Impact of COVID-19 on Patients With Asthma in US Routine Care

Author(s)

Noorduyn SG1, Paczkowski R2, Lee LY2, Steffens A3, Bancroft T3, Rothnie K4, Gelwicks S5, Birch HJ6, Compton C6, Leather D6, Requena G4, Ismaila A2
1Value Evidence and Outcomes, GSK, Mississauga, ON, Canada, 2Value Evidence and Outcomes, R&D Global Medical, GSK, Collegeville, PA, USA, 3Health Economics and Outcomes Research, Optum, Eden Prairie, MN, USA, 4Epidemiology, Value Evidence and Outcomes, R&D Global Medical, GSK, Brentford, Middlesex, UK, 5Real World Data Analytics, Value Evidence and Outcomes, R&D Global Medical, GSK, Collegeville, PA, USA, 6Value Evidence and Outcomes, R&D Global Medical, GSK, Brentford, Middlesex, UK

OBJECTIVES: To describe changes in the rate of exacerbations among patients with asthma before, during, and after the COVID-19 pandemic.

METHODS: A longitudinal cohort of patients with asthma was identified within the Optum Research Database of medical claims. Patients were followed from January 2018–May 2022 or until disenrollment. Baseline characteristics and exacerbation rates were described monthly across the study period, overall and by exacerbation components. Claims-based components of exacerbations included hospitalizations, emergency department (ED) visits, and systemic corticosteroids (SCS).

RESULTS: A cohort of 143,053 patients with asthma were identified in 2018 and followed until 2022. Mean age (standard deviation) was 59.8 (17.2) years and 69% of patients were female. Common comorbidities included allergic rhinitis (40%), cardiovascular disease (26%), and depression (23%).

From Jan 2018March 2020, the monthly proportion of patients with at least one exacerbation ranged between 1.4% and 2.7%, with peaks observed in DecemberFebruary of each year. At the start of the pandemic (April 2020) the monthly proportion dropped to its lowest point (1.0%) and remained low compared to pre-pandemic levels (ranged 0.9% to 1.3%) until the end of study period.

Exacerbation rates varied with seasonality across the study periods, with an apparent decrease in April 2020. ED visits, hospitalizations and SCS decreased proportionately. Exacerbation rates did not return to pre-pandemic time despite slight increases from April 2020 to the end of the study period in May 2022.

CONCLUSIONS: Asthma exacerbation rates decreased proportionately during the COVID-19 pandemic and did not appear to return to pre-pandemic levels by May 2022. COVID-19-related outcomes followed temporal trends in this cohort. It is unclear whether observed changes in asthma outcomes are attributable to changes in behaviors, care, or environmental factors. COVID-19 remains a potential confounder in claims-based analyses of asthma outcomes.

FUNDING: GSK (214628)

Conference/Value in Health Info

2023-11, ISPOR Europe 2023, Copenhagen, Denmark

Value in Health, Volume 26, Issue 11, S2 (December 2023)

Code

CO147

Topic

Clinical Outcomes

Topic Subcategory

Clinician Reported Outcomes

Disease

No Additional Disease & Conditions/Specialized Treatment Areas, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)

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