Polat Yulug Demet, Sen Elif, Alpaydin Aylin Ozgen, Nayci Sibel, Ozgur Eylem Sercan, Baydar Toprak Oya, Sahin Ahmet Melih, Selcuk Elif, Yigit Salih, Elmas Uysal Funda, Gurgun Alev, Kokturk Nurdan, Mammadova Ayshan, Varol Yelda, Baha Ayşe, Polatli Mehmet, Yaz Aybüke, Serifoglu Rahatli Irem, Kocabas Ali
Faculty of Medicine, Department of Pulmonary Diseases, Mersin University, Mersin, Turkey.
Faculty of Medicine, Department of Pulmonary Diseases, Ankara University, Ankara, Turkey.
BMC Pulm Med. 2025 Aug 30;25(1):414. doi: 10.1186/s12890-025-03883-8.
BACKGROUND: The COVID-19 pandemic and related public health restrictions have substantially altered healthcare access and delivery, particularly for patients with chronic conditions such as chronic obstructive pulmonary disease (COPD). This study aimed to evaluate the impact of the COVID-19 pandemic and lockdown measures on COPD-related symptoms and hospital admissions, and to compare these outcomes with the pre-pandemic period. METHODS: This multicenter cross-sectional study was conducted between July 2021 and February 2022 across ten tertiary pulmonary outpatient clinics in Turkey. A total of 347 COPD patients were included. Data on demographics, spirometry, symptom progression, medication access, COVID-19 history, and hospital admissions were collected via structured questionnaire and medical records. Pandemic-related outcomes were compared with data from the pre-pandemic year (March 2019-March 2020). Additional multivariable regression analyses were performed to identify predictors of hospital admission and COVID-19-related hospitalization. RESULTS: The mean number of hospital admissions significantly decreased during the pandemic compared to the pre-pandemic period (p < 0.001), while patient-reported respiratory symptoms increased over time. Hospital admissions were lowest during the first pandemic period, when restrictions were most intense. Regression analyses showed that lower FEV₁, advanced GOLD stage, and inhaled corticosteroid (ICS) use were independently associated with increased hospital admissions. COVID-19 was diagnosed in 21.1% of patients. Lower FEV₁, GOLD stage, and smoking were significantly associated with COVID-19-related hospitalization. CONCLUSION: Although COPD-related hospital admissions decreased during the pandemic, respiratory symptoms progressively worsened. These findings reflect the complex interplay between public health measures, healthcare accessibility, and chronic disease management. Disease severity and airflow limitation were key determinants of adverse outcomes. Maintaining access to routine care and adopting personalized approaches in COPD management are essential during public health emergencies.
背景：2019冠状病毒病（COVID-19）大流行及相关公共卫生限制措施已极大地改变了医疗服务的可及性和提供方式，尤其是对于慢性阻塞性肺疾病（COPD）等慢性病患者。本研究旨在评估COVID-19大流行和封锁措施对COPD相关症状及住院情况的影响，并将这些结果与大流行前时期进行比较。 方法：本多中心横断面研究于2021年7月至2022年2月在土耳其的十家三级肺科门诊进行。共纳入347例COPD患者。通过结构化问卷和病历收集人口统计学、肺功能测定、症状进展、药物获取、COVID-19病史及住院情况等数据。将与大流行相关的结果与大流行前一年（2019年3月至2020年3月）的数据进行比较。进行了额外的多变量回归分析以确定住院和COVID-19相关住院的预测因素。 结果：与大流行前时期相比，大流行期间的平均住院次数显著减少（p < 0.001），而患者报告的呼吸道症状随时间增加。在大流行的第一个时期，即限制最为严格的时候，住院次数最低。回归分析显示，较低的第一秒用力呼气容积（FEV₁）、较高的慢性阻塞性肺疾病全球倡议（GOLD）分级以及吸入糖皮质激素（ICS）的使用与住院次数增加独立相关。21.1%的患者被诊断为COVID-19。较低的FEV₁、GOLD分级和吸烟与COVID-19相关住院显著相关。 结论：尽管大流行期间与COPD相关的住院次数减少，但呼吸道症状逐渐恶化。这些发现反映了公共卫生措施、医疗服务可及性和慢性病管理之间复杂的相互作用。疾病严重程度和气流受限是不良结局的关键决定因素。在公共卫生紧急情况期间，维持常规护理的可及性并在COPD管理中采用个性化方法至关重要。
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