Significant decrease in COPD admissions seen during COVID-19 pandemic
COPD admissions significantly decreased following the implementation of public health measures during the COVID-19 pandemic, according to data published in the American Journal of Medicine.
“The recent COVID-19 pandemic has led to a significant interruption in health care delivery, with reduced admissions for COPD and other non-COVID illnesses. This is due to a variety of factors, including avoidance of crowded hospitals due to fear of contracting SARS-CoV-2, reallocation of hospital resources to treat rising number of COVID-19 patients and utilization of telemedicine to manage chronic diseases at home,” Jennifer Y. So, MD, assistant professor of medicine in the division of pulmonary and critical care at the University of Maryland School of Medicine, Baltimore, and colleagues wrote. “There is compelling evidence indicating that public health measures, such as stay at home orders, social distancing and masking mandates with strict limitations on large gatherings to curb the spread of COVID-19, are also effective at decreasing the transmission of seasonal viral pathogens.”
The retrospective analysis included data from 4,422 COPD admissions (mean age, 57 years; 57% women) from a large, multicenter health care system. Researchers evaluated trends in admission associated with community viral prevalence and initiation of COVID-19 pandemic public health measures. They compared season-matched weekly hospital admission frequency for COPD before and after COVID-19 pandemic public health measures estimated community viral prevalence through CDC data and correlated it to COPD admissions.
The primary outcome was weekly admissions and secondary outcomes included weekly in-hospital mortality counts, severe exacerbations requiring ICU admission and hospital length of stay.
There was a 53% decline in COPD admissions during the COVID-19 pandemic compared with COPD admissions prior to COVID-19 (31.5 vs. 67.4 admissions per week). This decline correlated with the community viral burden and represented a 36% greater decline in admission frequencies for other medical conditions not as effected by respiratory viral infections like COVID-19 (incidence RR = 0.64; 95% CI, 0.57-0.71; P < .001).
Researchers observed a more pronounced decline in COPD admissions among patients with three or fewer comorbidities (incidence RR = 0.6; 95% CI, 0.49-0.75) and those without recurrent hospital admissions (incidence RR = 0.66; 95% CI, 0.53-0.81).
There were no significant differences observed for in-hospital mortality (incidence RR = 0.66; 95% CI, 0.2-2.13) or severe exacerbations requiring ICU admission (incidence RR = 1.01; 95% CI, 0.72-1.35). In addition, researchers found no significant differences in median hospital length of stay for COPD hospital admissions.
As more people receive COVID-19 vaccinations and public health measures are relaxed, researchers anticipate that may expose patients with COPD to familiar seasonal triggers and, therefore, increase COPD admissions.
“There is a significant decrease in weekly COPD admissions during the COVID-19 pandemic, likely due to a decrease in respiratory virus prevalence from public health measures being taken during the pandemic,” the researchers wrote. “There may be opportunity to judiciously apply control measures outside of pandemic conditions to reduce the burden of disease imparted by community respiratory viral infections.”