COPD in the Time of COVID-19 [COVID-19]
Research type
Research Study
Full title
A Cross-Sectional Observation Telephone Survey Study to Understand the Changes in COPD Exacerbation Patterns and Potential Causes of These during the COVID-19 Pandemic
IRAS ID
284177
Contact name
Neil Greening
Contact email
Sponsor organisation
University of Leicester
Duration of Study in the UK
1 years, 1 months, 1 days
Research summary
As clinicians we have noticed a dramatic change in the admission rates of COPD patients during the COVID-19 Lockdown in the UK. Although we have no accurate quantification of this change we can say that we have seen fewer that one AECOPD admission per day through the Glenfield Hospital Clinical Decisions Unit since mid-March compared to an average of 5 per day during normal times. Anecdotally this pattern has been repeated across much of the UK as reported by other COPD specialists on Twitter. Unknown at present is whether the change in pattern represents a true reduction in AECOPD events or if these events are still occurring but are being managed at home with rescue packs or with GP prescribed home medication. Furthermore it is unknown if there has been a reduction in mortality in amongst COPD patients during this period as would be expected if there had been a reduction in AECOPD events.\nClinicians can only speculate as to the cause of this dramatic change at present as no data has been published either quantifying or evaluating possible reasons for this change in AECOPD admission rates. Indeed it seems counter intuitive that AECOPD events would decrease during the period of a respiratory virus pandemic such as COVID-19 as this would be presumed to be a likely trigger of AECOPD events. Much speculation among clinicians has been that effective social distancing, shielding and isolation have reduced the transmission of common respiratory viral pathogens. Other speculation has been that following the introduction of legally mandated home lock down patients have become better adherent to their prescribed medication. Other possible proposed mechanisms include reduced perceived symptom burden due to reduced opportunity for physical activity, increased family support either in person or through video-conferencing and telephone contact, and easier access to at home support via telephone consultations with GPs or COPD specialist nurses. If is also possible that patients are failing to attend hospital due to fear or being exposed to COVID-19 and are instead suffering severe AECOPD events at home and dying as a result.\nGiven the clear change in pattern during this period there appears an opportunity to gain better insight into both the physiological and social mechanism that drive severe AECOPD events. There also seems an urgent need to ensure that the population of COPD patients is not coming to harm as a result of fear of coming into hospital or hesitance among clinicians to advise hospital admission.
REC name
London - Brent Research Ethics Committee
REC reference
20/HRA/2510
Date of REC Opinion
18 May 2020
REC opinion
Favourable Opinion