scholarly journals COVID-19 public health measures: a reduction in hospital admissions for COPD exacerbations

Thorax ◽  
2020 ◽  
pp. thoraxjnl-2020-216083
Author(s):  
Jing Yuan Tan ◽  
Edwin Philip Conceicao ◽  
Liang En Wee ◽  
Xiang Ying Jean Sim ◽  
Indumathi Venkatachalam
Keyword(s):  
Public Health ◽  
Clinical Outcomes ◽  
Hospital Admissions ◽  
Viral Infections ◽  
Significant Morbidity ◽  
Common Cause ◽  
Copd Exacerbations ◽  
Health Measures ◽  
Acute Exacerbations ◽  
Respiratory Viral Infections

Hospitalisations for acute exacerbations of COPD (AECOPD) carry significant morbidity and mortality. Respiratory viral infections (RVIs) are the most common cause of AECOPD and are associated with worse clinical outcomes. During the COVID-19 pandemic, public health measures, such as social distancing and universal masking, were originally implemented to reduce transmission of SARS-CoV-2; these public health measures were subsequently also observed to reduce transmission of other common circulating RVIs. In this study, we report a significant and sustained decrease in hospital admissions for all AECOPD as well as RVI-associated AECOPD, which coincided with the introduction of public health measures during the COVID-19 pandemic.

scholarly journals Decline in COPD Admissions During the COVID-19 Pandemic Associated with Lower Burden of Community Respiratory Viral Infections

2021 ◽  
Author(s):  
Jennifer Y So ◽  
Nathan N O'Hara ◽  
Blaine Kenaa ◽  
John G Williams ◽  
Christopher L DeBorja ◽  
...  
Keyword(s):  
Public Health ◽  
Hospital Admissions ◽  
Viral Infections ◽  
Control Measures ◽  
Copd Exacerbations ◽  
Health Measures ◽  
Regional Center ◽  
Before And After ◽  
Control And Prevention ◽  
Respiratory Viral Infections

Background: The COVID-19 pandemic has led to widespread implementation of public health measures, such as stay-at-home orders, social distancing, and masking mandates. In addition to decreasing spread of SARS-CoV2, these measures also impact the transmission of seasonal viral pathogens, which are common triggers of COPD exacerbations. Whether reduced viral prevalence mediates reduction in COPD exacerbation rates is unknown. Methods: We performed retrospective analysis of data from a large, multicenter healthcare system to assess admission trends associated with community viral prevalence and with initiation of COVID-19 pandemic control measures. We applied difference-in-differences (DiD) analysis to compare season-matched weekly frequency of hospital admissions for COPD before and after implementation of public health measures for COVID-19. Community viral prevalence was estimated using regional Center for Disease Control and Prevention test positivity data and correlated to COPD admissions. Results: Data involving 4,422 COPD admissions demonstrated a season-matched 53% decline in COPD admissions during COVID-19 pandemic, which correlated to community viral burden (r=0.73; 95% CI: 0.67 to 0.78) and represented a 36% greater decline over admission frequencies observed in other medical conditions less affected by respiratory viral infections (IRR, 0.64; 95% CI, 0.57 to 0.71, p<0.001). The post-COVID-19 decline in COPD admissions was most pronounced in patients with fewer comorbidities and without recurrent admissions. Conclusion: The implementation of public health measures during the COVID-19 pandemic was associated with decreased COPD admissions. These changes are plausibly explained by reduced prevalence of seasonal respiratory viruses.

scholarly journals Public health measures during COVID-19 pandemic reduced hospital admissions for community respiratory viral infections

2020 ◽  
Vol 106 (2) ◽  
pp. 387-389 ◽  
Author(s):  
J.Y. Tan ◽  
E.P. Conceicao ◽  
X.Y.J. Sim ◽  
L.E.I. Wee ◽  
M.K. Aung ◽  
...  
Keyword(s):  
Public Health ◽  
Hospital Admissions ◽  
Viral Infections ◽  
Health Measures ◽  
Respiratory Viral Infections

scholarly journals Reduction in hospitalised COPD exacerbations during COVID-19: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255659
Author(s):  
Jaber S. Alqahtani ◽  
Tope Oyelade ◽  
Abdulelah M. Aldhahir ◽  
Renata Gonçalves Mendes ◽  
Saeed M. Alghamdi ◽  
...  
Keyword(s):  
Rate Ratio ◽  
Hospital Admissions ◽  
Viral Infections ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Health Index ◽  
Inclusion Criteria ◽  
Copd Exacerbations ◽  
Respiratory Viral Infections

Background Reports have suggested a reduction in exacerbations of chronic obstructive pulmonary disease (COPD) during the coronavirus disease 2019 (COVID-19) pandemic, particularly hospital admissions for severe exacerbations. However, the magnitude of this reduction varies between studies. Method Electronic databases were searched from January 2020 to May 2021. Two independent reviewers screened titles and abstracts and, when necessary, full text to determine if studies met inclusion criteria. A modified version of the Newcastle-Ottawa Scale was used to assess study quality. A narrative summary of eligible studies was synthesised, and meta-analysis was conducted using a random effect model to pool the rate ratio and 95% confidence intervals (95% CI) for hospital admissions. Exacerbation reduction was compared against the COVID-19 Containment and Health Index. Results A total of 13 of 745 studies met the inclusion criteria and were included in this review, with data from nine countries. Nine studies could be included in the meta-analysis. The pooled rate ratio of hospital admissions for COPD exacerbations during the pandemic period was 0.50 (95% CI 0.44–0.57). Findings on the rate of community-treated exacerbations were inconclusive. Three studies reported a significant decrease in the incidence of respiratory viral infections compared with the pre-pandemic period. There was not a significant relationship between exacerbation reduction and the COVID-19 Containment and Health Index (rho = 0.20, p = 0.53). Conclusion There was a 50% reduction in admissions for COPD exacerbations during the COVID-19 pandemic period compared to pre-pandemic times, likely associated with a reduction in respiratory viral infections that trigger exacerbations. Future guidelines should consider including recommendations on respiratory virus infection control measures to reduce the burden of COPD exacerbations beyond the pandemic period.

scholarly journals Reduction in COPD exacerbations during COVID-19: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Jaber S Alqahtani ◽  
Tope Oyelade ◽  
Abdulelah M Aldhahir ◽  
Renata Goncalves Mendes ◽  
Saeed M Alghamdi ◽  
...  
Keyword(s):  
Rate Ratio ◽  
Hospital Admissions ◽  
Viral Infections ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Health Index ◽  
Inclusion Criteria ◽  
Copd Exacerbations ◽  
Respiratory Viral Infections

Background Reports have suggested a reduction in exacerbations of chronic obstructive pulmonary disease (COPD) during the coronavirus (COVID-19) pandemic, particularly hospital admissions for severe exacerbations. However, the magnitude of this reduction varies between studies. Method Electronic databases were searched from January 2020 to May 2021. Two independent reviewers screened titles and abstracts and, when necessary, full text to determine if studies met inclusion criteria. A modified version of the Newcastle-Ottawa Scale was used to assess study quality. A narrative summary of eligible studies was synthesised, and meta-analysis was conducted using a random effect model to pool the rate ratio and 95% confidence intervals (95% CI) for hospital admissions. Exacerbation reduction was compared against the COVID-19 Containment and Health Index. Results A total of 13 of 745 studies met the inclusion criteria and were included in this review, with data from nine countries. Seven studies could be included in the meta-analysis. The pooled rate ratio of hospital admissions for COPD exacerbations during the pandemic period was 0.50 (95% CI 0.42-0.58). Findings on the rate of community-treated exacerbations were inconclusive. Three studies reported a significant decrease in the incidence of respiratory viral infections compared with the pre-pandemic period. There was not a significant relationship between exacerbation reduction and the COVID-19 Containment and Health Index. Conclusion There was a 50% reduction in admissions for COPD exacerbations during the COVID-19 pandemic period, associated with a reduction in respiratory viral infections that trigger exacerbations. We provide pooled evidence supporting the potential effectiveness of COVID-19 preventive interventions in reducing the risk of admissions for COPD exacerbations.

scholarly journals The impact of COVID-19 on hospital admissions and emergency department visits: A population-based study

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252441
Author(s):  
Elissa Rennert-May ◽  
Jenine Leal ◽  
Nguyen Xuan Thanh ◽  
Eddy Lang ◽  
Shawn Dowling ◽  
...  
Keyword(s):  
Public Health ◽  
Emergency Department ◽  
Hospital Admissions ◽  
Population Based ◽  
Emergency Department Visits ◽  
System Capacity ◽  
Population Based Study ◽  
Health Measures ◽  
Ed Visits ◽  
The Impact

Background As a result of the novel coronavirus disease 2019 (COVID-19), there have been widespread changes in healthcare access. We conducted a retrospective population-based study in Alberta, Canada (population 4.4 million), where there have been approximately 1550 hospital admissions for COVID-19, to determine the impact of COVID-19 on hospital admissions and emergency department (ED visits), following initiation of a public health emergency act on March 15, 2020. Methods We used multivariable negative binomial regression models to compare daily numbers of medical/surgical hospital admissions via the ED between March 16-September 23, 2019 (pre COVID-19) and March 16-September 23, 2020 (post COVID-19 public health measures). We compared the most frequent diagnoses for hospital admissions pre/post COVID-19 public health measures. A similar analysis was completed for numbers of daily ED visits for any reason with a particular focus on ambulatory care sensitive conditions (ACSC). Findings There was a significant reduction in both daily medical (incident rate ratio (IRR) 0.86, p<0.001) and surgical (IRR 0.82, p<0.001) admissions through the ED in Alberta post COVID-19 public health measures. There was a significant decline in daily ED visits (IRR 0.65, p<0.001) including ACSC (IRR 0.75, p<0.001). The most common medical/surgical diagnoses for hospital admissions did not vary substantially pre and post COVID-19 public health measures, though there was a significant reduction in admissions for chronic obstructive pulmonary disease and a significant increase in admissions for mental and behavioral disorders due to use of alcohol. Conclusions Despite a relatively low volume of COVID-19 hospital admissions in Alberta, there was an extensive impact on our healthcare system with fewer admissions to hospital and ED visits. This work generates hypotheses around causes for reduced hospital admissions and ED visits which warrant further investigation. As most publicly funded health systems struggle with health-system capacity routinely, understanding how these reductions can be safely sustained will be critical.

scholarly journals How health systems approached respiratory viral pandemics over time: a systematic review

2020 ◽  
Vol 5 (12) ◽  
pp. e003677
Author(s):  
Fidelia Cascini ◽  
Ilda Hoxhaj ◽  
Drieda Zaçe ◽  
Margherita Ferranti ◽  
Maria Luisa Di Pietro ◽  
...  
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Healthcare System ◽  
Viral Infections ◽  
Healthcare Systems ◽  
Evidence Based ◽  
Effective Response ◽  
Influenza A H1n1 ◽  
Pertinent Data ◽  
Respiratory Viral Infections

BackgroundSeveral healthcare systems facing respiratory viral infections outbreaks, like COVID-19, have not been prepared to manage them. Public health mitigation solutions ranging from isolation of infected or suspected cases to implementation of national lockdowns have proven their effectiveness for the outbreak’s control. However, the adjustment of public health measures is crucial during transition phases to avoid new outbreaks. To address the need for designing evidence-based strategies, we performed a systematic review to identify healthcare systems interventions, experiences and recommendations that have been used to manage different respiratory viral infections outbreaks in the past.MethodsPubMed, Web of Science, Scopus and Cochrane were searched to retrieve eligible studies of any study design, published in English until 17 April 2020. Double-blinded screening process was conducted by titles/abstracts and subsequently eligible full texts were read and pertinent data were extracted. When applicable, quality assessment was conducted for the included articles. We performed a narrative synthesis of each implemented public health approaches.ResultsWe included a total of 24 articles addressing the public health approaches implemented for respiratory viral infections outbreaks for COVID-19, influenza A H1N1, MERS and severe acute respiratory syndrome . The identified approaches are ascribable to two main categories: healthcare system strategies and healthcare provider interventions. The key components of an effective response on respiratory viral outbreaks included the implementation of evidence-based contextual policies, intrahospital management actions, community healthcare facilities, non-pharmaceutical interventions, enhanced surveillance, workplace preventive measures, mental health interventions and communication plans.ConclusionThe identified healthcare system strategies applied worldwide to face epidemics or pandemics are a useful knowledge base to inform decision-makers about control measures to be used in the transition phases of COVID-19 and beyond.

scholarly journals Epidemiological trends in COVID-19 pandemic: prospective critical appraisal of observations from six countries in Europe and the USA

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e045782
Author(s):  
Maria Alexandra Velicu ◽  
Luciano Furlanetti ◽  
Josephine Jung ◽  
Keyoumars Ashkan
Keyword(s):  
Public Health ◽  
Hospital Admissions ◽  
Disease Prevalence ◽  
Warning Signs ◽  
Contributing Factors ◽  
Admission Rates ◽  
Health Measures ◽  
The Usa ◽  
Using Data ◽  
Over Time

IntroductionEurope was the epicentre of the COVID-19 pandemic in March 2020, with the highest number of cases and deaths between March and April. In May, the infection numbers registered a fall followed by a second new rise, not proportionally reflected by an increase in the number of deaths. We aimed to investigate the relationship between disease prevalence and infection fatality rate (IFR), and the number of intensive care unit (ICU) and hospital admissions over time, to develop a predictive model, as well as appraising the potential contributing factors underpinning this complex relationship.MethodsA prospective epidemiological study using data from six countries collected between 10 March and 4 September 2020. Data on the number of daily hospital and ICU admissions with COVID-19 were gathered, and the IFR and the prevalence were calculated. Trends over time were analysed. A linear regression model was used to determine the association between the fatality rates and the number of admissions.FindingsThe prediction model confirmed the linear association between the fatality rates and the numbers of ICU and hospital admissions. The exception was during the peak of the COVID-19 pandemic when the model underestimated the fatalities indicating that a substantial number of deaths occurred outside of the hospitals. The fatality rates decreased in all countries from May until September regardless of the trends in prevalence, differences in healthcare systems or strategic variations in handling the pandemic.InterpretationThe observed gradual reduction in COVID-19 fatality rates over time despite varying disease prevalence and public health measures across multiple countries warrants search for a biological explanation. While our understanding of this novel virus grows, hospital and ICU admission rates remain effective predictors of patient outcomes which can be used as early warning signs for escalation of public health measures.

scholarly journals Clinical efficacy of acute respiratory viral infections prevention in patients with chronic heart failure

2019 ◽  
Vol 91 (3) ◽  
pp. 36-41 ◽  
Author(s):  
A V Budnevsky ◽  
A D Shurupova ◽  
A Ya Kravchenko ◽  
R E Tokmachev
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Standard Therapy ◽  
Hospital Admissions ◽  
Viral Infections ◽  
Clinical Course ◽  
Functional Class ◽  
Dynamic Monitoring ◽  
Interferon Inducer ◽  
Respiratory Viral Infections

The aim of the study was to evaluate the ARVI prevention effectiveness in patients with chronic heart failure (CHF) using interferon inducer amixin. Materials and methods. Conducted a comprehensive survey, dynamic monitoring and treatment of 60 patients aged from 49 to 70 years (mean age 60.25±4.57 years, 17 men and 43 women) with CHF with preserved ejection fraction of left ventricle (LVEF) (≥50%), II-III functional class (FC) according to the classification of new York Heart Association (NYHA), which developed as a result of coronary heart disease (CHD), hypertensive disease (HD). Of these, 30 patients (group 1) on the background of standard therapy for CHF received for the prevention of ARVI tiloron (Amixin) at a dose of 125 mg once a week for 6 weeks, two courses for 1 year. Group 2 patients received only standard therapy for CHF. Results. A decrease in the frequency of ARVI in patients with CHF treated with Amixin was found, which was accompanied by a decrease in the severity of subclinical inflammation by reducing the production of proinflammatory (IL-1β) and increasing the production of anti-inflammatory (IL-10) cytokines, reducing neurohumoral activation (reducing levels of aldosterone and Nt-proBNP), increasing the level of α- and γ-interferon. The positive dynamics of biomarkers of systemic inflammation and neurohormonal activation explains the improvement of the clinical course in patients with CHF (increase of tolerance to physical loads, reducing the number of visits to General practitioner and hospital admissions in the hospital during 12 months of observation). Conclusion. A promising approach to the prevention of SARS in patients with CHF is course therapy with Amixin (2 times a year before the seasonal rising in the incidence of respiratory viral infections and influenza), which allows to achieve both decreasing in the frequency of SARS per year, and improvement the clinical course of CHF.

scholarly journals Viral infections and asthma: an inflammatory interface?

2014 ◽  
Vol 44 (6) ◽  
pp. 1666-1681 ◽  
Author(s):  
Brian G.G. Oliver ◽  
Paul Robinson ◽  
Mathew Peters ◽  
Judy Black
Keyword(s):  
Viral Infections ◽  
Chronic Inflammatory Disease ◽  
Review Article ◽  
Current Therapy ◽  
Treatment Regimens ◽  
Asthma Exacerbations ◽  
Acute Exacerbations ◽  
Adrenoceptor Agonists ◽  
Respiratory Viral Infections ◽  
The Relationship

Asthma is a chronic inflammatory disease of the airways in which the majority of patients respond to treatment with corticosteroids and β2-adrenoceptor agonists. Acute exacerbations of asthma substantially contribute to disease morbidity, mortality and healthcare costs, and are not restricted to patients who are not compliant with their treatment regimens. Given that respiratory viral infections are the principal cause of asthma exacerbations, this review article will explore the relationship between viral infections and asthma, and will put forward hypotheses as to why virus-induced exacerbations occur. Potential mechanisms that may explain why current therapeutics do not fully inhibit virus-induced exacerbations, for example, β2-adrenergic desensitisation and corticosteroid insensitivity, are explored, as well as which aspects of virus-induced inflammation are likely to be attenuated by current therapy.

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