Impact of the UK lockdown on early COPD
Author(s)
Type
Conference Paper
Abstract
INTRODUCTION: Public health measures to reduce the transmission of COVID-19 have required various changes
in life-style, including loss or risk to employment and social isolation. We wished to assess how these measured
effected 30-45 year old smokers at risk of COPD participating in the BLF Early COPD cohort study METHODS: At
enrolment, participants were aged 30-45 years, tobacco smokers with >10 pack-year smoking history,
FEV1=>80% predicted and a BMI < 35kg/m2. Participants were seen face-to-face in clinic pre-COVID. During
lock-down, they were posted questionnaires and contacted by telephone. The last clinic visit took place on the 12
March 2020, remote visits took place between 16 April and 28 Sep. 260 individuals at six sites (25 Belfast, 38
Birmingham, 25 Edinburgh, 101 London, 27 Manchester and 44 Nottingham) were asked about smoking habits.
The MRC chronic bronchitis questionnaire, COPD Assessment test (CAT), Leicester cough questionnaire, Hospital
Anxiety and Depression questionnaire were completed in writing by the participant and returned by post or
photographed and returned by email. At enrolment, the post-BD FEV1 was 3.81 (SD 0.8) litres, 101% (11) of GLI
predicted. Comparisons were made by paired t-tests and chi-squared tests. RESULTS: Level of anxiety increased
from 6.74 (SD 4.4) to 7.37 (SD 4.7, n=233; p=0.010) during lock-down; depression scores increased from 4.30
(3.9) to 5.14 (SD 4.1; n=233; p<0.001). Anxiety increased in 78/233 and depression in 89/233 participants by 2
or more units, 2 units is considered the minimally important (MCID) in bronchiectasis, COPD and ILD (Wynne,
2020) Figure 1 shows that during lock-down, the proportion of participants not smoking increased from 31/259
(12.0%) to 62/259 (23.9%; p<0.001). In those who continued to smoke, cigarettes per day (p=0.59) and rolling
tobacco consumption (g/week) (p=0.92) were unchanged. Participants reported less chronic bronchitis defined
as “do you bring up phlegm like this on most days (or nights) as much as three months each year”, fell from
83/260 (31.9%) participants to 74/259 (28.6%; p<0.001). CAT scores fell from 10.5 (SD 6.4) to 9.6 (SD 6.3;
n=233; p=0.007) and total cough score improved from 18.7 (SD 2.7) to 19.1 (2.6; n=204; p=0.007).
CONCLUSIONS: Despite increased anxiety and depression, participants quit smoking and those that continued to
smoke, did not smoke more. Respiratory symptoms of chronic bronchitis, cough and CAT scores improved.
REFERENCES:Wynne SC, et al. Chron Respir Dis. 2020 Jan-Dec;17:1479973120933292. doi:
10.1177/1479973120933292
in life-style, including loss or risk to employment and social isolation. We wished to assess how these measured
effected 30-45 year old smokers at risk of COPD participating in the BLF Early COPD cohort study METHODS: At
enrolment, participants were aged 30-45 years, tobacco smokers with >10 pack-year smoking history,
FEV1=>80% predicted and a BMI < 35kg/m2. Participants were seen face-to-face in clinic pre-COVID. During
lock-down, they were posted questionnaires and contacted by telephone. The last clinic visit took place on the 12
March 2020, remote visits took place between 16 April and 28 Sep. 260 individuals at six sites (25 Belfast, 38
Birmingham, 25 Edinburgh, 101 London, 27 Manchester and 44 Nottingham) were asked about smoking habits.
The MRC chronic bronchitis questionnaire, COPD Assessment test (CAT), Leicester cough questionnaire, Hospital
Anxiety and Depression questionnaire were completed in writing by the participant and returned by post or
photographed and returned by email. At enrolment, the post-BD FEV1 was 3.81 (SD 0.8) litres, 101% (11) of GLI
predicted. Comparisons were made by paired t-tests and chi-squared tests. RESULTS: Level of anxiety increased
from 6.74 (SD 4.4) to 7.37 (SD 4.7, n=233; p=0.010) during lock-down; depression scores increased from 4.30
(3.9) to 5.14 (SD 4.1; n=233; p<0.001). Anxiety increased in 78/233 and depression in 89/233 participants by 2
or more units, 2 units is considered the minimally important (MCID) in bronchiectasis, COPD and ILD (Wynne,
2020) Figure 1 shows that during lock-down, the proportion of participants not smoking increased from 31/259
(12.0%) to 62/259 (23.9%; p<0.001). In those who continued to smoke, cigarettes per day (p=0.59) and rolling
tobacco consumption (g/week) (p=0.92) were unchanged. Participants reported less chronic bronchitis defined
as “do you bring up phlegm like this on most days (or nights) as much as three months each year”, fell from
83/260 (31.9%) participants to 74/259 (28.6%; p<0.001). CAT scores fell from 10.5 (SD 6.4) to 9.6 (SD 6.3;
n=233; p=0.007) and total cough score improved from 18.7 (SD 2.7) to 19.1 (2.6; n=204; p=0.007).
CONCLUSIONS: Despite increased anxiety and depression, participants quit smoking and those that continued to
smoke, did not smoke more. Respiratory symptoms of chronic bronchitis, cough and CAT scores improved.
REFERENCES:Wynne SC, et al. Chron Respir Dis. 2020 Jan-Dec;17:1479973120933292. doi:
10.1177/1479973120933292
Date Issued
2021-05-01
Date Acceptance
2021-05-01
Citation
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2021, 203 (9), pp.1-2
ISSN
1073-449X
Publisher
AMER THORACIC SOC
Start Page
1
End Page
2
Journal / Book Title
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
Volume
203
Issue
9
Copyright Statement
©The authors 2021
This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions@ersnet.org
This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions@ersnet.org
Sponsor
Novartis Pharma Ag
Boehringer Ingelheim Pharma Gmbh & Co KG
AstraZeneca UK Limited
Chiesi Farmaceutici S.P.A
GlaxoSmithKline Services Unlimited
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000685468901035&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Grant Number
C028-3002979185
PO 6101188364
PO 7100013120
PO 4500248634
PO6600145677
Source
International Conference of the American-Thoracic-Society (ATS)
Subjects
Science & Technology
Life Sciences & Biomedicine
Critical Care Medicine
Respiratory System
General & Internal Medicine
Publication Status
Published
Start Date
2021-05-14
Finish Date
2021-05-19
Coverage Spatial
ELECTR NETWORK
Date Publish Online
2021-05-14