COPD Exacerbations Before and During COVID-19 in France, Germany, Italy, the UK and the US

Int J Chron Obstruct Pulmon Dis. 2024 Jun 25:19:1433-1445. doi: 10.2147/COPD.S451009. eCollection 2024.

Abstract

Background: Exacerbations of chronic obstructive pulmonary disease (COPD) were reported less frequently during the COVID-19 pandemic. We report real-world data on COPD exacerbation rates before and during this pandemic.

Methods: Exacerbation patterns were analysed using electronic medical records or claims data of patients with COPD before (2017-2019) and during the COVID-19 pandemic (2020 through early 2022) in France, Germany, Italy, the United Kingdom and the United States. Data from each country were analysed separately. The proportions of patients with COPD receiving maintenance treatment were also estimated.

Results: The proportion of patients with exacerbations fell 45-78% across five countries in 2020 versus 2019. Exacerbation rates in most countries were reduced by >50% in 2020 compared with 2019. The proportions of patients with an exacerbation increased in most countries in 2021. Across each country, seasonal exacerbation increases seen during autumn and winter in pre-pandemic years were absent during the first year of the pandemic. The percentage of patients filling COPD prescriptions across each country increased by 4.53-22.13% in 2019 to 9.94-34.17% in 2021.

Conclusion: Early, steep declines in exacerbation rates occurred in 2020 versus 2019 across all five countries and were accompanied by a loss of the seasonal pattern of exacerbation.

Keywords: COPD exacerbation; COVID-19; chronic obstructive pulmonary disease; electronic health records; real-world study.

MeSH terms

  • Aged
  • COVID-19* / epidemiology
  • Disease Progression*
  • Female
  • France / epidemiology
  • Humans
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Pandemics
  • Pulmonary Disease, Chronic Obstructive* / diagnosis
  • Pulmonary Disease, Chronic Obstructive* / epidemiology
  • Pulmonary Disease, Chronic Obstructive* / physiopathology
  • SARS-CoV-2
  • Seasons
  • Time Factors
  • United Kingdom / epidemiology
  • United States / epidemiology

Grants and funding

This study was funded by Chiesi Farmaceutici S.p.A. Chiesi Farmaceutici S.p.A. participated in study design, data collection, data analysis, data interpretation, and writing the report. The funders reviewed the draft of the manuscript.