Abstract
Introduction The impact of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic and associated “lockdown” measures on acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is unknown. We aimed to evaluate the change in AECOPD treatment frequency during the first 6 weeks of lockdown in the UK compared with 2019 and assess changes in self-reported behaviour and wellbeing.
Methods In this observational study in Leicestershire, UK, patients with COPD under a secondary care clinic were recruited. Exacerbation frequency in the first 6 weeks of COVID-19 lockdown was compared with the same period in 2019 using electronic health records. A telephone survey was used to assess changes in anxiety, inhaler adherence, physical activity and behaviour during the pre-lockdown and lockdown periods compared with normal.
Results 160 participants were recruited (mean±sd age 67.3±8.1 years, 88 (55%) males, mean±sd forced expiratory volume in 1 s 34±13% pred). 140 (88%) reported at least one AECOPD in the previous year. Significantly more community managed exacerbations were observed in 2020 compared with 2019 (126 versus 99; p=0.026). The increase was a result of multiple courses of treatment, with a similar proportion of patients receiving at least one course (34.4% versus 33.8%).
Discussion During lockdown participants reported significantly increased anxiety, adherence to their preventative inhalers and good adherence to shielding advice (all p<0.001). A significant reduction in self-reported physical activity and visitors was reported (both p<0.001).
Conclusions Treatment for AECOPD events increased during the first 6 weeks of the SARS-CoV-2 pandemic in the UK compared with 2019. This was associated with increased symptoms of anxiety and significant behavioural change.
Abstract
The #COVID19 pandemic has changed healthcare provision and access. This study shows a 38% increase in the number of community treated #AECOPD in 2020 compared with 2019, alongside increased anxiety and inhaler adherence with reduced physical activity. https://bit.ly/3lV17Q6
Footnotes
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Data availability: All data requests should be submitted to the corresponding author for consideration. Access to anonymised data may be granted following review.
Conflict of interest: H. McAuley has nothing to disclose.
Conflict of interest: K. Hadley has nothing to disclose.
Conflict of interest: O. Elneima has nothing to disclose.
Conflict of interest: C.E. Brightling has nothing to disclose.
Conflict of interest: R.A. Evans reports Clinical Scientist Fellowship CS-2016-16-020 from the NIHR during the conduct of the study.
Conflict of interest: M.C. Steiner has nothing to disclose.
Conflict of interest: N.J. Greening reports Post-Doctoral Fellowship PDF-2017-10-052 from the NIHR during the conduct of the study.
Support statement: The research was supported by the NIHR Leicester Biomedical Research Centre – Respiratory Theme. N.J. Greening is funded by a NIHR Post-Doctoral Fellowship (PDF-2017-10-052). R.A. Evans is funded by a NIHR Clinician Scientist Fellowship (CS-2016-16-020). The views expressed are those of the author(s) and not necessarily those of the National Health Service and NIHR or the Dept of Health. Funding information for this article has been deposited with the Crossref Funder Registry.
- Received October 2, 2020.
- Accepted October 9, 2020.
- Copyright ©ERS 2021
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