PT  - JOURNAL ARTICLE
AU  - McAuley, Hamish
AU  - Hadley, Kate
AU  - Elneima, Omer
AU  - Brightling, Christopher E.
AU  - Evans, Rachael A.
AU  - Steiner, Michael C.
AU  - Greening, Neil J.
TI  - COPD in the time of COVID-19: an analysis of acute exacerbations and reported behavioural changes in patients with COPD
AID  - 10.1183/23120541.00718-2020
DP  - 2021 Jan 01
TA  - ERJ Open Research
PG  - 00718-2020
VI  - 7
IP  - 1
4099  - https://publications.ersnet.org//content/7/1/00718-2020.short
4100  - https://publications.ersnet.org//content/7/1/00718-2020.full
SO  - erjor2021 Jan 01; 7
AB  - 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.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