Asthma as a Risk Factor for Hospitalization in Children and Youth With COVID-19: A Retrospective Cohort Study.

BACKGROUND: Studies examining the association between asthma and hospitalization among children and youth with coronavirus disease 2019 (COVID-19) have yielded mixed results. Both asthma and COVID-19 hospitalization are characterized by racial, ethnic and socioeconomic disparities which also pattern geographically, yet no studies to date have adjusted for neighborhood context in the assessment of this association. METHODS: Mixed effects logistic regression was used to estimate the association between asthma and hospitalization due to COVID-19 in a sample of 28,997 children and youth diagnosed with COVID-19 in Milwaukee County, Wisconsin, from March 1, 2020, to May 31, 2022. Models adjusted for individual-level sociodemographic factors (age, gender, race, ethnicity and city/suburb residence) and season of diagnosis were examined as moderators. Random intercepts by census tract accounted for geographic variation in neighborhood factors and census tract-level measures of education, health and environment, and social and economic factors were assessed via childhood opportunity indices. RESULTS: Asthma history was statistically significantly associated with hospitalization due to COVID-19 among children and youth. Hospitalization rates varied statistically significantly by census tract, and results were unchanged after accounting for childhood opportunity indices and census tract. Season of diagnosis was not found to moderate the effect of asthma history on COVID-19 hospitalization. CONCLUSION: Our study suggests that asthma history is a risk factor for hospitalization in the context of COVID-19 infection among children and youth, warranting observation and follow-up of children with asthma as well as continued measures to prevent COVID-19 in this population.

Investigating the Trajectory of the COVID-19 Outbreak in Milwaukee County and Projected Effects of Relaxed Distancing.

INTRODUCTION: The coronavirus pandemic has placed enormous stresses on health care systems across the United States and internationally. Predictive modeling has been an important tool for projecting utilization rates and surge planning. As the initial outbreak begins to slow, questions are being raised regarding long-term coronavirus mitigation plans. This paper examines the current status of the coronavirus outbreak in Milwaukee County, Wisconsin, and simulates several scenarios where physical distancing measures are removed. METHODS: The outbreak's doubling time, reproductive numbers at several points, and incidence curve were calculated to assess outbreak progression. Compartmental models were used to estimate the number of hospitalizations and critically ill patients in Milwaukee County if distancing policies were removed. RESULTS: The compartmental models predict a substantial spike in cases and overwhelming medical resource utilization with an abrupt end to social distancing. Partial reduction in social distancing policies would likely result in a smaller spike, with less severe strain on available medical resources. CONCLUSIONS: Milwaukee County remains very susceptible to a resurgence of COVID-19 cases. Removing physical distancing policies poses significant risks with regard to resource management.