Decreasing rates of ambulatory and hospitalized exacerbations of COPD during COVID-19 pandemic

Introduction Acute exacerbation of COPD (AECOPD) is a significant event in COPD associated with worse outcome and progressive lung disease. Infectious agents are thought to play an important role in causing AECOPD. Prevention of an exacerbation is an important therapeutic aim in COPD.

Methods In order to gain insight into the relationship of ambulatory and hospitalized AECOPD cases we requested anonymized data from the largest local health care insurance including 4.5 Mio insurants of saxony and saxony-anhalt. Between 2016-2021 there were 516.591 ambulatory (466.841) and hospitalized (49.750) patients with an AECOPD (including J44.0 or J44.1; ICD-10). From 2016 to 2019 an average of 81.628 ambulatory and 9.378 hospitalized ECOPD cases per year were documented.

Results AECOPD diagnoses in ambulatory care were decreased by 9,7% (73.702) in 2020 and 18,4% (66.629) in 2021. AECOPD cases in hospitals were reduced by 27,6% in 2020 (6.791) and 41,9% (5.447) in 2021. The percental diagnosis per insurant dropped from a mean of 0,28% (2016 to 2019) to 0,18% in 2020 and 0,12% in 2021. During previous years there was a seasonal peak within the first quarter of the year, more pronounced during the influenza pandemic 2018. In 2021 this seasonal peak was not detectable ([Figure 1]). The reduction in hospitalized AECOPD was more significant than that seen in practicing doctor sector.

Fig. 1  

Discussion To our knowledge here we provide the biggest data set regarding information about decline of AECOPD in ambulatory care and hospital. Clearly the observed fall in case numbers of in and out patient AECOPD cases is related to preventive COVID-19 measures such as wearing masks, social isolation, improved hand hygiene, keeping distances, closure of public spaces and restaurants, testing and possibly also due to vaccination strategies. All together, these preventive measures showed effective in eliminating the usual seasonal peak.

Publication History

Article published online:
09 March 2023