Recurrence of wheeze in preschool aged children: a retrospective cohort study in primary care

Abstract

Abstract Background Approximately 1 in 7 children with wheeze will be admitted to hospital for treatment, often leading to repeat visits to emergency departments and hospital admissions. The UK lags other wealthy countries in the management of preschool wheeze and has amongst the highest rates of asthma deaths in Europe. There were reports that wheeze and asthma admissions to hospitals fell during the Covid-19 pandemic lockdowns, but the changing community incidence is unknown. We aimed to report the changing incidence of recurrent wheeze across the Covid-19 pandemic. Methods Using data from the UK Clinical Practice Datalink, a nationally representative sample of the UK population, we followed a cohort of 57,603 children aged 1-5 years who consulted their general practitioner with their first wheeze attack between January 2009 and July 2020. We calculated the incidence of wheezing recurrence by calendar year. We will calculate the incidence rate ratios for recurrent wheeze by level of area-based deprivation whilst accounting for potential confounders including child age, sex, birth weight, gestation age, ethnicity, comorbidities, bronchiolitis, maternal smoking, maternal asthma, and maternal age at birth. Results The incidence of recurrent preschool wheeze remained stable across the Covid-19 pandemic (e.g., 2019: 27% vs 2020: 23%) even though total wheeze events in general practice fell from 3,135 in 2019 to 1,280 in 2020. Conclusions Around a quarter of children with wheeze have repeat visits to the GP. Our next steps are to identify preventive actions to reduce the risks of recurrent wheeze for children presenting with their first wheeze attack in primary care. Key messages • Around a quarter of children will have a repeat visit to the GP for wheeze within the first year after their initial wheeze attack. • The incidence of recurrent preschool wheeze remained stable across the Covid-19 pandemic.