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Rebound in asthma exacerbations following relaxation of COVID-19 restrictions: a longitudinal population-based study (COVIDENCE UK)

Florence Tydeman, Paul E Pfeffer Orcid Logo, Giulia Vivaldi, Hayley Holt, Mohammad Talaei Orcid Logo, David Jolliffe Orcid Logo, Gwyneth Davies Orcid Logo, Ronan Lyons Orcid Logo, Christopher Griffiths, Frank Kee Orcid Logo, Aziz Sheikh Orcid Logo, Seif O Shaheen Orcid Logo, Adrian R Martineau Orcid Logo

Thorax, Volume: 78, Pages: thorax - 2022

Swansea University Authors: Gwyneth Davies Orcid Logo, Ronan Lyons Orcid Logo

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DOI (Published version): 10.1136/thorax-2022-219591

Abstract

Background The imposition of restrictions on social mixing early in the COVID-19 pandemic was followed by a reduction in asthma exacerbations in multiple settings internationally. Temporal trends in social mixing, incident acute respiratory infections (ARI) and asthma exacerbations following relaxat...

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Published in: Thorax
ISSN: 0040-6376 1468-3296
Published: BMJ 2023
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Temporal trends in social mixing, incident acute respiratory infections (ARI) and asthma exacerbations following relaxation of COVID-19 restrictions have not yet been described.Methods We conducted a population-based longitudinal study in 2312 UK adults with asthma between November 2020 and April 2022. Details of face covering use, social mixing, incident ARI and severe asthma exacerbations were collected via monthly online questionnaires. Temporal changes in these parameters were visualised using Poisson generalised additive models. Multilevel logistic regression was used to test for associations between incident ARI and risk of asthma exacerbations, adjusting for potential confounders.Results Relaxation of COVID-19 restrictions from April 2021 coincided with reduced face covering use (p&lt;0.001), increased frequency of indoor visits to public places and other households (p&lt;0.001) and rising incidence of COVID-19 (p&lt;0.001), non-COVID-19 ARI (p&lt;0.001) and severe asthma exacerbations (p=0.007). Incident non-COVID-19 ARI associated independently with increased risk of asthma exacerbation (adjusted OR 5.75, 95% CI 4.75 to 6.97) as did incident COVID-19, both prior to emergence of the omicron variant of SARS-CoV-2 (5.89, 3.45 to 10.04) and subsequently (5.69, 3.89 to 8.31).Conclusions Relaxation of COVID-19 restrictions coincided with decreased face covering use, increased social mixing and a rebound in ARI and asthma exacerbations. Associations between incident ARI and risk of severe asthma exacerbation were similar for non-COVID-19 ARI and COVID-19, both before and after emergence of the SARS-CoV-2 omicron variant.</abstract><type>Journal Article</type><journal>Thorax</journal><volume>78</volume><journalNumber/><paginationStart>thorax</paginationStart><paginationEnd>2022</paginationEnd><publisher>BMJ</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0040-6376</issnPrint><issnElectronic>1468-3296</issnElectronic><keywords/><publishedDay>2</publishedDay><publishedMonth>10</publishedMonth><publishedYear>2023</publishedYear><publishedDate>2023-10-02</publishedDate><doi>10.1136/thorax-2022-219591</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>This study was supported by a grant from the Barts Charity to ARM and CJG (ref MGU0466). The work was carried out with the support of BREATHE - The Health Data Research Hub for Respiratory Health in partnership with SAIL Databank. BREATHE is funded by UK Research and Innovation (ref MC_PC_19004 to AS) and delivered through Health Data Research UK. 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spelling 2024-06-19T13:24:07.1206752 v2 66443 2024-05-15 Rebound in asthma exacerbations following relaxation of COVID-19 restrictions: a longitudinal population-based study (COVIDENCE UK) 92d69cf8519a334ced3f55142c811d95 0000-0003-1218-1008 Gwyneth Davies Gwyneth Davies true false 83efcf2a9dfcf8b55586999d3d152ac6 0000-0001-5225-000X Ronan Lyons Ronan Lyons true false 2024-05-15 MEDS Background The imposition of restrictions on social mixing early in the COVID-19 pandemic was followed by a reduction in asthma exacerbations in multiple settings internationally. Temporal trends in social mixing, incident acute respiratory infections (ARI) and asthma exacerbations following relaxation of COVID-19 restrictions have not yet been described.Methods We conducted a population-based longitudinal study in 2312 UK adults with asthma between November 2020 and April 2022. Details of face covering use, social mixing, incident ARI and severe asthma exacerbations were collected via monthly online questionnaires. Temporal changes in these parameters were visualised using Poisson generalised additive models. Multilevel logistic regression was used to test for associations between incident ARI and risk of asthma exacerbations, adjusting for potential confounders.Results Relaxation of COVID-19 restrictions from April 2021 coincided with reduced face covering use (p<0.001), increased frequency of indoor visits to public places and other households (p<0.001) and rising incidence of COVID-19 (p<0.001), non-COVID-19 ARI (p<0.001) and severe asthma exacerbations (p=0.007). Incident non-COVID-19 ARI associated independently with increased risk of asthma exacerbation (adjusted OR 5.75, 95% CI 4.75 to 6.97) as did incident COVID-19, both prior to emergence of the omicron variant of SARS-CoV-2 (5.89, 3.45 to 10.04) and subsequently (5.69, 3.89 to 8.31).Conclusions Relaxation of COVID-19 restrictions coincided with decreased face covering use, increased social mixing and a rebound in ARI and asthma exacerbations. Associations between incident ARI and risk of severe asthma exacerbation were similar for non-COVID-19 ARI and COVID-19, both before and after emergence of the SARS-CoV-2 omicron variant. Journal Article Thorax 78 thorax 2022 BMJ 0040-6376 1468-3296 2 10 2023 2023-10-02 10.1136/thorax-2022-219591 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee This study was supported by a grant from the Barts Charity to ARM and CJG (ref MGU0466). The work was carried out with the support of BREATHE - The Health Data Research Hub for Respiratory Health in partnership with SAIL Databank. BREATHE is funded by UK Research and Innovation (ref MC_PC_19004 to AS) and delivered through Health Data Research UK. MT is supported by a grant from the Barts Charity (ref MGU0570). 2024-06-19T13:24:07.1206752 2024-05-15T12:09:44.8292914 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Florence Tydeman 1 Paul E Pfeffer 0000-0003-0369-2885 2 Giulia Vivaldi 3 Hayley Holt 4 Mohammad Talaei 0000-0002-6901-3665 5 David Jolliffe 0000-0003-3592-1945 6 Gwyneth Davies 0000-0003-1218-1008 7 Ronan Lyons 0000-0001-5225-000X 8 Christopher Griffiths 9 Frank Kee 0000-0002-0606-8167 10 Aziz Sheikh 0000-0001-7022-3056 11 Seif O Shaheen 0000-0002-7273-8691 12 Adrian R Martineau 0000-0001-5387-1721 13 66443__30381__688c3ece2def4311b8c3d0fb0b13544f.pdf 66443.pdf 2024-05-15T12:12:04.1468105 Output 1424312 application/pdf Version of Record true This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license. true eng https://creativecommons.org/licenses/by/4.0/
title Rebound in asthma exacerbations following relaxation of COVID-19 restrictions: a longitudinal population-based study (COVIDENCE UK)
spellingShingle Rebound in asthma exacerbations following relaxation of COVID-19 restrictions: a longitudinal population-based study (COVIDENCE UK)
Gwyneth Davies
Ronan Lyons
title_short Rebound in asthma exacerbations following relaxation of COVID-19 restrictions: a longitudinal population-based study (COVIDENCE UK)
title_full Rebound in asthma exacerbations following relaxation of COVID-19 restrictions: a longitudinal population-based study (COVIDENCE UK)
title_fullStr Rebound in asthma exacerbations following relaxation of COVID-19 restrictions: a longitudinal population-based study (COVIDENCE UK)
title_full_unstemmed Rebound in asthma exacerbations following relaxation of COVID-19 restrictions: a longitudinal population-based study (COVIDENCE UK)
title_sort Rebound in asthma exacerbations following relaxation of COVID-19 restrictions: a longitudinal population-based study (COVIDENCE UK)
author_id_str_mv 92d69cf8519a334ced3f55142c811d95
83efcf2a9dfcf8b55586999d3d152ac6
author_id_fullname_str_mv 92d69cf8519a334ced3f55142c811d95_***_Gwyneth Davies
83efcf2a9dfcf8b55586999d3d152ac6_***_Ronan Lyons
author Gwyneth Davies
Ronan Lyons
author2 Florence Tydeman
Paul E Pfeffer
Giulia Vivaldi
Hayley Holt
Mohammad Talaei
David Jolliffe
Gwyneth Davies
Ronan Lyons
Christopher Griffiths
Frank Kee
Aziz Sheikh
Seif O Shaheen
Adrian R Martineau
format Journal article
container_title Thorax
container_volume 78
container_start_page thorax
publishDate 2023
institution Swansea University
issn 0040-6376
1468-3296
doi_str_mv 10.1136/thorax-2022-219591
publisher BMJ
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
document_store_str 1
active_str 0
description Background The imposition of restrictions on social mixing early in the COVID-19 pandemic was followed by a reduction in asthma exacerbations in multiple settings internationally. Temporal trends in social mixing, incident acute respiratory infections (ARI) and asthma exacerbations following relaxation of COVID-19 restrictions have not yet been described.Methods We conducted a population-based longitudinal study in 2312 UK adults with asthma between November 2020 and April 2022. Details of face covering use, social mixing, incident ARI and severe asthma exacerbations were collected via monthly online questionnaires. Temporal changes in these parameters were visualised using Poisson generalised additive models. Multilevel logistic regression was used to test for associations between incident ARI and risk of asthma exacerbations, adjusting for potential confounders.Results Relaxation of COVID-19 restrictions from April 2021 coincided with reduced face covering use (p<0.001), increased frequency of indoor visits to public places and other households (p<0.001) and rising incidence of COVID-19 (p<0.001), non-COVID-19 ARI (p<0.001) and severe asthma exacerbations (p=0.007). Incident non-COVID-19 ARI associated independently with increased risk of asthma exacerbation (adjusted OR 5.75, 95% CI 4.75 to 6.97) as did incident COVID-19, both prior to emergence of the omicron variant of SARS-CoV-2 (5.89, 3.45 to 10.04) and subsequently (5.69, 3.89 to 8.31).Conclusions Relaxation of COVID-19 restrictions coincided with decreased face covering use, increased social mixing and a rebound in ARI and asthma exacerbations. Associations between incident ARI and risk of severe asthma exacerbation were similar for non-COVID-19 ARI and COVID-19, both before and after emergence of the SARS-CoV-2 omicron variant.
published_date 2023-10-02T14:33:23Z
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