Impact of COVID-19 Pandemic on the Frequency of Acute Exacerbations of Chronic Obstructive Pulmonary Disease

ABSTRACT

Background Respiratory virus infection is an important trigger of acute exacerbation of chronic obstructive pulmonary disease（AECOPD）. China has adopted a series of containment measures assisting to curb COVID-19 transmission since the outbreak of the pandemic. Several studies showed a decrease in hospitalizations for AECOPD during the COVID-19 pandemic. However，there has been a relative lack of studies investigating the effects of preventive measures on the frequency and severity of exacerbations. Objective To explore the impact of the COVID-19 pandemic on the frequency of AECOPD with or without medical attention. Methods The subjects were from a prospective COPD cohort study conducted in the First Affiliated Hospital of Guangzhou Medical University，which began recruiting patients in early 2016，with visits every 3 months to collect demographic and clinical data，including those who were followed up during June to August 2017（group 1），June to August 2018（group 2），June to August 2019 （group 3），and June to August 2020（group 4）. Basic clinical data （including the frequency of AECOPD，sex，age，symptom score and so on） were collected from group 1 from October 2016 to May 2017，group 2 from October 2017 to May 2018，group 3 from October 2018 to May 2019，and group 4 from October 2019 to May 2020（during which the periods from October 2019 to January 2020，and from February to May 2020 were defined as preCOVID-19 period，and post-COVID-19 period，respectively）. The frequency of AECOPD during October to May next year in group 4 was compared with that of the other three groups. The changes in the frequency of AECOPD between pre- and postCOVID-19 periods were analyzed. Results There were 162 patients in group 1，157 in group 2，167 in group 3，and 159 in group 4. Group 1 had a higher frequency of AECOPD in February to May than in October to January next year（P=0.013），so did group 2（P=0.016）. In contrast，group 4 had a higher frequency of AECOPD in October to January next year than in February to May（P=0.001）. The frequency of AECOPD during October to December in group 4 was similar to that of the other three groups（P>0.05）. But the frequency of AECOPD from February to April in group 4 was lower than that in groups 1-3 （P<0.05）. There was no significant difference in the monthly frequency of AECOPD without medical attention in group 4 compared with that of groups 1-3（P>0.05）. The frequency of AECOPD with medical attention from October to December in group 4 was similar to that of groups 1-3（P>0.05）. but it from February to April in group 4 was lower than that in groups 1-3（P<0.05）. Conclusion Prevention and control measures targeting COVID-19 may be contributive to reducing the frequency of AECOPD. It is suggested that COPD patients should reduce gathering activities，maintain social distance，wear masks when going out，and wash hands frequently even after the COVID-19. © 2023 Chinese General Practice. All rights reserved.