The Association of Environmental Factors and COVID19 on Acute Pediatric Asthma-Related Healthcare Utilization in New York City: A Retrospective Analysis

BACKGROUND AND AIM: Asthma is a multifactorial disease with well-established environmental triggers that contribute to asthma exacerbations, often requiring acute medical attention. During the onset of the COVID-19 pandemic, healthcare utilization patterns for both preventive and acute services were altered. We aim to identify how the rates of pediatric emergency department (ED) visits and hospitalizations for asthma were impacted by the COVID-19 pandemic in a hospital setting in New York City (NYC). METHODS: A time series analysis for pediatric asthma-related ED visits and hospitalizations will be analyzed from 3/1/2015 to 2/28/21. Using this data we will develop a statistical inference system to identify healthcare utilization patterns for asthma exacerbations attributable to various environmental triggers (I.e., air pollutants, pollens, infectious agents). RESULTS:Pediatric asthma-related ED visits and hospitalizations decreased by 78% and 75%, respectively, during the first year of the pandemic (3/1/20-2/28/21). During the initial 12 weeks following NYC’s PAUSE order (March 22nd, 2020) a 92% reduction in admissions was observed, relative to the same time period the previous year. We plan to use environmental exposure data to make projections of the number of ED visits and hospitalizations that would have been expected during the 1st year of the outbreak and will then compare this projected data to the observed asthma-related encounters. This counterfactual simulation will provide us insight into the difference between expected and observed asthma-related acute healthcare utilization during the pandemic. CONCLUSIONS:It is important to develop an inference system to provide insight on how changes in behavioral patterns and environment exposures affect asthma-related health care utilization, in order to plan current and future public health interventions in a timely manner. KEYWORDS: Asthma, COVID-19, Children's environmental health, Policy research, Environmental justice