365 - The Disappearance and Return of the September Asthma Peak

Sunday, April 30, 2023

3:30 PM – 6:00 PM ET

Poster Number: 365
Publication Number: 365.302

Jessica P. Hollenbach, Connecticut Children's medical Center, Hartford, CT, United States; Alexander H. Hogan, Connecticut Children's, Hartford, CT, United States; Christopher Carroll, Connecticut Children's Medical Center, Hartford, CT, United States; Jesse Sturm, University of Connecticut School of Medicine, West Hartford, CT, United States; Caleb Wasser, UCONN School of Medicine, Hartford, CT, United States; Melanie S. Collins, University of CT SOM, Hartford, CT, United States

Presenting Author(s)

JH

Jessica P. Hollenbach, PhD (she/her/hers)

Connecticut Children's medical Center
Hartford, Connecticut, United States

Background: The return to school is a major risk factor for asthma exacerbations among school-aged children and leads to a Northern Hemisphere phenomenon called “asthma September peak.”

Objective:

Whether a similar trend would resume after schoolchildren returned to in-person school without SARS-CoV-2 mitigation measures is the issue addressed in this analysis.

Design/Methods:

This is a retrospective cross-sectional study using the Pediatric Health Information System database. Inclusion criteria were comprised of children 2 – 18 years, discharged with an APR-DRG for asthma (141.xx) from a hospital with continuous data throughout the study timeframe. We fit a seasonally-adjusted autoregressive integrated moving average model to assess temporal trends.

Results:

Between September 2012 and October 2022, 652,652 children presented to the ED for an asthma exacerbation. The median age was 6 years old (IQR 4.0-10.0) with 61% reporting male sex at birth, almost half (48%) reporting Black race, and 70% publicly-insured. When modeling actual versus predicted rates, actual asthma-related ED visits were below the predicted rates in the Spring of 2020 (~1,000 vs 5,000), whereas the actual rates were higher than the predicted rates in October 2022 (~8,000 vs 6,800).

Conclusion(s): The asthma September peak, after blunting in 2020, has returned with a vengeance, with cases in 2022 exceeding predicted rates. These data likely reflect the return of seasonal upper respiratory virus transmission in the Northern Hemisphere as SARS-CoV-2 mitigation measures have abated.