ERJ Open Res . COPD in the time of COVID-19: an analysis of acute exacerbations and reported behavioural changes in patients with COPD

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ERJ Open Res


. 2021 Jan 18;7(1):00718-2020.
doi: 10.1183/23120541.00718-2020. eCollection 2021 Jan.
COPD in the time of COVID-19: an analysis of acute exacerbations and reported behavioural changes in patients with COPD


Hamish McAuley ^{1 2} , Kate Hadley ² , Omer Elneima ^{1 2} , Christopher E Brightling ^{1 2} , Rachael A Evans ^{1 2} , Michael C Steiner ^{1 2} , Neil J Greening ^{1 2}



Affiliations

• PMID: 33527075
• PMCID: PMC7607968
• DOI: 10.1183/23120541.00718-2020

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.