Background The COVID-19 pandemic’s impact on people with asthma is poorly understood. We hypothesised that lockdown restrictions were associated with reductions in severe asthma exacerbations requiring emergency asthma admissions and/or leading to death. Methods Using data from Public Health Scotland and the Secure Anonymised Information Linkage Databank in Wales, we compared weekly counts of emergency admissions and deaths due to asthma over the first 18 weeks in 2020 with the national averages over 2015–2019. We modelled the impact of instigating lockdown on these outcomes using interrupted time-series analysis. Using fixed-effect meta-analysis, we derived pooled estimates of the overall changes in trends across the two nations. We also investigated trends in asthma-related primary care prescribing and emergency department (ED) attendances in Wales. Results Lockdown was associated with a 36% pooled reduction in emergency admissions for asthma (incidence rate ratio, IRR: 0.64, 95% CI: 0.49 to 0.83, p value 0.001) across both countries. There was no significant change in asthma deaths (pooled IRR: 0.57, 95% CI: 0.17 to 1.94, p value 0.37). ED asthma attendances in Wales declined during lockdown (IRR: 0.85, 95% CI: 0.73 to 0.99, p value 0.03). A large spike of 121% more inhaled corticosteroids and 133% more oral corticosteroid prescriptions was seen in Wales in the week before lockdown. Conclusions National lockdowns were associated with substantial reductions in severe asthma exacerbations leading to hospital admission across both Scotland and Wales, with no corresponding increase in asthma deaths. The anonymised person-level data used in this study are held by Public Health Scotland (PHS) and the Secure Anonymised Information Linkage (SAIL) Databank and are restricted and not publicly available but can be accessed upon reasonable requests from PHS and SAIL. All proposals to use SAIL are carefully reviewed by an independent Information Governance Review Panel to ensure proper and appropriate use of data (). When approved, access is then provided through the SAIL Gateway, a privacy-protecting safe haven and a secure remote access system.

中文翻译：

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COVID-19 封锁对哮喘紧急入院和死亡的影响：苏格兰和威尔士的全国中断时间序列分析

背景 人们对 COVID-19 大流行对哮喘患者的影响知之甚少。我们假设封锁限制与需要紧急哮喘入院和/或导致死亡的严重哮喘发作的减少有关。方法 利用苏格兰公共卫生部门和威尔士安全匿名信息链接数据库的数据，我们将 2020 年头 18 周内因哮喘而紧急入院和死亡的每周计数与 2015-2019 年全国平均水平进行了比较。我们使用中断时间序列分析来模拟封锁对这些结果的影响。使用固定效应荟萃分析，我们得出了两国趋势总体变化的汇总估计。我们还调查了威尔士哮喘相关初级保健处方和急诊科 (ED) 就诊率的趋势。结果 在这两个国家，封锁与哮喘紧急入院人数合计减少 36%（发病率比，IRR：0.64，95% CI：0.49 至 0.83，p 值 0.001）。哮喘死亡人数没有显着变化（汇总 IRR：0.57，95% CI：0.17 至 1.94，p 值 0.37）。威尔士的急诊室哮喘就诊率在封锁期间有所下降（IRR：0.85，95% CI：0.73 至 0.99，p 值 0.03）。在封锁前一周，威尔士的吸入皮质类固醇增加了 121%，口服皮质类固醇处方增加了 133%。结论 在苏格兰和威尔士，全国封锁与导致入院的严重哮喘发作大幅减少有关，但哮喘死亡人数没有相应增加。本研究中使用的匿名个人数据由苏格兰公共卫生局 (PHS) 和安全匿名信息链接 (SAIL) 数据库持有，受到限制且不公开，但可以根据 PHS 和 SAIL 的合理请求进行访问。所有使用 SAIL 的提案均由独立的信息治理审查小组仔细审查，以确保数据的正确和适当使用（）。获得批准后，将通过 SAIL 网关（保护隐私的安全港和安全远程访问系统）提供访问权限。