P32 Reduction in the rate of acute exacerbations of COPD and asthma during the COVID-19 pandemic

Introduction and ObjectivesThe COVID-19 pandemic has had a devastating impact on a number of patient populations, not least those with airways disease Despite initial conflicting data, subsequent research has shown COPD patients to be at increased risk from the virus Other coronaviruses are also well recognised as viral precipitants of exacerbations in airways disease Therefore, it was reasonable to anticipate that COVID-19 would take a particular toll on this population We investigated the rate of acute exacerbations in a cohort of our airways disease patients to determine the impact the virus had MethodsTelephone consultations and review of electronic records of 149 patients from the COPD/asthma clinic at a South London district general hospital during the period March 23rd – June 23rd 2020 were reviewed This corresponded to the date the United Kingdom was placed into lockdown due to the pandemic This was used to establish whether, i) they had presented to ED with exacerbation symptoms, ii) required inpatient admission, iii) self-reported episodes of exacerbations (and corroborated this with dispensation of rescue packs from GP records) This data was then compared to the same period in 2019 using this methodology ResultsIn total, in the equivalent time period in 2019 there were 72 reported exacerbations of COPD, with 25 requiring inpatient admission In the corresponding time period in 2020 there were 55 reported exacerbations, with 20 requiring inpatient admission This represents a 23 6% and 20% decrease respectively In the asthma group there was a decrease in total number of exacerbations from 13 in 2019 to 7 in 2020 (46 2%) and those requiring inpatient admission from 4 in 2019 to 1 in 2020 (75%) ConclusionWe observed a reduction in the number of acute exacerbations in our cohort during the lockdown period of the coronavirus pandemic in 2020 compared to the same period in 2019 This may reflect effective shielding by these patients, minimising exposure to precipitant pathogens However, it may also be related to other consequences of the lockdown period, such as reduced air pollution These findings are notable and may provide further insights into future management of airways disease