ArticleAllergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology2026
The acuity of paediatric asthma in the emergency department worsened after the COVID-19 pandemic in Alberta, Canada.
Article in Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAsthma affects about 13% of Canadian children and is a common reason for emergency department (ED) visits or hospitalization. The COVID-19 pandemic significantly impacted the health care utilisation of children with asthma. The aim of this study was to investigate how paediatric ED visits were influenced by the pandemic.
methodsWe conducted a retrospective study examining asthma ED visits, admission rates, and presentation acuity for children 2 to 17-years-old from 2011 to 2024. Presentation acuity was determined using Canadian Triage and Acuity Scale (CTAS). Data were collected from the Government of Alberta Interactive Health Data Application and the Alberta Health Services aggregated administrative database. Data were analysed graphically. Interrupted time series (ITS) analysis of monthly ED visits and admissions, with March 2020 as the intervention point.
resultsThe mean daily incidence of ED visits remained at 5-10 per million per year for ages 2-12 years, and under 5 per million per year for ages 13-17 years, except for a transient interruption in the early pandemic, in 2020. Following this interruption, the pre-existing trend to worsening acuity and greater rates of hospitalization accelerated in the late pandemic. The acuity and hospitalization rates have remained elevated in the post-pandemic years. Emergency medical services (EMS) visits increased substantially across paediatric subgroups in 2024, ranging from 1.53× to 2.26× higher among children aged 2-12 years compared with pre-pandemic levels. ITS analysis showed a significant immediate decrease in ED visits and admissions, followed by a positive post-intervention slope, indicating gradual recovery over time.
conclusionPre-existing trends in paediatric asthma exacerbations worsened in the years following 2020. Although the incidence of ED visits did not substantially increase, children were more likely to have severe exacerbations and require hospitalization in the late pandemic and post-pandemic years relative to pre-pandemic years.
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