COPD Exacerbations Before and During COVID-19 in France, Germany, Italy, the UK and the US.

Background: Exacerbations of chronic obstructive pulmonary disease (COPD) were reported less frequently during the COVID-19 pandemic. We report real-world data on COPD exacerbation rates before and during this pandemic.
Methods: Exacerbation patterns were analysed using electronic medical records or claims data of patients with COPD before (2017-2019) and during the COVID-19 pandemic (2020 through early 2022) in France, Germany, Italy, the United Kingdom and the United States. Data from each country were analysed separately. The proportions of patients with COPD receiving maintenance treatment were also estimated.
Results: The proportion of patients with exacerbations fell 45-78% across five countries in 2020 versus 2019. Exacerbation rates in most countries were reduced by >50% in 2020 compared with 2019. The proportions of patients with an exacerbation increased in most countries in 2021. Across each country, seasonal exacerbation increases seen during autumn and winter in pre-pandemic years were absent during the first year of the pandemic. The percentage of patients filling COPD prescriptions across each country increased by 4.53-22.13% in 2019 to 9.94-34.17% in 2021.
Conclusion: Early, steep declines in exacerbation rates occurred in 2020 versus 2019 across all five countries and were accompanied by a loss of the seasonal pattern of exacerbation.
Competing Interests: F.J. Martinez reports support for the present manuscript from Chiesi Farmaceutici S.p.A.; reports grants or contracts from AstraZeneca, Chiesi Farmaceutici S.p.A., GSK and Sanofi/Regeneron; reports consulting fees from AstraZeneca, Boehringer Ingelheim, Chiesi Farmaceutici S.p.A., CSL Behring, GSK, Novartis, Polarean, Pulmatrix, Pulmonx, Sanofi/Regeneron, Sunovion, Teva, Theravance/Viatris and UpToDate®; reports payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing or educational events from AstraZeneca and GSK; and reports participation on a Data Safety Monitoring Board or advisory board for GSK and Medtronic. A. Papi reports study support from Chiesi Farmaceutici S.p.A.; reports grants or contracts from Agenzia Italiana del Farmaco (AIFA), AstraZeneca, Chiesi Farmaceutici S.p.A., GSK and Sanofi; reports consulting fees from AstraZeneca, Avillion, Chiesi Farmaceutici S.p.A., Elpen Pharmaceuticals, GSK, Novartis, Roche and Sanofi; reports payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing or educational events from AstraZeneca, Avillion, Chiesi Farmaceutici S.p.A., Edmond Pharma, Elpen Pharmaceuticals, GSK, IQVIA, Menarini, Mundipharma, Novartis, Sanofi and Zambon; and reports advisory board membership for AstraZeneca, Avillion, Chiesi Farmaceutici S.p.A., Elpen Pharmaceuticals, GSK, IQVIA, MSD, Novartis, Regeneron and Sanofi. T. Welte reports all support for the present manuscript from Chiesi Farmaceutici S.p.A.; reports consulting fees from AstraZeneca, Berlin-Chemie, Boehringer Ingelheim, Chiesi Farmaceutici S.p.A. and GSK; and reports payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing or educational events from AstraZeneca, Berlin-Chemie, Boehringer Ingelheim, Chiesi Farmaceutici S.p.A. and GSK. He also reports a grant paid to his institution from the German Ministry of Research and Education. D. Singh reports consulting fees from Aerogen, AstraZeneca, Boehringer Ingelheim, Chiesi Farmaceutici S.p.A., Cipla, CSL Behring, EpiEndo, Genentech, GSK, Glenmark, Gossamer Bio, Kinaset Therapeutics, Menarini, Novartis, Orion, Pulmatrix, Sanofi, Synairgen, Teva, Theravance Biopharma and Verona Pharma. D. Singh is also supported by the National Institute for Health Research Manchester Biomedical Research Centre. D.V. Galkin is an employee of Chiesi Farmaceutici S.p.A.; reports support for this manuscript from Chiesi Farmaceutici S.p.A.; and holds stock or stock options with GSK. A. Guasconi is an employee of Chiesi Farmaceutici S.p.A. S. Pirondi is an employee of Chiesi Farmaceutici S.p.A. and is on SiMEF Società Italiana di Medicina Farmaceutica Working Group on Observational Studies. G. Georges is an employee of Chiesi Farmaceutici S.p.A. J. Imperato and R. Hermans are employees of IQVIA and were on the consulting team that led the analysis of the real-world data for this manuscript. The authors report no other conflicts of interest in this work.
(© 2024 Martinez et al.)