Comparative analysis of COPD exacerbations requiring hospital admission: pre, during, and post-COVID-19 pandemic in a tertiary centre in the UK

<bold>Introduction:</bold> Evidence suggests a decrease in COPD exacerbation hospitalization during the COVID-19 pandemic but comparative data across pre-, during, and post-pandemic periods are lacking. <bold>Aim:</bold> This paper aims to compare hospitalized COPD exacerbations to assess disease severity before, during, and after the COVID-19 pandemic. Method: A retrospective observational study of hospital electronic records was conducted for patients admitted with COPD exacerbation with or without COVID-19 over three different periods: December to mid-January in 2018-2019 and 2022-2023, and from May to mid-June 2020. <bold>Results:</bold> Hospitalized COPD exacerbation decreased during the pandemic (n=99) than pre-pandemic (n=130) but increased significantly in the post-pandemic period (n = 166). Mortality rate rose during the pandemic (14%) and post-pandemic (14%) than pre-pandemic (5%) era. Influenza A and RSV prevalence and associated mortality have increased post-pandemic compared to pre-pandemic. Table1: COPD exacerbation severity <table-wrap><object-id>erj;64/suppl_68/PA384/TB1</object-id><object-id>T1</object-id><object-id>TB1</object-id><table><colgroup><col></col><col></col><col></col><col></col></colgroup><tbody><tr><td><bold>Variables</bold></td><td><bold>Pre-pandemic</bold></td><td><bold>Pandemic</bold></td><td><bold>Post-pandemic</bold></td></tr><tr><td>Total mortality</td><td>6 (5%)</td><td>14 (14%)</td><td>23 (14%)</td></tr><tr><td> <bold>Exacerbating factors</bold> </td><td> </td><td> </td><td> </td></tr><tr><td> Influenza A RSV COVID-19 Sputum culture Nil positive </td><td> 1 (0.78%) 5 (4%) 0 7 (5%) 117 (90%) </td><td> 0 0 10 (10%) 2 (2%) 87 (88%) </td><td> 19 (11%) 21 (13%) 32 (19%) 7 (4%) 87 (52%) </td></tr><tr><td> <bold>Mortality in positive microbiology & virology</bold> </td><td> </td><td> </td><td> </td></tr><tr><td> Influenza A RSV COVID-19 Sputum culture Nil positive </td><td> 0 0 0 1 (14%) 5 (4%) </td><td> 0 0 5 (50%) 0 5 (6%) </td><td> 1 (5%) 3 (14%) 7 (22%) 0 12 (14%) </td></tr></tbody></table></table-wrap> <bold>Conclusion:</bold> COVID-19 remains a significant burden on COPD admission and mortality along with notable prevalence of other respiratory viruses. Hence continuous reinforcement of precautionary measures to prevent COPD exacerbation is vital.