TY - JOUR T1 - COPD in the time of COVID-19: An analysis of acute exacerbations and reported behavioural changes in patients with COPD JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00718-2020 SP - 00718-2020 AU - Hamish McAuley AU - Kate Hadley AU - Omer Elneima AU - Christopher E Brightling AU - Rachael A Evans AU - Michael C Steiner AU - Neil J Greening Y1 - 2020/01/01 UR - http://openres.ersjournals.com/content/early/2020/10/15/23120541.00718-2020.abstract N2 - Introduction The impact of the SARS-CoV-2 pandemic, and lockdown measures, on acute exacerbations of COPD (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 well-being.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 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 to normal.Results 160 participants were recruited (mean [sd] age 67.3 [8.1] years, 88 [55%] male, FEV1 34.3 [13] % predicted). 140 [88%] reported at least one AECOPD in the previous year. Significantly more community treated 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%).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).Discussion Treatment for AECOPD events increased during the first 6 weeks of the SARS-CoV-2 pandemic in the UK compared to 2019. This was associated with increased symptoms of anxiety and significant behavioural change.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. McAuley has nothing to disclose.Conflict of interest: Kate Hadley has nothing to disclose.Conflict of interest: Dr. Elneima has nothing to disclose.Conflict of interest: Prof. Brightling has nothing to disclose.Conflict of interest: R.A. Evans reports Clinical Scientist Fellowship CS-2016-16-020 from the National Institute for Health Research during the conduct of the study.Conflict of interest: Prof. Steiner has nothing to disclose.Conflict of interest: N.J. Greening reports NIHR Post doctoral fellowship pdf-2017-10-052 from the National Institute for Health Research during the conduct of the study. ER -