Utilizing patient-centered and administrative data to uncover the COVID-19 pandemic's impact on adverse asthma outcomes in children

Asthma affects 1 in 10 Canadian children. Typically, an annual peak in asthma flare-ups is observed in the fall months, with a smaller peak in the spring. There was a significant decrease in asthma-related emergency department (ED) visits and hospitalizations during the initial lockdown in spring 2020, likely due to the limited spread of respiratory viruses, a common asthma trigger in children, during the lockdown. However, our preliminary data show that with the relaxation of lockdown measures in spring 2021, there is a resurgence in the number of ED visits and hospitalizations. We hypothesize that respiratory viruses increased with the relaxation of lockdown measures, and that reduced access to healthcare services, reduced asthma medication adherence, and decrease physical activity during the pandemic could have led to poorly controlled asthma when relaxation of lockdown measures occurred, leading to a vulnerable period for asthma flare-ups. Our study's goal is to evaluate the impact of the COVID-19 pandemic on adverse asthma outcomes and to uncover the underlying mechanisms at the patient and population level. Having a better understanding of the trends in asthma flare-ups during/after the pandemic and the factors that influence these trends can help clinicians better manage childhood asthma during the rest of the pandemic and in the future. First, we will leverage an online platform built by our team to determine the associations between patient-related behaviors and asthma control, asthma-related ED visits and hospitalizations during and after the pandemic through electronic questionnaires. Second, we will use Canadian and provincial administrative databases to evaluate the impact of province-specific lockdown/lockdown-lifting measures and school closures/reopenings on asthma-related ED visits and hospitalizations.