ABSTRACT
Background: Social distancing measures introduced during the COVID-19 pandemic have reduced admission rates for a variety of respiratory tract infections. We hypothesized that rates of asthma exacerbations would decline following the national lockdown introduced on March 12, 2020, in Denmark. Aim(s): To determine weekly rates of in- and out of hospital asthma exacerbations prior to and during the national lockdown. Method(s): All persons >18 years with at least one outpatient hospital contact with asthma as the primary diagnosis from January 1, 2013, to December 31, 2017, were included. Weekly asthma exacerbation rates from January 1, 2018, to May 22, 2020, were assessed. An interrupted time-series (ITS model) with March 12, 2020, as the point of interruption was conducted. Result(s): A total of 38,225 patients with asthma were identified. The ITS model showed no immediate changes in exacerbation rates during the first week after March 12, 2020. However, there was a significant decrease in weekly exacerbation rates in the following 10 weeks (change in trend for exacerbations requiring hospitalisation: -0.75 [95% CI -1.39,-0.12], (p < 0.02) corresponding to a reduction of about 1 exacerbation per year per 100 patients in the cohort, and a change in trend for all asthma exacerbations: -12.2 [95% CI -19.1,-5.4], p<0.001 corresponding to a reduction of 16.5 exacerbations per year per 100 patients in the cohort). Conclusion(s): The introduction of the social distancing measures in Denmark on March 12, 2020, did not lead to an immediate reduction in asthma exacerbation rates, however a gradual decline in exacerbation rates during the following 10-weeks period was observed.
ABSTRACT
Background: Patients with bronchiectasis are at high risk of community acquired pneumonia. It remains unclear if this risk is reduced by social distancing (SD) measures. Method(s): Nationwide registry study with data from patients with specialist verified bronchiectasis between 1 January 2019 and 20 May 2020. Pneumonia hospitalisation was the primary outcome. Patients with COVID-19 and age < 18 were excluded. The incidence of pneumonia hospitalisations in the SD period (12 March 2020 to 20 May 2020) was compared to the same period in 2019 (control period). Result(s): A total of 672 patients with bronchiectasis were followed in the SD period and the control period. Median age was 68, and 36% were males. During the SD intervention, 7 incidents of pneumonia hospitalisation were observed, compared to 31 during the control period (Fig. 1). The corresponding incidence rate ratio was 0.24 (95% confidence interval: 0.17 to 0.33, p < 0.001). 6/642 (0.9%) patients died during the SD period compared to 8/672 (1.2%) during control period (p = 0.9). Conclusion(s): The social distancing intervention was associated with a substantially lower incidence of pneumoniahospitalizations among patients with bronchiectasis. Hygienic measures as used during SD are important in preventing serious life-threatening infections like pneumonias that require hospitalisation.