Population Decline in COPD Admissions During the COVID-19 Pandemic Associated with Lower Burden of Community Respiratory Viral Infections

Abstract

Background: The COVID-19 pandemic has led to widespread implementation of public health measures, such as stay-at-home orders, social distancing, and masking mandates. In addition to decreasing spread of SARS-CoV2, these measures also impact the transmission of seasonal viral pathogens, which are common triggers of COPD exacerbations. Whether reduced viral prevalence mediates reduction in COPD exacerbation rates is unknown. Methods: We performed retrospective analysis of data from a large, multicenter healthcare system to assess admission trends associated with community viral prevalence and with initiation of COVID-19 pandemic control measures. We applied difference-in-differences (DiD) analysis to compare season-matched weekly frequency of hospital admissions for COPD before and after implementation of public health measures for COVID-19. Community viral prevalence was estimated using regional Center for Disease Control and Prevention test positivity data and correlated to COPD admissions. Results: Data involving 4,422 COPD admissions demonstrated a season-matched 53% decline in COPD admissions during COVID-19 pandemic, which correlated to community viral burden (r=0.73; 95% CI: 0.67 to 0.78) and represented a 36% greater decline over admission frequencies observed in other medical conditions less affected by respiratory viral infections (IRR, 0.64; 95% CI, 0.57 to 0.71, p<0.001). The post-COVID-19 decline in COPD admissions was most pronounced in patients with fewer comorbidities and without recurrent admissions. Conclusion: The implementation of public health measures during the COVID-19 pandemic was associated with decreased COPD admissions. These changes are plausibly explained by reduced prevalence of seasonal respiratory viruses.

Hospital admissions and mortality for acute exacerbations of COPD during the COVID-19 pandemic: a nationwide study in France

“…12 Another study in the United States showed a positive correlation between COPD admissions and community viral burden. 11 The present study shows that in France, in contrast with what was observed during the pre-pandemic years, the number of hospital admissions for AECOPD did not increase during the winter months of the pandemic, a season when the circulation of VRI is usually high. Furthermore, a considerable increase in flu vaccination coverage was observed in France in 2020 compared with 2019.…”

“…Two studies found an increased mortality in 2020 compared to pre-pandemic years, of respectively +53% and +130% but both were based on small numbers, 8,16 while others did not find a significant difference. 11,12,14 To date, time trends in in-hospital mortality have not been analysed with large-scale and exhaustive data. Finally, while most studies found a stable proportion of AECOPD stays involving intensive care units (ICU) admission in 2020 compared to previous years, 11,14,16 a cohort study in Denmark found a 36% decrease in the risk of admission to an ICU in COPD patients.…”

“…11,12,14 To date, time trends in in-hospital mortality have not been analysed with large-scale and exhaustive data. Finally, while most studies found a stable proportion of AECOPD stays involving intensive care units (ICU) admission in 2020 compared to previous years, 11,14,16 a cohort study in Denmark found a 36% decrease in the risk of admission to an ICU in COPD patients. 7…”

COVID-19 Prevention Guidance and the Incidence of Febrile Neutropenia in Breast Cancer Patients Receiving TAC Chemotherapy with Prophylactic Pegfilgrastim

“…This prevention guidance has proven effective against the transmission of respiratory diseases. [12,24,25] Our study showed that these guidelines were also effective in reducing the likelihood of FN in patients receiving TAC.…”

Impact of coronavirus disease 2019 on respiratory care in Japan: A nationwide survey by the Japanese Respiratory Society

“…The number of patients hospitalized with asthma showed similar trends from 2017 to 2019, even in studies using databases in Japan [ 8 ], but in 2020 (from the ninth week onward), there was a large decrease compared with the previous 3 years. This decrease could be due to a decrease in cases of viral infection as a result of standard infection control measures, such as face masks and hand disinfection for SARS-CoV-2, restrictions on going out, and other factors [ 9 , 10 ]. The decrease in outpatient and inpatient admissions apart from asthma may also be the result of fewer opportunities for infection.…”