Population Decline in COPD Admissions During the COVID-19 Pandemic Associated with Lower Burden of Community Respiratory Viral Infections

Jennifer Y. So; Nathan N. O'Hara; Blaine Kenaa; John G. Williams; Christopher L. deBorja; Julia F. Slejko; Zafar Zafari; Michael Sokolow; Paul Zimand; Meagan Deming; Jason Marx; Andrew N. Pollak; Robert M. Reed

doi:10.1016/j.amjmed.2021.05.008

Population Decline in COPD Admissions During the COVID-19 Pandemic Associated with Lower Burden of Community Respiratory Viral Infections

Jennifer Y. So, Nathan N. O'Hara, Blaine Kenaa, John G. Williams, Christopher L. deBorja, Julia F. Slejko, Zafar Zafari, Michael Sokolow, Paul Zimand, Meagan Deming, Jason Marx, Andrew N. Pollak, Robert M. Reed

School of Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

Background: The Coronavirus disease 2019 (COVID-19) pandemic has led to widespread implementation of public health measures, such as stay-at-home orders, social distancing, and masking mandates. In addition to decreasing spread of severe acute respiratory syndrome coronavirus 2, these measures also impact the transmission of seasonal viral pathogens, which are common triggers of chronic obstructive pulmonary disease (COPD) exacerbations. Whether reduced viral prevalence mediates reduction in COPD exacerbation rates is unknown. Methods: We performed retrospective analysis of data from a large, multicenter health care system to assess admission trends associated with community viral prevalence and with initiation of COVID-19 pandemic control measures. We applied difference-in-differences analysis to compare season-matched weekly frequency of hospital admissions for COPD prior to and after implementation of public health measures for COVID-19. Community viral prevalence was estimated using regional Centers for Disease Control and Prevention test positivity data and correlated to COPD admissions. Results: Data involving 4422 COPD admissions demonstrated a season-matched 53% decline in COPD admissions during the COVID-19 pandemic, which correlated to community viral burden (r = 0.73; 95% confidence interval, 0.67-0.78) and represented a 36% greater decline over admission frequencies observed in other medical conditions less affected by respiratory viral infections (incidence rate ratio 0.64; 95% confidence interval, 0.57-0.71, P <.001). The post-COVID-19 decline in COPD admissions was most pronounced in patients with fewer comorbidities and without recurrent admissions. Conclusion: The implementation of public health measures during the COVID-19 pandemic was associated with decreased COPD admissions. These changes are plausibly explained by reduced prevalence of seasonal respiratory viruses.

Original language	English (US)
Pages (from-to)	1252-1259.e3
Journal	American Journal of Medicine
Volume	134
Issue number	10
DOIs	https://doi.org/10.1016/j.amjmed.2021.05.008
State	Published - Oct 2021

Keywords

COPD
COVID
Community viral infections
Exacerbations

ASJC Scopus subject areas

General Medicine

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10.1016/j.amjmed.2021.05.008

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So, J. Y., O'Hara, N. N., Kenaa, B., Williams, J. G., deBorja, C. L., Slejko, J. F., Zafari, Z., Sokolow, M., Zimand, P., Deming, M., Marx, J., Pollak, A. N., & Reed, R. M. (2021). Population Decline in COPD Admissions During the COVID-19 Pandemic Associated with Lower Burden of Community Respiratory Viral Infections. American Journal of Medicine, 134(10), 1252-1259.e3. https://doi.org/10.1016/j.amjmed.2021.05.008

So, JY, O'Hara, NN, Kenaa, B, Williams, JG, deBorja, CL, Slejko, JF, Zafari, Z, Sokolow, M, Zimand, P, Deming, M, Marx, J, Pollak, AN & Reed, RM 2021, 'Population Decline in COPD Admissions During the COVID-19 Pandemic Associated with Lower Burden of Community Respiratory Viral Infections', American Journal of Medicine, vol. 134, no. 10, pp. 1252-1259.e3. https://doi.org/10.1016/j.amjmed.2021.05.008

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title = "Population Decline in COPD Admissions During the COVID-19 Pandemic Associated with Lower Burden of Community Respiratory Viral Infections",

abstract = "Background: The Coronavirus disease 2019 (COVID-19) pandemic has led to widespread implementation of public health measures, such as stay-at-home orders, social distancing, and masking mandates. In addition to decreasing spread of severe acute respiratory syndrome coronavirus 2, these measures also impact the transmission of seasonal viral pathogens, which are common triggers of chronic obstructive pulmonary disease (COPD) exacerbations. Whether reduced viral prevalence mediates reduction in COPD exacerbation rates is unknown. Methods: We performed retrospective analysis of data from a large, multicenter health care system to assess admission trends associated with community viral prevalence and with initiation of COVID-19 pandemic control measures. We applied difference-in-differences analysis to compare season-matched weekly frequency of hospital admissions for COPD prior to and after implementation of public health measures for COVID-19. Community viral prevalence was estimated using regional Centers for Disease Control and Prevention test positivity data and correlated to COPD admissions. Results: Data involving 4422 COPD admissions demonstrated a season-matched 53% decline in COPD admissions during the COVID-19 pandemic, which correlated to community viral burden (r = 0.73; 95% confidence interval, 0.67-0.78) and represented a 36% greater decline over admission frequencies observed in other medical conditions less affected by respiratory viral infections (incidence rate ratio 0.64; 95% confidence interval, 0.57-0.71, P <.001). The post-COVID-19 decline in COPD admissions was most pronounced in patients with fewer comorbidities and without recurrent admissions. Conclusion: The implementation of public health measures during the COVID-19 pandemic was associated with decreased COPD admissions. These changes are plausibly explained by reduced prevalence of seasonal respiratory viruses.",

keywords = "COPD, COVID, Community viral infections, Exacerbations",

author = "So, {Jennifer Y.} and O'Hara, {Nathan N.} and Blaine Kenaa and Williams, {John G.} and deBorja, {Christopher L.} and Slejko, {Julia F.} and Zafar Zafari and Michael Sokolow and Paul Zimand and Meagan Deming and Jason Marx and Pollak, {Andrew N.} and Reed, {Robert M.}",

note = "Publisher Copyright: {\textcopyright} 2021 Elsevier Inc.",

year = "2021",

month = oct,

doi = "10.1016/j.amjmed.2021.05.008",

language = "English (US)",

volume = "134",

pages = "1252--1259.e3",

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T1 - Population Decline in COPD Admissions During the COVID-19 Pandemic Associated with Lower Burden of Community Respiratory Viral Infections

AU - So, Jennifer Y.

AU - O'Hara, Nathan N.

AU - Kenaa, Blaine

AU - Williams, John G.

AU - deBorja, Christopher L.

AU - Slejko, Julia F.

AU - Zafari, Zafar

AU - Sokolow, Michael

AU - Zimand, Paul

AU - Deming, Meagan

AU - Marx, Jason

AU - Pollak, Andrew N.

AU - Reed, Robert M.

PY - 2021/10

Y1 - 2021/10

N2 - Background: The Coronavirus disease 2019 (COVID-19) pandemic has led to widespread implementation of public health measures, such as stay-at-home orders, social distancing, and masking mandates. In addition to decreasing spread of severe acute respiratory syndrome coronavirus 2, these measures also impact the transmission of seasonal viral pathogens, which are common triggers of chronic obstructive pulmonary disease (COPD) exacerbations. Whether reduced viral prevalence mediates reduction in COPD exacerbation rates is unknown. Methods: We performed retrospective analysis of data from a large, multicenter health care system to assess admission trends associated with community viral prevalence and with initiation of COVID-19 pandemic control measures. We applied difference-in-differences analysis to compare season-matched weekly frequency of hospital admissions for COPD prior to and after implementation of public health measures for COVID-19. Community viral prevalence was estimated using regional Centers for Disease Control and Prevention test positivity data and correlated to COPD admissions. Results: Data involving 4422 COPD admissions demonstrated a season-matched 53% decline in COPD admissions during the COVID-19 pandemic, which correlated to community viral burden (r = 0.73; 95% confidence interval, 0.67-0.78) and represented a 36% greater decline over admission frequencies observed in other medical conditions less affected by respiratory viral infections (incidence rate ratio 0.64; 95% confidence interval, 0.57-0.71, P <.001). The post-COVID-19 decline in COPD admissions was most pronounced in patients with fewer comorbidities and without recurrent admissions. Conclusion: The implementation of public health measures during the COVID-19 pandemic was associated with decreased COPD admissions. These changes are plausibly explained by reduced prevalence of seasonal respiratory viruses.

AB - Background: The Coronavirus disease 2019 (COVID-19) pandemic has led to widespread implementation of public health measures, such as stay-at-home orders, social distancing, and masking mandates. In addition to decreasing spread of severe acute respiratory syndrome coronavirus 2, these measures also impact the transmission of seasonal viral pathogens, which are common triggers of chronic obstructive pulmonary disease (COPD) exacerbations. Whether reduced viral prevalence mediates reduction in COPD exacerbation rates is unknown. Methods: We performed retrospective analysis of data from a large, multicenter health care system to assess admission trends associated with community viral prevalence and with initiation of COVID-19 pandemic control measures. We applied difference-in-differences analysis to compare season-matched weekly frequency of hospital admissions for COPD prior to and after implementation of public health measures for COVID-19. Community viral prevalence was estimated using regional Centers for Disease Control and Prevention test positivity data and correlated to COPD admissions. Results: Data involving 4422 COPD admissions demonstrated a season-matched 53% decline in COPD admissions during the COVID-19 pandemic, which correlated to community viral burden (r = 0.73; 95% confidence interval, 0.67-0.78) and represented a 36% greater decline over admission frequencies observed in other medical conditions less affected by respiratory viral infections (incidence rate ratio 0.64; 95% confidence interval, 0.57-0.71, P <.001). The post-COVID-19 decline in COPD admissions was most pronounced in patients with fewer comorbidities and without recurrent admissions. Conclusion: The implementation of public health measures during the COVID-19 pandemic was associated with decreased COPD admissions. These changes are plausibly explained by reduced prevalence of seasonal respiratory viruses.

KW - COPD

KW - COVID

KW - Community viral infections

KW - Exacerbations

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SN - 0002-9343

VL - 134

SP - 1252-1259.e3

JO - American Journal of Medicine

JF - American Journal of Medicine

IS - 10

ER -

Population Decline in COPD Admissions During the COVID-19 Pandemic Associated with Lower Burden of Community Respiratory Viral Infections

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