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Impact of COVID-19 pandemic waves on pediatric emergency department patients presenting with asthma attacks in Taiwan

  • Hsin-Kuan Wu1
  • En-Shuo Chang2
  • Chien-Wei Cheng1
  • Wei-Che Chien3
  • Hsin-Hui Chou1,*,

1Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 204 Keelung, Taiwan

2Division of Pediatric Gastroenterology, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, 333 Taoyuan, Taiwan

3Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and Chang Gung University College of Medicine, 333 Taoyuan, Taiwan

DOI: 10.22514/sv.2022.045 Vol.18,Issue 6,November 2022 pp.27-32

Submitted: 09 February 2022 Accepted: 14 April 2022

Published: 08 November 2022

*Corresponding Author(s): Hsin-Hui Chou E-mail:


The number of pediatric emergency department (PED) visits fell significantly during the coronavirus disease 2019 (COVID-19) pandemic. However, the impact of the ongoing pandemic on PED patients suffering from asthma attacks in Taiwan has not been studied. We thus analyzed patients with asthma attacks visiting a PED during the early stage of the COVID-19 pandemic and the following (resurgent) waves. We retrospectively studied pediatric patients with asthma attacks who visited the PED from 01 January 2019 to 30 September 2021. We retrieved patient numbers, demographic characteristics, triage acuities, medications, and PED dispositions during the various waves of the COVID-19 pandemic. A total of 1842 patients with asthmatic attacks presented to the PED during the study period. PED visits caused by asthmatic attacks declined by 55% after the first COVID-19 outbreak in early 2020 (p = 0.009) and fell even more remarkably (by 85%) in mid-2021 (p = 0.038), during the time when the numbers of confirmed COVID-19 cases skyrocketed (the second wave). However, neither the high-triage acuity rate nor the rate of admission differed between the two periods (p = 0.08 and 0.406, respectively). However, the proportion of systemic corticosteroid (SCS) prescriptions increased during the pandemic (81.90 vs. 77.77%, p = 0.029). The COVID-19 pandemic notably impacted the number of asthmatic PED visits not only during the first peak period but also during the following waves, but asthma severity did not vary over time. Physicians tended to prescribe more SCSs during the pandemic to control respiratory symptoms. We suggest that SCSs should be used cautiously even during the pandemic to minimize their adverse effects.


Pediatric emergency department; Asthma; Pediatric; Hospital volume; COVID-19; Corticosteroid

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Hsin-Kuan Wu,En-Shuo Chang,Chien-Wei Cheng,Wei-Che Chien,Hsin-Hui Chou. Impact of COVID-19 pandemic waves on pediatric emergency department patients presenting with asthma attacks in Taiwan. Signa Vitae. 2022. 18(6);27-32.


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