Impact of COVID-19 shielding on physical activity and quality of life in patients with COPD

Hume, Emily; Armstrong, Matthew; Manifield, James; McNeillie, Laura; Chambers, Francesca; Wakenshaw, Lynsey; Burns, Graham; Heslop-Marshall, Karen; Vogiatzis, Ioannis

doi:10.1183/20734735.0231-2020

Cited by 19 publications

(16 citation statements)

References 19 publications

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“…Regardless, the self-reported physical capacity of the patients decreased, in accordance with objective measurements. [20] The assumption that the protective measures against COVID-19 were effective, is in line with the observation that only five of 564 patients became infected with COVID-19. Considering that severe exacerbations are known to have a major impact on the course of the disease, [3,21] it could be argued that in the future COPD patients might benefit from some of the protective measures established during the pandemic., such as a careful selection of contacts and the wearing of face-masks under specific conditions.…”

Section: Discussionmentioning

confidence: 57%

Impact of the COVID-19 pandemic on the behaviour and health status of patients with COPD: results from the German COPD cohort COSYCONET

et al. 2021

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BackgroundInfection control measures for COVID-19 might have affected management and clinical state of patients with chronic obstructive pulmonary disease (COPD). We analysed to which extent this common notion is fact-based.MethodsPatients of the COSYCONET cohort were contacted with three recurring surveys (COVID1, 2, 3 at 0, 3 and 6 months). The questionnaires comprised behaviour, clinical and functional state and medical treatment. The responses to the questionnaires were compared amongst themselves and with pre-COVID information from the last visit of COSYCONET.ResultsOverall, 594 patients were contacted and 375 patients (58% males, FEV1 61±22%predicted) provided valid data in COVID1 and COVID2. Five patients reported infections with SARS-CoV-2. Most patients – except for patients with higher education – reported compliance with recommended protective measures, whereby compliance to hygiene, contact and access to physicians slightly improved between COVID1 and COVID2. Also, patients obtained more information from physicians than from public media. In the majority of cases, the personal physician could not be substituted by remote consultation. Over time, symptoms slightly increased and self-assessed physical capacity decreased. Results of COVID3 were similar. Women and patients with more exacerbations and dyspnoea avoided medical consultations, whereas GOLD D patients were more amenable to tele-consultation.ConclusionIn well-characterised COPD patients, we observed on average slight deteriorations of clinical state during the period of COVID-19 restrictions, with high and partially increasing adherence to protective measures. The data suggest that in particular women and GOLD D patients should be actively contacted by physicians to identify deteriorations.

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Section: Discussionmentioning

confidence: 57%

Impact of the COVID-19 pandemic on the behaviour and health status of patients with COPD: results from the German COPD cohort COSYCONET

et al. 2021

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“…This corroborates a small cohort study of 10 COPD patients who had a significant reduction in their level of physical activity during the first 3 months of the pandemic while under instructions to physically and socially isolate following a course of pulmonary rehabilitation. 35 Furthermore, we found the impact on reduced activity in non-malignant respiratory disease was significantly greater than malignant respiratory disease. However, even pre-pandemic, over time, physical activity in COPD has been shown to follow a downwards trajectory and exacerbated by sedentary behaviour.…”

Section: Discussionmentioning

confidence: 71%

Relationships between prolonged physical and social isolation during the COVID-19 pandemic, reduced physical activity and disability in activities of daily living among people with advanced respiratory disease

et al. 2021

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In people with advanced respiratory disease, we examined (i) the impact of COVID-19–related physical and social isolation on physical activity and (ii) relationships between time spent in isolation and disability in activities of daily living. Cross-sectional analysis was conducted in adults with advanced non-small cell lung cancer, chronic obstructive lung disease or interstitial lung disease. Measures included change in physical activity since physically and socially isolating (Likert scale) and disability (Barthel Index and Lawton–Brody IADL scale) or difficulty (World Health Organisation Disability Assessment Schedule-2.0) in daily activities. Multiple logistic regression was used to examine factors associated with disability in daily activities. 194/201 participants were isolating for a median [IQR] 5 [3–8]-month period, often leading to lower levels of physical activity at home ( n = 94, 47%), and outside home ( n = 129, 65%). 104 (52%) and 142 (71%) were not fully independent in basic and instrumental activities of daily living, respectively. 96% reported some degree of difficulty in undertaking daily activities. Prolonged physical and social isolation related to increased disability in basic (r = −0.28, p < 0.001) and instrumental (r = −0.24, p < 0.001) activities of daily living, and greater difficulty in daily activities (r = 0.22, p = 0.002). Each month spent in physical or social isolation was independently related to disability in basic activities of daily living (odds ratio [OR], 1.17 [95% CI: 1.03–1.33], p = 0.013). These findings suggest disability in daily activities is associated with prolonged physical or social isolation, which may present as difficulty in people who are fully independent. Post-isolation recovery and rehabilitation needs should be considered for all people deemed extremely clinically vulnerable.

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“…Our survey revealed long-term consequences of COVID-19 shielding on individuals’ physical activity behavior with 46% of pwCF reporting to undertake less physical activity during the pandemic. Reduced physical activity levels during earlier phases of the COVID-19 pandemic have also been reported in people living with chronic obstructive pulmonary disease and renal disease [ 21 , 22 ]. Our data suggest unfavorable and prolonged effects of COVID-19 restrictions on a cornerstone therapy of CF care, given the fact that a similar proportion of pwCF in this survey (i.e., 45% in our previous survey covering a shorter time-period during the first phase of the pandemic) reported less daily physical activity.…”

Section: Discussionmentioning

confidence: 98%

COVID-19 pandemic restrictions continuously impact on physical activity in adults with cystic fibrosis

et al. 2021

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Background We have recently reported reduced physical activity (PA) in people with cystic fibrosis (pwCF) with and without lung transplantation (LTX) during a 6-week stringent lockdown in Switzerland. This follow-up study explores the impact of coronavirus-2019 disease (COVID-19) related pandemic restrictions on individuals’ therapy regimens and health-related aspects in pwCF. Methods We conducted a cross-sectional web-based national survey in Spring 2021. The survey included questions on daily PA, airway clearance and inhalation therapy, questions on COVID-19-compatible symptoms, diagnostic tests and vaccination status, and enquired health-related aspects covering the pandemic period between March 2020 to April 2021. Results 193 individuals with CF (53% female; 25% LTX recipients) participated. Among pwCF, 10 reported COVID-19 (n = 2 LTX recipients), two subjects were hospitalized, no invasive ventilation required, no deaths. The clinical course was generally mild. Overall, 46% reported less PA during the pandemic, mostly due to closed fitness facilities (85%), lack of motivation (34%), and changes in daily structures (21%). In contrast, 32/193 (17%) pwCF were able to increase their PA levels: 12 (38%) and 11 (34%) reported undertaking home-based training and outdoor activities more frequently; 6 (19%) reported an increase in routine PA, and another 3 (9%) started new activities. Among pwCF without LTX, 5% and 4% reported to undertake less airway clearance and inhalation therapy, respectively. Conclusions Our study reveals unfavorable consequences of COVID-19 pandemic restrictions on PA of pwCF with unknown long-term consequences for their overall physical fitness and lung health. Strategies to overcome this undesirable situation are needed; increased uptake of telehealth PA programs and virtual exercise classes to promote PA participation might be one promising approach along with vaccination of pwCF and their close contacts.

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Impact of COVID-19 shielding on physical activity and quality of life in patients with COPD

Abstract: @ERSpublications In response to #COVID19, healthcare professionals should scale up virtual consultations for assessing core patient-reported outcomes and providing home-based rehabilitation programmes #COPD https://bit.ly/30gQEpG @emilyhume

Cited by 19 publications

References 19 publications

Impact of the COVID-19 pandemic on the behaviour and health status of patients with COPD: results from the German COPD cohort COSYCONET

Impact of the COVID-19 pandemic on the behaviour and health status of patients with COPD: results from the German COPD cohort COSYCONET

Relationships between prolonged physical and social isolation during the COVID-19 pandemic, reduced physical activity and disability in activities of daily living among people with advanced respiratory disease

COVID-19 pandemic restrictions continuously impact on physical activity in adults with cystic fibrosis

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