Caring for patients with COPD and COVID-19: a viewpoint to spark discussion

Simons, Sami O.; Hurst, John R.; Miravitlles, Marc; Franssen, Frits M.E.; Janssen, Daisy J.A.; Papi, Alberto; Duiverman, Marieke L.; Kerstjens, Huib A. M.

doi:10.1136/thoraxjnl-2020-215095

Cited by 21 publications

(23 citation statements)

References 29 publications

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“…However, it is unclear whether this is due to a genuine reduction in AECOPD rates (potentially due to lower respiratory viral transmission 7 and/or atmospheric pollution) or due to higher thresholds for patient reporting to healthcare services because of fearfulness about contracting SARS-CoV-2 in healthcare environments, particular hospitals. In addition there is limited understanding of the impact of enhanced shielding on the psychological wellbeing and physical activity in people with pre-existing respiratory disease such as COPD 8 9 . Having a chronic condition such as COPD does not appear to increase the likelihood of SARS-CoV-2 infection 10 , it does convey increased risk of hospitalisation and death 4 .…”

Section: Introductionmentioning

confidence: 99%

COPD in the time of COVID-19: An analysis of acute exacerbations and reported behavioural changes in patients with COPD

McAuley

Hadley

Elneima

et al. 2020

Preprint

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Introduction: The impact of the SARS-CoV-2 pandemic, and lockdown measures, on acute exacerbations of COPD (AECOPD) is unknown. We aimed to evaluate the change in AECOPD treatment frequency during the first six weeks of lockdown in the UK compared with 2019 and assess changes in self-reported behaviour and well-being. Methods: In this observational study patients with established COPD were recruited. Exacerbation frequency was measured in the first six weeks of COVID lockdown and compared with the same period in 2019 using electronic health records. A telephone survey was used to assess changes in anxiety, inhaler adherence, physical activity, shopping and visitor behaviour during the pre-lockdown and lockdown periods compared to normal. Results: 160 participants were recruited (mean [SD] age 67.3 [8.1] years, 88 [55%] male, FEV1 34.3 [13] % predicted) and 140 [88%] reported at least one AECOPD in the previous year. Significantly more community treated exacerbations were observed in 2020 compared with 2019 (126 vs 99, p=0.026). The increase was as a result of multiple courses of treatment, with a similar proportion of patients receiving at least one course (34.4% vs 33.8%). During 'lockdown' participants reported significantly increased anxiety, adherence to their preventative inhalers, and good adherence to shielding advice (all p<0.001). A significant reduction in self-reported physical activity and visitors was reported (both p<0.001). Discussion: Treatment for AECOPD events increased during the first six weeks of the SARS-CoV-2 pandemic in the UK compared to 2019. This was associated with increased symptoms of anxiety and significant behavioural change.

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Section: Introductionmentioning

confidence: 99%

COPD in the time of COVID-19: An analysis of acute exacerbations and reported behavioural changes in patients with COPD

McAuley

Hadley

Elneima

et al. 2020

Preprint

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“…Moreover, having COPD does not seem to confer a substantial risk for severe disease and mortality. These are interesting in that the results from numerous epidemiologic studies have suggested that COPD is associated with an increased risk of poor outcome in patients with COVID-19, although they failed to clearly demonstrate COPD as a risk factor for acquiring COVID-19 (2,4). Since most data so far that can potentially explain the relationship between COPD and SARS-CoV-2 in the emergence of COVID-19 has come from a limited global population, the data will inevitably involve heterogeneous patients having different proportions of medical comorbidities under the variability in testing and admission strategies (2), and this may obscure the effect of COPD on contracting COVID-19.…”

Section: Discussionmentioning

confidence: 99%

“…Initially, the prevalence of COPD among hospitalized patients with COVID-19 has been reported to be lower than in the general population and in those reported with other comorbidities (3), a nding contrary to the common speculation that COPD may be more susceptible to contracting respiratory viruses. Paradoxically, COVID-19 in COPD is increasingly associated with critical illness of COVID-19 (2,4). A nationwide analysis on the comorbidity of 1590 COVID-19 patients in China showed that COPD was a risk factor for reaching the composite end points related to poorer clinical outcomes (5).…”

Section: Introductionmentioning

confidence: 99%

COPD is a Risk Factor for COVID-19, But Does Not Confer Increased Severity of the Disease

Jeong

Kim

You

et al. 2021

Preprint

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Epidemiologic studies suggest that COPD is associated with an increased risk of poor outcome in patients with COVID-19, although they failed to demonstrate COPD as a risk factor for acquiring COVID-19. However, most data have come from a limited global population. In this nationwide cohort study based on the Korean national health insurance claims-based database, COPD is associated with increased risk for COVID-19 and having COPD does not seem to confer substantial risk for severe COVID-19 and mortality. These findings indicate that heterogeneity in the populations across many countries may complicate the net effects of COPD on the COVID-19-related outcomes.

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“…However, a controlled trial of Dexamethasone ("RECOVERY" trial) conducted in the United Kingdom showed a one-third reduction in mortality [83]. Bronchodilators are frequently administered via nebuliser in hospitalised patients with severe symptoms of COVID-19 [84]. Critical patients having hypoxemic COPD and COVID-19 are given controlled oxygen therapy as the first line treatment.…”

Section: Respiratory Disordersmentioning

confidence: 99%

Therapeutics and Vaccines: Strengthening Our Fight Against the Global Pandemic COVID-19

et al. 2021

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The newly identified 2019 novel coronavirus (SARS-CoV-2) has become a public health concern globally posing a significant threat to human health and economy and creating an unprecedented crisis in all spheres of the global life. Emergence of new genotypes of SARS-CoV during the last few years has pointed out the limited efficacy of available vaccines and antivirals, constraining the global response to the COVID-19 outburst to largely monitoring/containment. There is high priority for treatment regimes and new potential therapeutic and vaccine strategies. Several candidates have shown promising outcomes in various in vitro and in vivo models. In addition, clinical trials are in progress to test conceivable therapies showing promising outcomes in various in vivo studies. Unfortunately, very little information is available in the scientific scope which offers details to the diverse strategies being targeted to fight the pandemic, particularly with respect to the molecular targets. This review article summarizes and highlights the ongoing advances and approaches that are being carried out across the globe in designing vaccines and novel therapeutics, with particular reference to the previous knowledge gained from other viral infections like with the earlier SARS and MERS-CoV. A detailed knowledge may pave the way to combat this pandemic COVID-19 as well as prevent similar deadly epidemics in future.

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Caring for patients with COPD and COVID-19: a viewpoint to spark discussion

Cited by 21 publications

References 29 publications

COPD in the time of COVID-19: An analysis of acute exacerbations and reported behavioural changes in patients with COPD

COPD in the time of COVID-19: An analysis of acute exacerbations and reported behavioural changes in patients with COPD

COPD is a Risk Factor for COVID-19, But Does Not Confer Increased Severity of the Disease

Therapeutics and Vaccines: Strengthening Our Fight Against the Global Pandemic COVID-19

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