![]() ![]() Finally, we compared ED utilization trends with the daily positivity for COVID-19 testing for all children, as well as children with asthma, within the same ED. We then stratified asthma visits by level of triage acuity for 2020 in a second time series plot and calculated the proportion of children subsequently hospitalized in the pre-COVID and COVID-era intervals. We used a X and S statistical process control chart to depict mean daily ED utilization from 2016-2019, as well as 3 standard deviations (SD) from the mean.( 3, 4) We then compared the mean daily asthma ED visits in 2020 pre-COVID-19 (-) to the mean daily asthma ED visits for the month following the first positive case in our ED (-) using a paired t-test. We abstracted data on visits to the ED during the first four months of 2020 that included an asthma diagnosis entered by an ED provider into the electronic health record using a validated ICD code grouping system.( 2) We compared these data to average daily visits for the corresponding four months of years 2016-2019 using longitudinal time series plots. In this report, we describe the trends in ED utilization in the first four months of 2020 in comparison to prior years, allowing us to account for year-to-year differences in seasonal utilization. With nearly 6000 asthma ED visits and over 2000 asthma hospitalizations every year, our hospital is a high-volume center with several on-going data collection efforts to monitor and respond to changes in asthma emergency care utilization. The emergence and spread of the novel SARS-CoV2 virus in the US coincided with spring in the Northeastern US, and many national and international health organizations, including the Centers for Disease Control, were concerned that asthma would be a risk factor for worse outcomes.( 1) The impact of the emergence of COVID-19 and institution of social distancing public health measures on health system utilization for childhood asthma has not been described. Putative drivers of this phenomenon include seasonal allergens and the tail of winter respiratory viruses. ![]() Spring in the Northeastern United States (US) usually represents a period of relatively high emergency department (ED) utilization for childhood asthma. ![]()
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