Date of Award

Spring 2023

Degree Type


Director of Thesis

Robin Dawson, PhD, APRN, CPNP-PC, FAAN

First Reader

Nakita Barnes, DNP, ACNP-BC, PPCNP-BC

Second Reader

Nakita Barnes, DNP, ACNP-BC, PPCNP-BC


Background & Objective: Prior to the onset of the COVID-19 pandemic, the most common reasons for ED visits among children ages 0-18 were acute upper respiratory infections and asthma, a chronic disease that causes narrowing and swelling in the airways of the lungs. Asthma has various triggers, one of the most common being respiratory tract infections that further impair the airways (Busse et al., 2010). Caused by SARS-CoV-2, COVID-19 infection is associated with respiratory symptoms including shortness of breath, congestion, coughing, and sore throat. While there was a sharp decline in the number of total pediatric ED after the pandemic onset, there was also a significant reduction in those related to childhood asthma, an unexpected and seemingly paradoxical outcome. The purpose of this scoping review was to evaluate and characterize research focused on pediatric asthma ED visits after the onset of the COVID-19 pandemic.

Methods: A scoping review following the PRISMA-ScR guidelines was completed. After consultation with a university librarian, 3 databases (Embase, CINAHL, and PubMed) were searched using key terms of asthma, emergency/emergency department/emergency room, COVID/coronavirus/pandemic, and pediatric. Both authors conducted searches, then met to review articles to determine eligibility for inclusion and extract relevant information. Articles were included if they were data-based research studies examining ED trends between 2019 and 2022 related to asthma exacerbation in children.

Results: Of the 187 articles identified, 43 met inclusion criteria. All but one were retrospective studies; one was a prospective cohort study. All but one study demonstrated a significant decline in pediatric ED asthma visits during the pandemic compared to years prior. Many reductions aligned with periods of lockdown and school closures implemented during 2019 and 2020, with authors concluding that stay-at-home mitigation strategies likely resulted in avoidance of pollen exposures and a resultant decrease in asthma symptomatology. Four studies associated declines in asthma-related pediatric ED visits with improvements in air quality. One study noted children experienced fewer upper respiratory tract infections and febrile episodes that were associated with decreased incidence of asthma exacerbation.

Conclusion: Despite the respiratory symptoms associated with COVID-19, global pediatric asthma ED visits were significantly reduced during the pandemic.

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© 2023, Peyton Law and Robin Dawson