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Commentary
COVID-19 and ‘basal’ exacerbation frequency in COPD
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  1. Daryl O Cheng,
  2. John R Hurst
  1. UCL Respiratory, University College London, London, UK
  1. Correspondence to Professor John R Hurst, UCL Respiratory, University College London, London NW3 2PF, London, UK; j.hurst{at}ucl.ac.uk

https://doi.org/10.1136/thoraxjnl-2020-216637

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    The 2020 coronavirus pandemic has been particularly difficult for people living with chronic respiratory diseases, including chronic obstructive pulmonary disease (COPD). COPD is associated with greater severity of COVID-19 infection and increased mortality.1 Interventions such as social distancing, face coverings, hand hygiene and closure of public spaces have been implemented across the world, although with significant local variations. It remains unclear whether patients with COPD have altered risk of acquiring COVID-19, and ‘shielding’ (maximum avoidance of interpersonal interaction for those at highest risk) was intended to limit this risk. However, shielding also significantly limits physical activity, social interactions and access to healthcare, all of which may adversely impact physical and mental health.2

    Much of the morbidity, mortality and healthcare costs in COPD are related to exacerbations, and these events (especially hospitalisations) are considered by patients to be the most disruptive aspect of their disease.3 Most exacerbations are caused by respiratory viruses, especially rhinovirus. The widespread adoption of the interventions described above might, therefore, be expected to reduce the transmission of such viruses, not just coronavirus, and thereby reduce the incidence of COPD exacerbations (and the proportion of any remaining exacerbations that are attributable to viruses).

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