interventions to reduce asthma attacks in Black and Hispanic/Latinx adults with moderate to severe asthma supported by The Patient Centered Outcome Research Institute. For the study, nearly 1200 participants completed monthly questionnaires remotely for 15 months, either online, by phone, or by mail.

According to the results, there was an overall significant reduction (40%) in asthma exacerbation rates between the winter and spring of 2020 compared with 2019. The effect was greatest in Hispanic/Latinx individuals, those working outside the home at the time of enrollment, and in those with non-type-2 inflammation. Non-hypertensive patients also demonstrated a greater reduction. 

“We found a substantial decrease in asthma exacerbation––on the order of what we see for biologic therapies for severe asthma,” said lead author Justin Salciccioli, MBBS, MA, a fellow in the Division of Pulmonary and Critical Care Medicine at Brigham. “Although we don’t know for sure who in the cohort changed their behavior, it’s likely that decreased exposure to environmental or viral triggers contributed to our findings.”

The investigators noted that potential explanations for these observed decreases may include decreased exposure to environmental and occupational factors, reduced respiratory infections, and/or changes in stress.

“This is the first study to assess asthma exacerbation before and after the COVID-19 pandemic using data that are unlikely to be affected by patients avoiding the health care system,” Salciccioli said. “Because this was part of a prospective trial that started before the pandemic and was planned to be remote, it gave us a unique window into how changes during the pandemic may have led to a dramatic decrease in asthma exacerbation.”

References

1. Salciccioli JD, She L, Tulchinsky A, Rockhold F, et al. Effect of Covid19 on asthma exacerbation. The Journal of Allergy and Clinical Immunology: In Practice. 2021. doi: https://doi.org/10.1016/j.jaip.2021.04.038.
2. Asthma attacks plummeted among Black and hispanic/latinx individuals during the COVID-19 pandemic. News Release. Brigham and Women’s Hospital; May 6, 2021. Accessed May 7, 2021.