The Impact of the COVID-19 Pandemic on Healthcare Utilization, Pulmonary Exacerbations, Incidence and Mortality in Patients with Chronic Obstructive Pulmonary Disease (COPD): A Provincial Population-Based Retrospective Database Study

The COVID-19 pandemic has profoundly impacted everyone, particularly those who have chronic lung diseases. It can be hypothesized that the pandemic might have brought greater accessibility via telemedicine but patients might have avoided seeking medical care to avoid catching COVID-19. We therefore first examined how the pandemic impacted the outcomes of one of the most common lung diseases, chronic obstructive pulmonary disease (COPD). In our initial study, we found a drop in ED visits and hospital admissions but also an increase in deaths despite an increase in the number of outpatient visits within the first 18 months of the pandemic. In this project, we next examined if the trends seen in the early pandemic continued throughout the pandemic (March 2020 - March 2023) and after (ie: did the death rates increase because people were avoiding care and thus when they did show up, they were much sicker and more at risk of dying? If so, did this trend correct itself as the pandemic restrictions eased? How does the trend in death rates change after the pandemic compare to before the pandemic - did the pandemic permanently change the risk of death for patients with COPD?). Our findings showed that ED visits and hospitalizations rebounded from the initial drop early pandemic and have since steadily increased. Unfortunately, mortality rates have not returned to pre-pandemic levels and patients when they do present to acute care are far sicker. COVID-related deaths appear to account for the majority of the increase in mortality. Outpatient clinic visits, however, have dropped over the pandemic and continue to be significantly reduced compared to pre-pandemic levels. We are now working with end-knowledge users and policy makers to determine why outpatient visits have dropped and whether policy changes can increase outpatient care while reducing mortality.