Background Measures to address coronavirus (COVID-19) pandemic have included worldwide strict containment measures, informally known as ‘lockdown’. Acute severe episodes of wheezing are one of the commonest presentations to paediatric emergency departments (PED). The 2020 coronavirus pandemic has dramatically changed the pattern of PED attendances.

Objectives To assess the impact of COVID-19 lockdown on the number of children presenting to PED with acute wheezing.

Methods A single-centre prospective observational cohort study, comparing the total number of children aged 0 – 18 years presenting to PED of University Hospitals of Leicester between January 2018 to June 2020. Demographic data including age at presentation and gender were extracted. The patient group were further divided to under 5 years (aged 1 month to 5 years) and above 5 years (aged 5 year 1 month to 18 years).

Results An average of 2892 children presented to PED per year with acute wheeze between 2018 and 2019 (62% male), of which 73% (n = 2112) were aged < 5 years. Following COVID-19, we noted a total of 641 PED attendances for acute wheeze from January to June 2020 (63% male), with children under 5 years representing 65% (n = 418) of the cohort. Between April-June 2020, there has been an 85% decrease in total number of PED presentations and 95% decrease in total number of hospital admissions of children with acute wheezing when compared to the mean of April-June 2018 and 2019. There was 90% decrease in PED presentation for children under 5 years, whereas 70% decrease for children above 5 years. Between January-March 2020, the number of PED presentations and hospital admissions of acute wheezing did not substantially differ compared with January-March 2018 and 2019.

Conclusions Strict containment measures secondary to COVID-19 lockdown has had a positive impact in children with respiratory conditions. Whilst the current restrictions are not indefinitely sustainable, they demonstrate the potential health benefits of improved adherence to hand hygiene, pharmaceutical therapy, and sensible social distancing.