COVID-19 Admissions Associated with Asthma Related Diagnosis: A Closed Scheme Case Study
Background: The COVID-19 epidemic has adversely affected health systems globally. Most are overwhelmed because of the unprecedented spread of the virus. COVID-19 is a respiratory disease that impacts the respiratory tract which includes your lungs. When COVID-19 is severe it can bring on pneumonia or acute respiratory distress syndrome (ARDS). Chronic respiratory diseases (CRDs) are among the leading causes of death worldwide. The World Health Organization (WHO) estimates that non-communicable disease (NCDs) represent 63% of all global deaths of which 3.9 million are due to CRDs and Chronic Obstructive Pulmonary Disease (COPD). The most common chronic respiratory diseases globally are asthma and chronic obstructive pulmonary disease and impact on the poor quality of life worldwide. Asthma is also amongst the top 5 most prevalent chronic conditions in medical schemes. Both asthma and COVID-19 are part of the Prescribed Minimum Benefits (PMB). There are various studies depict that asthma may increase the risk of hospitalization from COVID-19. According to Wang et al. (2020), asthma as comorbidity may not increase the mortality of COVID-19. Further studies indicate no casual association between Asthma and COVID-19, it is also unclear whether patients with asthma are at a higher risk of developing COVID-19 and/or becoming severely ill.
Objectives: The objective of this study was to assess COVID-19 related admissions that are possibly associated with asthmatic diagnosis at discharge phase.
Methods: The study entailed a descriptive cross-section analysis of a closed medical scheme using claims information on COVID-19. Patients were included if they had laboratory-confirmed (RT – PCR assay) COVID-19 infection at admission phase and a hospital discharge primary diagnosis linked to Asthma.
Results: The analysis covered a total of 71 closed medical scheme patients that were admitted for COVID- 19 related diagnosis and primary diagnosis code linked to Asthma. The primary diagnosis for admission was used as a guide to identify a COVID-19 confirmed case or suspected case. The median age of patients admitted to hospital was 51 (IQR 44-60). The median number of inpatient days was seven (IQR 5-12). Significantly more of the patients were males, 85.92% vs. 14.02%, p <0.0001.
Nearly thirty percent of admissions were in General Ward, 29.58%, just under twenty percent were admitted in High Care, 18.31%. Less than two percent of admissions were in ICU, 1.41%, The reminder which was just over half were in other types admitting facilities which included home-based or outpatient care, 50.7%. Significantly more of the discharge diagnosis was liked to Asthma, unspecified which accounted for 92% of patients.
Conclusion: The study found evidence that restricted scheme patients admitted for COVID-19 had symptoms associated with Asthma. This finding further depicts some evidence of a link between COVID-19 and Asthma, which are both respiratory chronic conditions. Both these conditions are listed as PMBs by the CMS and that medical schemes must fund in full. The findings of this study indicate a further need for a more comprehensive analysis on the possible associations between asthma and COVID-19 infection and severity. These insights will further assist in efforts and interventions to support asthma care and better healthcare management.