Hospital admissions and mortality for acute exacerbations of COPD during the COVID-19 pandemic: A nationwide study in France

Abstract

Background: A global reduction in hospital admissions for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) was observed during the first months of the COVID-pandemic. Large-scale studies covering the entire pandemic period are lacking. We investigated hospitalizations for AECOPD and the associated in-hospital mortality at the national level in France during the first years of the pandemic.Methods: We used the French National Hospital Database to analyse the time trends in ( ) monthly incidences of hospitalizations for AECOPD, considering intensive care unit (ICU) admission and COVID-diagnoses, and ( ) the related in-hospital mortality, from January to November . Pandemic years were compared with the pre-pandemic years using Poisson regressions.Results: The database included , hospitalizations for AECOPD during the study period. The median age at admission was years (interquartile range -), and % of the stays concerned women. We found: ( ) a dramatic and sustainable decline in hospitalizations for AECOPD over the pandemic period (from , to , monthly admissions, relative risk (RR) . , % confidence interval (CI) . -. ), and ( ) a concomitant increase in in-hospital mortality for AECOPD stays (from . to . % per month, RR . , % CI . -. ). The proportion of stays yielding ICU admission was similar in the pre-pandemic and pandemic years, . and . %, respectively. In-hospital mortality increased to a greater extent for stays without ICU admission (RR . , % CI . -. ) than for those with ICU admission (RR . , % CI . -. ). Since January , only . % of stays were associated with a diagnosis of COVID-, and their mortality rate was nearly three-times higher than those without COVID-(RR . , % CI . -. ).

Chronic Obstructive Pulmonary Disease Mortality and Hospitalization during the COVID-19 Pandemic Compared with before the Pandemic: A Systematic Review and Meta-Analysis

“…The studies included eleven with the outcome of mortality [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ] and eleven with the outcome of hospitalization for AECOPD [ 22 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ]. Dang et al reported the outcomes of mortality and hospitalization rates for AECOPD [ 22 ].…”

“…Dang et al reported the outcomes of mortality and hospitalization rates for AECOPD [ 22 ]. Twelve studies had a European research region, including France, Germany, Hungary, Malta, Portugal, Slovenia, Spain, Türkiye, and the United Kingdom [ 23 , 24 , 25 , 28 , 29 , 30 , 32 , 33 , 34 , 35 , 36 , 37 ]. There were eleven multicenter [ 22 , 23 , 25 , 26 , 28 , 29 , 30 , 32 , 35 , 39 , 40 ] and ten single-center studies.…”

“…Twelve studies had a European research region, including France, Germany, Hungary, Malta, Portugal, Slovenia, Spain, Türkiye, and the United Kingdom [ 23 , 24 , 25 , 28 , 29 , 30 , 32 , 33 , 34 , 35 , 36 , 37 ]. There were eleven multicenter [ 22 , 23 , 25 , 26 , 28 , 29 , 30 , 32 , 35 , 39 , 40 ] and ten single-center studies. Fifteen studies were observational cohort studies [ 21 , 22 , 23 , 24 , 25 , 26 , 28 , 29 , 32 , 34 , 35 , 37 , 38 , 39 ], and six studies were letters or conference abstracts [ 20 , 27 , 30 , 34 , 37 , 40 ] ( Table 1 ).…”

Impact of Coronavirus Disease 2019 on Hospital Admissions, Health Status, and Behavioral Changes of Patients with COPD

“…Nevertheless, data on the mortality of COPD patients during the pandemic are inconsistent and further studies are warranted. 22,32,33 The ventilation therapy use among COPD deaths was significantly lower during the pandemic when compared to the pre-pandemic time period. This is an interesting observation and could be due to the fact that COPD patients were admitted to the clinic at an already severely exacerbated state of their disease, too advanced to administer mechanical ventilation.…”

Direct and indirect impact of the COVID-19 pandemic on the survival of kidney transplant recipients: a national observational study in France

“…With the growing interest of the scientific medical community in real-world data from large administrative healthcare databases, the SNDS is increasingly used for pharmacoepidemiologic studies, 16,17 including studies on COVID-19. 8,11,18,19 The study took advantage of the G9 mapping, a useful tool provided within the SNDS which allows an automatic selection of individuals labelled with a given chronic disease in a given year. 20 Several pathologies have been considered in the G9 mapping including persons with end stage terminal kidney disease (ESKD) and we used it for selecting the persons included in the study.…”