Impact of COVID-19 on Hospital Admissions, Health Status, and Behavioral Changes of Patients with COPD.

Introduction Patient with chronic obstructive lung disease (COPD) have an increased risk of severe Coronavirus disease (COVID-19), which is why self-isolation was recommended. However, long periods of social isolation accompanied with limited access to health care systems might influence the outcome of patients with severe COPD negatively. Methods Data from COPD and pneumonia patients at Charité-Universitätsmedizin, Berlin and the volume of endoscopic lung volume reduction (ELVR) from the German lung emphysema registry (Lungenemphysem Register e.V.) were analyzed from pre-pandemic (2012 to 2019) to pandemic (2020 and 2021) period. In addition, 52 patients with COPD GOLD IV status included in the lung emphysema registry received questionnaires during lockdowns from June 2020 to April 2021. Results Admissions and ventilation therapies administered to COPD patients significantly decreased during the COVID-19 pandemic. Likewise, there was a reduction of ELVR treatments and follow-ups registered in German emphysema centers. Mortality was slightly higher among patients hospitalized with COPD during pandemic. Increasing proportions of COPD patients with GOLD III and GOLD IV status reported behavioral changes and subjective feelings of increasing COPD symptoms the longer the lockdown lasted. However, COPD symptom questionnaires revealed stable COPD symptoms over the pandemic time-period. Summary This study reveals reduced COPD admissions and elective treatment procedures of COPD patients during pandemic, but a slight increase of mortality among patients hospitalized with COPD irrespective of COVID-19. Correspondingly, patients with severe COPD reported subjective deterioration of their health status probably caused by their very strict compliance to lockdown measures.