Impact of COVID-19 lockdown on the incidence and mortality of acute exacerbations of chronic obstructive pulmonary disease: national interrupted time series analyses for Scotland and Wales.
Impact of COVID-19 lockdown on the incidence and mortality of acute exacerbations of chronic obstructive pulmonary disease: national interrupted time series analyses for Scotland and Wales.
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DOI：
10.1186/s12916-021-02000-w
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发表时间：
2021-05-17
期刊：
影响因子：
9.3
通讯作者：
EAVE II Collaborators
中科院分区：
文献类型：
--
作者：
Alsallakh MA;Sivakumaran S;Kennedy S;Vasileiou E;Lyons RA;Robertson C;Sheikh A;Davies GA;EAVE II Collaborators
COVID-19 大流行和随后的全国封锁极大地改变了医疗保健格局。这场流行病对慢性阻塞性肺疾病（COPD）患者的影响仍知之甚少。我们假设英国范围内的封锁限制与慢性阻塞性肺病严重恶化的减少有关。我们首次提供国家层面的 COVID-19 大流行影响和首次封锁对慢性阻塞性肺病严重恶化（导致紧急入院和/或导致死亡）以及初级保健或急诊科记录的影响的分析。利用苏格兰公共卫生部门和威尔士安全匿名信息链接数据库的数据，我们获取了 2020 年前 30 周因慢性阻塞性肺病 (COPD) 导致的每周紧急住院和死亡人数，并将这些数据与过去 5 年的全国平均水平进行了比较。对于苏格兰和威尔士，我们进行了中断时间序列分析，以模拟封锁对这些结果的影响。使用固定效应荟萃分析，我们得出了两国趋势总体变化的汇总估计。相对于 5 年平均值，封锁导致两国因慢性阻塞性肺病 (COPD) 急诊入院人数合计减少 48%（发病率，IRR 0.52，95% CI 0.46 至 0.58）。 COPD 导致的死亡没有统计学上的显着变化（汇总 IRR 1.08，95% CI 0.87 至 1.33）。在威尔士，封锁导致 COPD 急性加重的初级保健咨询减少 39%（IRR 0.61，95% CI 0.52 - 0.71），COPD 相关急诊科就诊率减少 46%（IRR 0.54，95% CI 0.36 - 0.81）。英国范围内的封锁与苏格兰和威尔士有史以来最大幅度地减少慢性阻塞性肺病恶化有关，但慢性阻塞性肺病死亡人数没有相应增加。这可能是由于呼吸道感染传播减少、户外空气污染暴露减少和/或慢性阻塞性肺病自我管理改善所致。在线版本包含可在 10.1186/s12916-021-02000-w 获取的补充材料。
The COVID-19 pandemic and ensuing national lockdowns have dramatically changed the healthcare landscape. The pandemic’s impact on people with chronic obstructive pulmonary disease (COPD) remains poorly understood. We hypothesised that the UK-wide lockdown restrictions were associated with reductions in severe COPD exacerbations. We provide the first national level analyses of the impact of the COVID-19 pandemic and first lockdown on severe COPD exacerbations resulting in emergency hospital admissions and/or leading to death as well as those recorded in primary care or emergency departments. Using data from Public Health Scotland and the Secure Anonymised Information Linkage Databank in Wales, we accessed weekly counts of emergency hospital admissions and deaths due to COPD over the first 30 weeks of 2020 and compared these to the national averages over the preceding 5 years. For both Scotland and Wales, we undertook interrupted time-series analyses to model the impact of instigating lockdown on these outcomes. Using fixed-effect meta-analysis, we derived pooled estimates of the overall changes in trends across the two nations. Lockdown was associated with 48% pooled reduction in emergency admissions for COPD in both countries (incidence rate ratio, IRR 0.52, 95% CI 0.46 to 0.58), relative to the 5-year averages. There was no statistically significant change in deaths due to COPD (pooled IRR 1.08, 95% CI 0.87 to 1.33). In Wales, lockdown was associated with 39% reduction in primary care consultations for acute exacerbation of COPD (IRR 0.61, 95% CI 0.52 to 0.71) and 46% reduction in COPD-related emergency department attendances (IRR 0.54, 95% CI 0.36 to 0.81). The UK-wide lockdown was associated with the most substantial reductions in COPD exacerbations ever seen across Scotland and Wales, with no corresponding increase in COPD deaths. This may have resulted from reduced transmission of respiratory infections, reduced exposure to outdoor air pollution and/or improved COPD self-management. The online version contains supplementary material available at 10.1186/s12916-021-02000-w.
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德国 COVID-19 大流行期间急症室入院的差异趋势。
影响因子：
2.5
作者：
Jaehn P;Holmberg C;Uhlenbrock G;Pohl A;Finkenzeller T;Pawlik MT;Quack I;Ernstberger A;Rockmann F;Schreyer AG
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影响因子：
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作者：
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通讯作者：
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DOI：
10.2147/copd.s265004
发表时间：
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影响因子：
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作者：
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通讯作者：
Hu K
影响因子：
--
作者：
Jones, K H;Ford, D V;Lyons, R A
通讯作者：
Lyons, R A
DOI：
10.1377/hlthaff.2020.00980
发表时间：
2020-11
期刊：
Health affairs (Project Hope)
影响因子：
--
作者：
Birkmeyer JD;Barnato A;Birkmeyer N;Bessler R;Skinner J
通讯作者：
Skinner J