Study finds increased risk of severe asthma attacks after easing Covid-19 restrictions

Adults with asthma were at any given time about twice as likely to have a severe asthma attack after the UK eased Covid-19 restrictions, according to a new study from Queen Mary University of London funded by Barts Charity.

Episodes of progressive worsening of asthma symptoms, known as exacerbations or asthma attacks, are the leading cause of illness and death in the condition. Asthma affects more than 5 million people in the UK and more than 300 million worldwide. Symptoms include shortness of breath and chest tightness, as well as wheezing and coughing.

Published in thorax The study, presented at today’s British Thoracic Society meeting, found an increased risk of these attacks after Covid-19 restrictions were eased. When restrictions were lifted, fewer people wore face coverings and there was more social mixing and consequently a higher risk of Covid-19 and other acute respiratory infections. The research also found that Covid-19 is not significantly more likely to trigger asthma attacks than other respiratory infections.

In April 2021, when restrictions on social contact and the requirement for face coverings were eased, 1.7 percent of participants reported having had a severe asthma attack in the previous month. In January 2022, this share more than doubled to 3.7 percent.

The study analyzed data from 2,312 UK adults with asthma who participated in Queen Mary’s COVIDENCE UK study between November 2020 and April 2022. Details on face covering use, social mixing and asthma symptoms were collected via monthly online questionnaires.

Professor Adrian Martineau, lead author of the study and Clinical Professor of Respiratory Infections and Immunity at Queen Mary University of London, said: “This study shows that the easing of Covid-19 restrictions is associated with an increased risk of severe asthma attacks. Our study was observational, so it cannot prove cause and effect. But our findings raise the possibility that certain elements of the public health measures put in place during the pandemic — such as wearing face masks — could help reduce respiratory illness in the future.”

It is also reassuring to see that Covid-19 did not trigger asthma attacks significantly more often than other respiratory infections in our study participants.”

dr Florence Tydeman, first author of the paper

The study is the first to compare the impact of COVID-19 versus other respiratory infections on the risk of asthma exacerbations. And it’s one of the few studies looking at the impact of lifting national restrictions on people with asthma.


Queen Mary University of London

Magazine reference:

Tydemann, F., et al. (2022) Rebound in asthma exacerbations following easing of COVID-19 restrictions: a population-based longitudinal study (COVIDENCE UK). Thorax.

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