TY - JOUR
T1 - Social Distancing in Relation to Severe Exacerbations of Chronic Obstructive Pulmonary Disease
T2 - A Nationwide Semi-Experimental Study During the COVID-19 Pandemic
AU - Saeed, Mohamad Isam
AU - Sivapalan, Pradeesh
AU - Eklöf, Josefin
AU - Ulrik, Charlotte Suppli
AU - Browatzki, Andrea
AU - Weinreich, Ulla Møller
AU - Jensen, Torben Tranborg
AU - Biering-Sørensen, Tor
AU - Jensen, Jens-Ulrik Stæhr
N1 - © The Author(s) 2022. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
PY - 2022/5
Y1 - 2022/5
N2 - Social distancing measures introduced on March 12, 2020, in Denmark during the COVID-19 pandemic may affect non-COVID-19 admissions for severe acute exacerbation of chronic obstructive pulmonary disease (s-AECOPD). We compared rates of s-AECOPD in a nationwide, observational, semi-experimental cohort study using data from all Danish inhabitants between calendar week 1 through 25 in 2019 and 2020. In a sub-cohort of patients with chronic obstructive pulmonary disease, we examined incidence of s-AECOPD, admissions to an intensive care unit, and all-cause mortality. A total of 3.0 million inhabitants aged ≥40 years, corresponding to 3.0 million person-years, were followed for s-AECOPD. In the social distancing period in 2020, there were 6,212 incidents of s-AECOPD, compared with 11,260 incidents in 2019, resulting in a 45% relative risk reduction. In the cohort with chronic obstructive pulmonary disease (n = 16,675), we observed a lower risk of s-AECOPD in the social distancing period (subdistribution hazard ratio (HR) = 0.34, 95% confidence interval (CI): 0.33, 0.36; absolute risk: 25.4% in 2020 and 42.8% in 2019). The risk of admissions to an intensive care unit was reduced (subdistribution HR = 0.64, 95% CI: 0.47, 0.87), as was all-cause mortality (HR = 0.83, 95% CI: 0.76, 0.90). Overall, the social distancing period was associated with a significant risk reduction for hospital admittance with s-AECOPD.
AB - Social distancing measures introduced on March 12, 2020, in Denmark during the COVID-19 pandemic may affect non-COVID-19 admissions for severe acute exacerbation of chronic obstructive pulmonary disease (s-AECOPD). We compared rates of s-AECOPD in a nationwide, observational, semi-experimental cohort study using data from all Danish inhabitants between calendar week 1 through 25 in 2019 and 2020. In a sub-cohort of patients with chronic obstructive pulmonary disease, we examined incidence of s-AECOPD, admissions to an intensive care unit, and all-cause mortality. A total of 3.0 million inhabitants aged ≥40 years, corresponding to 3.0 million person-years, were followed for s-AECOPD. In the social distancing period in 2020, there were 6,212 incidents of s-AECOPD, compared with 11,260 incidents in 2019, resulting in a 45% relative risk reduction. In the cohort with chronic obstructive pulmonary disease (n = 16,675), we observed a lower risk of s-AECOPD in the social distancing period (subdistribution hazard ratio (HR) = 0.34, 95% confidence interval (CI): 0.33, 0.36; absolute risk: 25.4% in 2020 and 42.8% in 2019). The risk of admissions to an intensive care unit was reduced (subdistribution HR = 0.64, 95% CI: 0.47, 0.87), as was all-cause mortality (HR = 0.83, 95% CI: 0.76, 0.90). Overall, the social distancing period was associated with a significant risk reduction for hospital admittance with s-AECOPD.
KW - COPD exacerbations
KW - chronic obstructive pulmonary disease
KW - clinical epidemiology
KW - cohort study
KW - respiratory infections
KW - social distancing
UR - http://www.scopus.com/inward/record.url?scp=85129998544&partnerID=8YFLogxK
U2 - 10.1093/aje/kwab292
DO - 10.1093/aje/kwab292
M3 - Journal article
C2 - 34999742
SN - 0002-9262
VL - 191
SP - 874
EP - 885
JO - American Journal of Epidemiology
JF - American Journal of Epidemiology
IS - 5
ER -