Table 1.
Comparison of Exacerbations and Symptoms and Health Care Costs Before and During COVID-19 Lockdown
| Exacerbations, Symptoms and Costs | 2019 (Before Lockdown) | 2020 (During Lockdown) | P Valuea |
|---|---|---|---|
| Exacerbations | n = 310 | n = 310 | |
| Total exacerbations, No. (%) | 102 (32.9) | 39 (12.6) | <.001 |
| Average exacerbations per patient, mean (SD) | 0.37 (0.56) | 0.14 (0.37) | <.001 |
| Exacerbations according to severity, No. (%) | .153b | ||
| Mild | 5 (4.9%) | 5 (12.8%) | |
| Moderate | 67 (65.7%) | 27 (69.2%) | |
| Severe | 30 (29.4%) | 7 (17.9%) | |
| Length of hospital stay, mean (SD) | 13.1 (11.3) | 13.1 (15.4) | .999 |
| CAT questionnaire | n = 279 | n = 279 | |
| Severity, No. (%) | <.001c | ||
| Low (<10) | 76 (27.2) | 98 (35.1) | |
| Medium (10-20) | 118 (42.3) | 131 (47.0) | |
| High (21-30) | 66 (23.7) | 44 (15.8) | |
| Very high (>30) | 19 (6.81) | 6 (2.15) | |
| Total score, mean (SD) | 16.2 (9.46) | 13.2 (7.76) | <.001 |
| Dimensions, No. (%) | |||
| Cough | 1.92 (1.67) | 1.53 (1.35) | <.001 |
| Mucus | 2.32 (1.71) | 1.62 (1.49) | <.001 |
| Oppression | 1.33 (1.73) | 0.82 (1.24) | <.001 |
| Stairs | 3.58 (1.67) | 3.13 (1.60) | <.001 |
| Home | 2.45 (1.98) | 1.97 (1.82) | <.001 |
| Street | 1.80 (1.83) | 1.27 (1.67) | <.001 |
| Sleep | 1.52 (1.79) | 0.76 (1.39) | <.001 |
| Power | 2.64 (1.75) | 2.14 (1.43) | <.001 |
| mMRC dyspnea scale | n = 302 | n = 302 | |
| Severity, No. (%) | <.001c | ||
| Degree 0 | 59 (19.3) | 45 (14.7) | |
| Degree 1 | 111 (36.4) | 91 (29.6) | |
| Degree 2 | 72 (23.6) | 79 (25.7) | |
| Degree 3 | 53 (17.4) | 54 (17.6) | |
| Degree 4 | 10 (3.28) | 38 (12.4) | |
| Total score, mean (SD) | 1.48 (1.09) | 1.83 (1.23) | <.001 |
| COPD-related health care costs (€ /patient) | n = 310 | n = 310 | |
| Emergency visits (primary care), mean (95%CI) | 16 (13-20) | 7 (4-9) | <.001 |
| Emergency visits (hospital), mean (95%CI) | 15 (10-21) | 4 (1-8) | <.001 |
| Hospitalizations, mean (95%CI) | 421 (209-634) | 109 (0-233) | <.001 |
| Total costs, mean (95%CI) | 453 (237-669) | 120 (0-246) | <.001 |
Compared periods: March 1 to May 31, 2019 (before lockdown) and March 1 to May 31, 2020 (during lockdown).
CAT = COPD Assessment Test; mMRC = modified Medical Research Council.
a
McNemar’s test or paired Wilcoxon rank-sum test, as appropriate.
b
Fisher exact test.
c
Mixed proportional-odds model with the predictors being period (as fixed effect) and patient (as random effect).