Background The impact of COVID-19 and ensuing national lockdown on asthma exacerbations is unclear. Methods We conducted an interrupted time-series (lockdown on 23 March 2020 as point of interruption) analysis in asthma cohort identified using a validated algorithm from a national-level primary care database, the Optimum Patient Care Database. We derived asthma exacerbation rates for every week and compared exacerbation rates in the period: January to August 2020 with a pre-COVID-19 period and January to August 2016–2019. Exacerbations were defined as asthma-related hospital attendance/admission (including accident and emergency visit), or an acute course of oral corticosteroids with evidence of respiratory review, as recorded in primary care. We used a generalised least squares modelling approach and stratified the analyses by age, sex, English region and healthcare setting. Results From a database of 9 949 387 patients, there were 100 165 patients with asthma who experienced at least one exacerbation during 2016–2020. Of 278 996 exacerbation episodes, 49 938 (17.9%) required hospital visit. Comparing pre-lockdown to post-lockdown period, we observed a statistically significant reduction in the level (−0.196 episodes per person-year; p<0.001; almost 20 episodes for every 100 patients with asthma per year) of exacerbation rates across all patients. The reductions in level in stratified analyses were: 0.005–0.244 (healthcare setting, only those without hospital attendance/admission were significant), 0.210–0.277 (sex), 0.159–0.367 (age), 0.068–0.590 (region). Conclusions There has been a significant reduction in attendance to primary care for asthma exacerbations during the pandemic. This reduction was observed in all age groups, both sexes and across most regions in England. Data may be obtained from a third party and are not publicly available. The dataset for this work can be accessed from OPCRD () subject to protocol approval from an independent scientific advisory committee, ADEPT (Anonymized Data Ethics and Protocol Transparency committee). The code used in the analysis in our current work will be made available at under Creative Commons License.

中文翻译：

---

COVID-19 全国封锁对哮喘急性发作的影响：英国初级保健数据的中断时间序列分析


背景 COVID-19 和随后的全国封锁对哮喘恶化的影响尚不清楚。方法 我们对哮喘队列进行了中断时间序列（以 2020 年 3 月 23 日为中断点）分析，该分析使用来自国家级初级保健数据库（最佳患者护理数据库）的经过验证的算法进行识别。我们得出每周的哮喘急性发作率，并将 2020 年 1 月至 8 月期间与 COVID-19 之前时期以及 2016-2019 年 1 月至 8 月期间的哮喘发作率进行比较。病情加重被定义为与哮喘相关的医院就诊/入院（包括事故和急诊就诊），或口服皮质类固醇的急性疗程，并有初级保健记录的呼吸系统检查证据。我们使用广义最小二乘建模方法，并按年龄、性别、英国地区和医疗保健环境进行分层分析。结果 在包含 9 949 387 名患者的数据库中，有 100 165 名哮喘患者在 2016 年至 2020 年期间经历过至少一次哮喘加重。在 278 996 例急性加重发作中，有 49 938 例 (17.9%) 需要去医院就诊。比较封锁前和封锁后，我们观察到哮喘发作率在统计上显着下降（每人每年 -0.196 次发作；p<0.001；每年每 100 名哮喘患者几乎有 20 次发作）所有患者。分层分析中的水平降低为：0.005–0.244（医疗机构，仅那些没有住院/入院的患者才显着）、0.210–0.277（性别）、0.159–0.367（年龄）、0.068–0.590（地区）。结论 在大流行期间，因哮喘急性加重而前往初级保健机构就诊的人数显着减少。 在英格兰大部分地区的所有年龄组、男女中都观察到了这种下降。数据可能从第三方获得，并且不公开。这项工作的数据集可以从 OPCRD () 访问，但须经独立科学咨询委员会 ADEPT（匿名数据伦理和协议透明度委员会）的协议批准。我们当前工作中分析中使用的代码将在知识共享许可下提供。