Table 3.
Modification of the association between respiratory disease and severe COVID-19 by the introduction of lockdown and shielding
| Overall | Associations reflecting infection before shielding* | Associations reflecting infection after shielding* | |
|---|---|---|---|
| Hospitalisation | |||
| COPD | 1·54 (1·45–1·63) | 1·54 (1·45–1·64) | 1·53 (1·45–1·63) |
| Asthma | 1·18 (1·13–1·24) | 1·20 (1·14–1·26) | 1·17 (1·11–1·28) |
| Active asthma | 1·26 (1·20–1·33) | 1·28 (1·21–1·35) | 1·25 (1·20–1·33) |
| Severe asthma | 1·29 (1·22–1·37) | 1·30 (1·22–1·38) | 1·28 (1·20–1·39) |
| Bronchiectasis | 1·34 (1·20–1·50) | 1·36 (1·21–1·53) | 1·33 (1·19–1·49) |
| Cystic fibrosis | 1·55 (0·65–3·73) | 1·65 (0·69–3·97) | 1·55 (0·62–3·81) |
| Sarcoidosis | 1·36 (1·10–1·68) | 1·37 (1·10–1·70) | 1·25 (0·99–1·58) |
| Extrinsic allergic alveolitis | 1·35 (0·82–2·21) | 1·36 (0·83–2·21) | 1·22 (0·70–2·10) |
| Idiopathic pulmonary fibrosis | 1·59 (1·30–1·95) | 1·60 (1·31–1·95) | 1·54 (1·24–1·91) |
| Other interstitial lung diseases | 1·66 (1·30–2·12) | 1·67 (1·30–2·13) | 1·62 (1·25–2·11) |
| Lung cancer | 2·24 (1·89–2·65) | 2·31 (1·94–2·75) | 2·23 (1·88–2·64) |
| ICU admission† | |||
| COPD | 0·89 (0·68–1·17) | 0·89 (0·68–1·17) | 0·80 (0·59–1·09) |
| Asthma | 1·08 (0·93–1·25) | 1·10 (0·94–1·28) | 1·07 (0·91–1·27) |
| Active asthma | 1·34 (1·14–1·58) | 1·37 (1·14–1·63) | 1·32 (1·14–1·59) |
| Severe asthma | 1·30 (1·08–1·58) | 1·36 (1·06–1·59) | 1·29 (1·08–1·60) |
| Bronchiectasis | 1·47 (0·91–2·36) | 1·49 (0·91–2·35) | 1·33 (0·78–2·27) |
| Sarcoidosis | 1·51 (0·81–2·81) | 1·53 (0·82–2·81) | 1·19 (0·57–2·51) |
| Idiopathic pulmonary fibrosis | 1·97 (0·85–4·55) | 2·35 (1·01–5·47) | 1·96 (0·85–4·54) |
| Death‡ | |||
| COPD | 1·54 (1·42–1·67) | 1·55 (1·31–1·68) | 1·49 (1·36–1·63) |
| Asthma | 0·99 (0·91–1·07) | 0·98 (0·91–1·07) | 1·01 (0·93–1·10) |
| Active asthma | 1·05 (0·96–1·15) | 1·04 (0·97–1·15) | 1·06 (0·95–1·17) |
| Severe asthma | 1·08 (0·98–1·19) | 1·07 (0·98–1·19) | 1·09 (0·97–1·21) |
| Bronchiectasis | 1·12 (0·94–1·33) | 1·13 (0·98–1·42) | 1·11 (0·93–1·34) |
| Sarcoidosis | 1·41 (0·99–1·99) | 1·42 (1·00–2·00) | 1·22 (0·80–1·86) |
| Extrinsic allergic alveolitis | 1·56 (0·78–3·13) | 1·57 (0·78–3·14) | 1·42 (0·36–2·56) |
| Idiopathic pulmonary fibrosis | 1·47 (1·12–1·92) | 1·48 (1·11–1·92) | 1·30 (0·94–1·77) |
| Other interstitial lung diseases | 2·05 (1·49–2·81) | 2·06 (1·50–2·82) | 2·04 (1·48–2·95) |
| Lung cancer | 1·77 (1·37–2·29) | 1·89 (1·43–2·48) | 1·76 (1·36–2·27) |
Data are hazard ratio (95% CI). People with active asthma had at least one prescription for asthma medication. People with severe asthma were prescribed at least three different classes of medication for asthma in the year before cohort entry. COPD=chronic obstructive pulmonary disease. ICU=intensive care unit.
Adjusted for demographic factors (age, gender, ethnicity, socioeconomic status, and region of England), body-mass index (categorical variable), smoking status, non-smoking-related illness (hypertension, type 1 diabetes, chronic liver disease, and chronic neurological disease), smoking-related illness (coronary heart disease, stroke, atrial fibrillation, type 2 diabetes, and chronic kidney disease), and all other respiratory diseases.
Data for people with cystic fibrosis, sarcoidosis, extrinsic allergic alveolitis, idiopathic pulmonary fibrosis, other interstitial lung disease, and lung cancer not presented because fewer than five people had the outcome.
Data for people with cystic fibrosis not presented as there were no deaths in this group.