{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T03:59:26Z","timestamp":1791863966997,"version":"4.3.4"},"reference-count":29,"publisher":"BMJ","funder":[{"DOI":"10.13039\/100015652","name":"Barts\n                                    Charity","doi-asserted-by":"publisher","award":["MGU0466"],"award-info":[{"award-number":["MGU0466"]}],"id":[{"id":"10.13039\/100015652","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015652","name":"Barts\n                                    Charity","doi-asserted-by":"publisher","award":["MGU0570"],"award-info":[{"award-number":["MGU0570"]}],"id":[{"id":"10.13039\/100015652","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014013","name":"UK\n                                    Research and Innovation","doi-asserted-by":"publisher","award":["MC_PC_19004"],"award-info":[{"award-number":["MC_PC_19004"]}],"id":[{"id":"10.13039\/100014013","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Thorax"],"abstract":"<jats:sec>\n                        <jats:title>Background<\/jats:title>\n                        <jats:p>The imposition of restrictions on social mixing early in the\n                            COVID-19 pandemic was followed by a reduction in asthma exacerbations in\n                            multiple settings internationally. Temporal trends in social mixing,\n                            incident acute respiratory infections (ARI) and asthma exacerbations\n                            following relaxation of COVID-19 restrictions have not yet been\n                            described.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>Methods<\/jats:title>\n                        <jats:p>We conducted a population-based longitudinal study in 2312 UK adults\n                            with asthma between November 2020 and April 2022. Details of face\n                            covering use, social mixing, incident ARI and severe asthma\n                            exacerbations were collected via monthly online questionnaires. Temporal\n                            changes in these parameters were visualised using Poisson generalised\n                            additive models. Multilevel logistic regression was used to test for\n                            associations between incident ARI and risk of asthma exacerbations,\n                            adjusting for potential confounders.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>Results<\/jats:title>\n                        <jats:p>Relaxation of COVID-19 restrictions from April 2021 coincided with\n                            reduced face covering use (p&lt;0.001), increased frequency of indoor\n                            visits to public places and other households (p&lt;0.001) and rising\n                            incidence of COVID-19 (p&lt;0.001), non-COVID-19 ARI (p&lt;0.001) and\n                            severe asthma exacerbations (p=0.007). Incident non-COVID-19 ARI\n                            associated independently with increased risk of asthma exacerbation\n                            (adjusted OR 5.75, 95% CI 4.75 to 6.97) as did incident COVID-19, both\n                            prior to emergence of the omicron variant of SARS-CoV-2 (5.89, 3.45 to\n                            10.04) and subsequently (5.69, 3.89 to 8.31).<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>Conclusions<\/jats:title>\n                        <jats:p>Relaxation of COVID-19 restrictions coincided with decreased face\n                            covering use, increased social mixing and a rebound in ARI and asthma\n                            exacerbations. Associations between incident ARI and risk of severe\n                            asthma exacerbation were similar for non-COVID-19 ARI and COVID-19, both\n                            before and after emergence of the SARS-CoV-2 omicron variant.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>Study registration number<\/jats:title>\n                        <jats:p>\n<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clinical-trials-gov\" xlink:href=\"NCT04330599\">NCT04330599<\/jats:ext-link>.<\/jats:p>\n                    <\/jats:sec>","DOI":"10.1136\/thorax-2022-219591","type":"journal-article","created":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T18:00:25Z","timestamp":1685469625000},"page":"thorax-2022-219591","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Rebound in asthma exacerbations following relaxation of COVID-19\n                        restrictions: a longitudinal population-based study (COVIDENCE UK)"],"prefix":"10.1136","clinical-trial-number":[{"clinical-trial-number":"nct04330599","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Florence","family":"Tydeman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0369-2885","authenticated-orcid":false,"given":"Paul E","family":"Pfeffer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Vivaldi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayley","family":"Holt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6901-3665","authenticated-orcid":false,"given":"Mohammad","family":"Talaei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3592-1945","authenticated-orcid":false,"given":"David","family":"Jolliffe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1218-1008","authenticated-orcid":false,"given":"Gwyneth","family":"Davies","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5225-000X","authenticated-orcid":false,"given":"Ronan A","family":"Lyons","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Griffiths","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0606-8167","authenticated-orcid":false,"given":"Frank","family":"Kee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7022-3056","authenticated-orcid":false,"given":"Aziz","family":"Sheikh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7273-8691","authenticated-orcid":false,"given":"Seif O","family":"Shaheen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5387-1721","authenticated-orcid":false,"given":"Adrian R","family":"Martineau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,11,23]]},"reference":[{"key":"2023060504422107000_thorax-2022-219591v2.1","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/S2213-2600(20)30105-3","article-title":"Prevalence and attributable health burden of chronic respiratory diseases, 1990-2017: a systematic analysis for the global burden of disease study 2017","volume":"8","year":"2020","journal-title":"Lancet Respir 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Omicron daily overview:\n                            17 December 2021, 2021. Available:\n                            https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/1042100\/20211217_OS_Daily_Omicron_Overview.pdf"},{"key":"2023060504422107000_thorax-2022-219591v2.8","doi-asserted-by":"crossref","first-page":"100428","DOI":"10.1016\/j.lanepe.2022.100428","article-title":"Impact of COVID-19 pandemic on asthma exacerbations: retrospective cohort study of over 500,000 patients in a national English primary care database","volume":"19","author":"Shah","year":"2022","journal-title":"Lancet Reg Health Eur"},{"key":"2023060504422107000_thorax-2022-219591v2.9","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1001\/jamapediatrics.2022.1110","article-title":"Acute upper airway disease in children with the omicron (B.1.1.529) variant of SARS-CoV-2-A report from the US national COVID cohort collaborative","volume":"176","author":"Martin","year":"2022","journal-title":"JAMA Pediatr"},{"key":"2023060504422107000_thorax-2022-219591v2.10","article-title":"Cohort profile: longitudinal population-based study of COVID-19 in UK adults (COVIDENCE UK)","author":"Holt","year":"2022","journal-title":"Int J Epidemiol"},{"key":"2023060504422107000_thorax-2022-219591v2.11","doi-asserted-by":"crossref","DOI":"10.1093\/infdis\/jiac321","article-title":"Correlation between post-vaccination anti-Spike antibody titres and protection against breakthrough SARS-CoV-2 infection: a population-based longitudinal study","author":"Vivaldi","year":"2022","journal-title":"J Infect Dis"},{"key":"2023060504422107000_thorax-2022-219591v2.12","doi-asserted-by":"crossref","first-page":"1601","DOI":"10.3390\/vaccines10101601","article-title":"Determinants of antibody responses to SARS-CoV-2 vaccines: population-based longitudinal study (COVIDENCE UK)","volume":"10","author":"Jolliffe","year":"2022","journal-title":"Vaccines"},{"key":"2023060504422107000_thorax-2022-219591v2.13","doi-asserted-by":"crossref","unstructured":"Holt H , Jolliffe DA , Talaei M . Incidence,\n                            determinants and serological correlates of reactive symptoms following\n                            SARS-CoV-2 vaccination: a population-based longitudinal study (COVIDENCE\n                            UK). NPJ Vaccines 2022:in\n                            press.doi:10.21203\/rs.3.rs-1692845\/v1","DOI":"10.21203\/rs.3.rs-1692845\/v1"},{"key":"2023060504422107000_thorax-2022-219591v2.14","article-title":"Risk factors for SARS-CoV-2 infection after primary vaccination with ChAdOx1 nCoV-19 or BNT162b2 and after booster vaccination with BNT162b2 or mRNA-1273: a population-based cohort study (COVIDENCE UK)","volume":"22","author":"Vivaldi","year":"2022","journal-title":"Lancet Reg Health Eur"},{"key":"2023060504422107000_thorax-2022-219591v2.15","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2021-217487"},{"key":"2023060504422107000_thorax-2022-219591v2.16","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-022-02286-4"},{"key":"2023060504422107000_thorax-2022-219591v2.17","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-065083"},{"key":"2023060504422107000_thorax-2022-219591v2.18","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1958.00260140099015"},{"key":"2023060504422107000_thorax-2022-219591v2.19","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.56.2.109"},{"key":"2023060504422107000_thorax-2022-219591v2.20","doi-asserted-by":"publisher","DOI":"10.2807\/esm.10.12.00585-en"},{"key":"2023060504422107000_thorax-2022-219591v2.21","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2020-216512"},{"key":"2023060504422107000_thorax-2022-219591v2.22","unstructured":"Office for National Statistics . Coronavirus and the\n                            social impacts on behaviours during different lockdown periods, great\n                            Britain: up to February 2021, 2021. Available:\n                            https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/healthandsocialcare\/healthandwellbeing\/articles\/coronavirusandthesocialimpactsonbehavioursduringdifferentlockdownperiodsgreatbritain\/uptofebruary2021"},{"key":"2023060504422107000_thorax-2022-219591v2.23","unstructured":"Office for National Statistics . Coronavirus\n                            (COVID-19) latest insights: infections, 2022. Available:\n                            https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/healthandsocialcare\/conditionsanddiseases\/articles\/coronaviruscovid19latestinsights\/infections"},{"key":"2023060504422107000_thorax-2022-219591v2.24","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.abo5395"},{"key":"2023060504422107000_thorax-2022-219591v2.25","unstructured":"UK Health Security Agency . Surveillance of influenza\n                            and other seasonal respiratory viruses in winter 2021 to 2022;\n                            2022."},{"key":"2023060504422107000_thorax-2022-219591v2.26","doi-asserted-by":"publisher","DOI":"10.1136\/bmjresp-2021-001056"},{"key":"2023060504422107000_thorax-2022-219591v2.27","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.jaip.2021.09.032","article-title":"Prescribing patterns and treatment adherence in patients with asthma during the COVID-19 pandemic","volume":"10","author":"Dhruve","year":"2022","journal-title":"J Allergy Clin Immunol Pract"},{"key":"2023060504422107000_thorax-2022-219591v2.28","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2015-206996"},{"key":"2023060504422107000_thorax-2022-219591v2.29","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2017-210650"}],"container-title":["Thorax"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/thorax-2022-219591","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,5]],"date-time":"2023-06-05T13:32:25Z","timestamp":1685971945000},"score":1,"resource":{"primary":{"URL":"https:\/\/thorax.bmj.com\/lookup\/doi\/10.1136\/thorax-2022-219591"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,23]]},"references-count":29,"alternative-id":["10.1136\/thorax-2022-219591"],"URL":"https:\/\/doi.org\/10.1136\/thorax-2022-219591","relation":{},"ISSN":["0040-6376","1468-3296"],"issn-type":[{"value":"0040-6376","type":"print"},{"value":"1468-3296","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,23]]}}}