Changes in exercise capacity, symptom burden and mental health scores in individuals with chronic obstructive pulmonary disease pre and post the COVID-19 pandemic

<bold>Background:</bold> During the COVID-19 pandemic physical and social distancing (lockdowns and cocooning) were recommended for high-risk groups including those with chronic obstructive pulmonary disease (COPD) to reduce infection risk. However, social isolation has the potential to result in adverse effects on physical activity and mental health and may lead to deconditioning particularly in already vulnerable individuals. <bold>Methods:</bold> To assess the impact of cocooning in COPD, we examined exercise capacity (six-minute walk test (6MWT) distance), symptom burden (COPD Assessment Test (CAT)) and mental health scores (using the Hospital Anxiety and Depression Scale (HADS)) in COPD patients referred for pulmonary rehabilitation (PR) before and after the onset of the COVID-19 pandemic. <bold>Results:</bold> A total of 160 patients with COPD undergoing assessment for PR were included, with n=118 undergoing assessment in 2018 and 2019 (pre-pandemic) and n=42 undergoing assessment in 2020 and 2021 (during/post pandemic onset). Unexpectedly, the mean 6MWT distance was significant higher in the post-pandemic group (p<0.05). Despite this finding, the post pandemic cohort reported a significantly higher symptom burden (p<0.05) versus their pre-pandemic counterparts and exhibited as a trend towards an increased HADS score (p>0.05). <bold>Conclusion:</bold> Though no reduction in exercise capacity was observed, COPD patients attending for PR assessment after the COVID-19 pandemic onset were significantly more symptomatic, with higher anxiety and depression scores than prior to the pandemic.