AAAAI 2023: Prescription Rate for Systemic Corticosteroids for Asthma Higher in Delta, Omicron Versus Early COVID-19 Wave
Increased prescription rate seen despite overall milder clinical course as evidenced by decreases in emergency visits and hospitalizations for asthma patients
MONDAY, March 6, 2023 (HealthDay News) – Despite evidence of less severe disease, asthma exacerbations increased during the delta and omicron waves of the COVID-19 pandemic based on increases in prescriptions for systemic corticosteroids, according to a study presented at the annual meeting of the American Academy of Allergy, Asthma, and Immunology, held from Feb. 24 to 27 in San Antonio.
Elizabeth A. Kudlaty, M.D., from Northwestern University in Chicago, and colleagues analyzed medical records from asthma patients with polymerase chain reaction test-confirmed COVID-19 across three time periods associated with the alpha (2,424 patients), delta (2,136 patients), and omicron (8,338 patients) variants. Prescription rates of systemic corticosteroids and antibiotics, as well as emergency department visits and hospitalizations, were compared across the three time periods.
The researchers found that 18.5 percent of patients received systemic corticosteroid prescriptions during the alpha wave versus 32 percent during the delta wave and 28 percent during the omicron wave. The researchers hypothesized that the lower rate of systemic corticosteroid prescriptions during the alpha wave may reflect either an actual decreased rate of asthma exacerbations or a lower number of prescriptions due to the unknown impact of corticosteroids during the early days of the pandemic.
Rates of emergency department visits by asthma patients declined across the three time periods, from 31 percent during the alpha wave to 21.1 percent in the delta wave and 18.4 percent in the omicron wave. Similarly, rates of hospitalization decreased from 25 percent during the alpha wave to 17.6 percent during the delta wave and 11 percent during the omicron wave. Patients with asthma were no more likely to be hospitalized versus those without asthma during the omicron wave, suggesting that asthmatics do not have higher severity of disease.
“This study informs our practice in that it suggests that omicron may have a milder clinical course for both asthmatics and nonasthmatics, as evidenced by health care utilization,” Kudlaty told Elsevier’s PracticeUpdate. “It confirms and informs our practice of being thoughtful about prescribing systemic corticosteroids following infection with the emerging COVID-19 variants in asthmatic patients, as these patients may continue to experience increased asthma exacerbations relative to the initial alpha variant.”
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