Trujillo Christian, Garnet Brian, Zadeh Ali Vaeli, Urdaneta Gisel, Campos Michael
Jackson Memorial Medical Center, Miami, Florida, United States.
Miami Veterans Administration Medical Center, Miami, Florida, United States.
Chronic Obstr Pulm Dis. 2021 Oct 28;8(4):572-579. doi: 10.15326/jcopdf.2021.0234.
Studies have shown a decline in hospitalizations due to acute exacerbations of COPD (AECOPD) during the coronavirus disease 2019 (COVID-19) pandemic. However, the impact of the pandemic in AECOPD of all severities in longitudinal cohorts of patients is lacking.
We conducted analysis of 123 individuals with COPD who have been followed since 2017. AECOPDs of mild (treatment at home), moderate (emergency department or urgent visit evaluation), and severe (hospitalization) type were assessed by chart review and patient interview. Compliance with preventive measures to avoid COVID-19 infection was assessed in 2020. Differences between the rate of AECOPD by year was analyzed as well as differences in preventive measures by COPD disease severity.
During the COVID-19 pandemic in 2020, there was a significant reduction in AECOPDs in our cohort with 26 participants (21%) having an exacerbation compared to 46 (37%) in 2019, 52 (42%) in 2018, and 44 (36%) in 2017. Mean exacerbation rates decreased 54% overall and 74% in frequent exacerbators compared with the prior 3-year average. The decrease was noted in AECOPDs of all severities. Overall, there was a high rate of reported compliance with social distancing and face mask use that was significantly higher in the group with more severe COPD based on symptoms and forced expiratory volume in 1 second.
Individuals with COPD, including frequent exacerbators, showed a marked decrease in AECOPD during the COVID-19 pandemic and high adherence to recommended preventive measures. Evaluation of the impact of preventive strategies on AECOPD in a non-pandemic setting may be of value and requires further study.
研究表明，在2019冠状病毒病（COVID-19）大流行期间，慢性阻塞性肺疾病急性加重（AECOPD）导致的住院人数有所下降。然而，大流行对患者纵向队列中所有严重程度的AECOPD的影响尚不清楚。
我们对自2017年以来随访的123例慢性阻塞性肺疾病患者进行了分析。通过病历审查和患者访谈评估轻度（在家治疗）、中度（急诊科或紧急就诊评估）和重度（住院）类型的AECOPD。2020年评估了预防COVID-19感染的预防措施的依从性。分析了每年AECOPD发生率的差异以及不同COPD疾病严重程度的预防措施差异。
在2020年COVID-19大流行期间，我们队列中的AECOPD显著减少，26名参与者（21%）出现病情加重，而2019年为46名（37%），2018年为52名（42%），2017年为44名（36%）。与前三年的平均水平相比，平均加重率总体下降了54%，频繁加重者下降了74%。所有严重程度的AECOPD均出现下降。总体而言，报告的社交距离和口罩使用依从率较高，根据症状和第1秒用力呼气量，在COPD更严重的组中显著更高。
慢性阻塞性肺疾病患者，包括频繁加重者，在COVID-19大流行期间AECOPD显著减少，并且对推荐的预防措施有很高的依从性。在非大流行环境中评估预防策略对AECOPD的影响可能有价值，需要进一步研究。
