Impact of COVID-19 on Hospital Admissions, Health Status, and Behavioral Changes of Patients with COPD.

E. Pappe, R. Hammerich, J. Saccomanno, T. Sgarbossa, A. Pohrt, B. Schmidt, C. Grah, S. Eisenmann, A. Holland, S. Eggeling, F. Stanzel, M. Witzenrath, R. Hübner
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Abstract

Introduction Patient with chronic obstructive lung disease (COPD) have an increased risk of severe Coronavirus disease (COVID-19), which is why self-isolation was recommended. However, long periods of social isolation accompanied with limited access to health care systems might influence the outcome of patients with severe COPD negatively. Methods Data from COPD and pneumonia patients at Charité-Universitätsmedizin, Berlin and the volume of endoscopic lung volume reduction (ELVR) from the German lung emphysema registry (Lungenemphysem Register e.V.) were analyzed from pre-pandemic (2012 to 2019) to pandemic (2020 and 2021) period. In addition, 52 patients with COPD GOLD IV status included in the lung emphysema registry received questionnaires during lockdowns from June 2020 to April 2021. Results Admissions and ventilation therapies administered to COPD patients significantly decreased during the COVID-19 pandemic. Likewise, there was a reduction of ELVR treatments and follow-ups registered in German emphysema centers. Mortality was slightly higher among patients hospitalized with COPD during pandemic. Increasing proportions of COPD patients with GOLD III and GOLD IV status reported behavioral changes and subjective feelings of increasing COPD symptoms the longer the lockdown lasted. However, COPD symptom questionnaires revealed stable COPD symptoms over the pandemic time-period. Summary This study reveals reduced COPD admissions and elective treatment procedures of COPD patients during pandemic, but a slight increase of mortality among patients hospitalized with COPD irrespective of COVID-19. Correspondingly, patients with severe COPD reported subjective deterioration of their health status probably caused by their very strict compliance to lockdown measures.
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COVID-19对COPD患者入院、健康状况和行为改变的影响
慢性阻塞性肺疾病(COPD)患者患严重冠状病毒病(COVID-19)的风险增加,这就是建议自我隔离的原因。然而,长期的社会隔离,加上获得卫生保健系统的机会有限,可能会对严重慢性阻塞性肺病患者的预后产生负面影响。方法分析Charité-Universitätsmedizin、Berlin的COPD和肺炎患者的数据,以及德国肺气肿登记处(Lungenemphysem Register e.v.)的内镜下肺减容(ELVR)数据,从大流行前(2012年至2019年)到大流行期间(2020年和2021年)。此外,在2020年6月至2021年4月的封锁期间,纳入肺气肿登记处的52名COPD GOLD IV状态患者接受了问卷调查。结果在COVID-19大流行期间,COPD患者入院率和通气治疗率显著下降。同样,在德国肺气肿中心登记的ELVR治疗和随访也有所减少。大流行期间因COPD住院的患者死亡率略高。GOLD III和GOLD IV状态的COPD患者报告的行为改变和主观感觉COPD症状随着封锁持续时间的延长而增加。然而,COPD症状调查问卷显示,在大流行期间,COPD症状稳定。本研究显示,在大流行期间,COPD患者入院率和选择性治疗程序减少,但与COVID-19无关,COPD住院患者的死亡率略有增加。相应地,严重慢性阻塞性肺病患者报告其健康状况主观恶化,这可能是由于他们非常严格地遵守封锁措施造成的。
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