CCU052: An observational retrospective cohort study describing the changing epidemiology pre, during and post COVID-19 of asthma, interstitial lung disease (ILD) and chronic obstructive pulmonary disease (COPD) in England.

Project lead:
Jennifer Quint, Imperial College London

Asthma, interstitial lung disease (ILD) and chronic obstructive pulmonary disease (COPD) are chronic respiratory diseases that cause substantial disability and are associated with increased risk of death. Past studies have usually provided high-level snapshot pictures of their frequencies and associated impacts and costs. Given the impact of the COVID-19 pandemic we need to understand how these diseases are changing at a national level, to inform public health policy and planning.

Acute flare ups of asthma, or COPD, termed “exacerbations” represent a substantial socio-economic impact and preventing them is a high priority for management.  Several countries reported a substantial reduction in asthma or COPD exacerbations during the pandemic. To our knowledge, the largest study assessing routinely collected data from over 100,000 asthma patients from England reported a substantial and sustained reduction in asthma exacerbations during the pandemic until October 2021. However, it is still unclear if the substantial reduction has been sustained beyond October 2021, and whether vaccination to protect against COVID-19 or having COVID-19 has any impact on asthma or COPD exacerbations.

The aim of this study is to describe the number and population structure (e.g. age, sex, region, ethnicity and socioeconomic status) of people with asthma, ILD and COPD, across England and by region, from 2019 comparing how this has changed in the past three years since the start of the COVID-19 pandemic.  We will also describe trends in treatments, healthcare utilisation and disease outcomes such as deaths and hospital admissions over the same time period. To do this, we are developing an observatory, i.e. a large dataset of asthma, ILD and COPD patients which can potentially be maintained and regularly updated in the long term to answer further research questions about these diseases. In addition, we will describe the rate of asthma and COPD exacerbations across England and in different groups by population characteristics (e.g., age, sex, region, ethnicity, covid vaccination status and socioeconomic status). This project will tell us if the asthma or COPD exacerbations have bounced back to normal levels now that society is fully open, and whether getting infected with COVID-19 or vaccination has any role.

Our results will provide insights into how common and severe these diseases are in different areas and populations. This knowledge will play a crucial role in public health planning and identifying areas for future research and development and help us to better understand the impact of the COVID-19 pandemic on respiratory diseases. We will add value to these data, sharing respiratory clinical and data expertise. Our work could be used to develop disease specific risk models’ clinicians, healthcare providers and policy makers and influencers can use to better understand these diseases at a population level.