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Pandemic Measures Reduced Exposure to Seasonal Viruses, a Common COPD Trigger

Researchers at the University of Maryland School of BOB体育 (UMSOM) analyzed data at the 13-hospital University of Maryland Medical System (UMMS) and found public health measures designed to reduce the spread of the COVID-19 virus may have fostered a substantial side benefit: Hospital admissions for chronic obstructive pulmonary disease (COPD) were reduced by 53 percent, according to a new study published in . This is likely due to a drop in circulating seasonal respiratory viruses such as influenza.

Hospitalizations for COPD, a group of lung diseases that make it hard to breathe and get worse over time, are commonly driven by flare-ups where symptoms are triggered by such factors as tobacco smoke, air pollution and respiratory infections. Seasonal respiratory viruses, including those that cause the common cold or influenza, trigger nearly half of those flare-ups.

In the wake of a marked drop in COPD admissions during the pandemic, the researchers theorized that COVID-19 behavior changes 鈥� a mix of stay-at-home orders, social distancing, masking mandates and strict limitations on large gatherings 鈥� not only protected against COVID-19, but they may have also reduced exposure to other respiratory infections.

Conversely, they worry that the return to normal behavior may lead to more COPD flare-ups.

鈥淥ur study shows there鈥檚 a silver lining to the behavior changes beyond protecting against COVID-19,鈥� said senior author Robert M. Reed, MD, UMSOM Professor of BOB体育 and pulmonologist at the University of Maryland Medical Center (UMMC). 鈥淚f we completely eliminate masks and distancing during cold and flu season, we鈥檒l allow all those viruses that have been effectively suppressed to come raging back. There could be a lot of illness.鈥�

Prior to the COVID-19 pandemic, COPD was the fourth-leading cause of death worldwide and a leading cause of hospital admissions in the United States. The pandemic has led to significant changes in health care delivery, including reduced admissions for COPD and other non-COVID illnesses, some of which may have stemmed from patients鈥� fear of contracting COVID in various hospital settings, as well as a shift toward telemedicine and outpatient COPD management during the pandemic.

To understand what may have occurred to reduce COPD admissions, the researchers compared weekly hospital admissions for COPD in the pre-COVID-19 years of 2018 and 2019, with admissions after the COVID-19 public health measures were instituted.

At UMMS, those measures were implemented before April 1, 2020, so the investigators chose the same five-month period in each year for their comparison, April 1 to Sept. 30.

Co-lead author Jennifer Y. So, MD, UMSOM Assistant Professor of BOB体育 and COPD specialist at UMMC, said electronic medical records from multiple hospitals across a range of communities in the UMMS database facilitated a granular evaluation of changes over time. 鈥淲e assessed a variety of possible causes that could affect COPD admissions including the presence of multiple diseases or medical conditions and the frequency of COPD exacerbations.鈥�

The database findings were correlated with data on respiratory viral trends from the U.S. Centers for Disease Control and Prevention for the period of Jan. 1, 2018, through Oct. 1, 2020.

鈥淲e found a 53 percent drop in COPD admissions throughout UMMS during COVID-19. That is substantial, but equally significant, the drop in weekly COPD admissions was 36 percent lower than the declines seen in other serious medical conditions, including congestive heart failure, diabetes and heart attack,鈥� said Dr. So.

As more and more people are vaccinated against COVID-19 and many of the public health measures of the past year are relaxed, the researchers warn that a full return to normal may again expose COPD patients to the familiar seasonal triggers.

鈥淥ur study did not assess which public health components worked to tame seasonal respiratory viruses, but a simple thing like wearing a mask while riding on public transit or working from home when you鈥檙e sick with a cold could go a long way to reduce virus exposure,鈥� said Dr. Reed.

Dr. So, who is from South Korea, said it is a cultural norm to wear masks during the winter in her native country. 鈥淭he COVID-19 pandemic has helped a lot of people around the world become more aware of the role of masking and social distancing to reduce the spread of disease,鈥� she said.

鈥淭his is a compelling study that raises some important public health questions about protecting our most vulnerable patient populations after we are finished with the COVID-19 pandemic. I certainly think it warrants a fuller discussion,鈥� said UMSOM Dean E. Albert Reece, MD, PhD, MBA, University Executive Vice President for Medical Affairs and the John Z. and Akiko K. Bowers Distinguished Professor.

So JY, O鈥橦ara NN, Kenaa B, Williams JG, deBorja CL, Slejko JF, Zafari Z, Sokolow M, Zimand P, Deming M, Marx J, Pollak A, Reed RM. Decline in COPD Admissions During the COVID-19 Pandemic Associated with Lower Burden of Community Respiratory Viral Infections. The American Medical Journal of BOB体育. doi: 

About the University of Maryland School of BOB体育

Now in its third century, the University of Maryland School of BOB体育 was chartered in 1807 as the first public medical school in the United States. It continues today as one of the fastest growing, top-tier biomedical research enterprises in the world -- with 46 academic departments, centers, institutes, and programs, and a faculty of more than 3,000 physicians, scientists, and allied health professionals, including members of the National Academy of BOB体育 and the National Academy of Sciences, and a distinguished two-time winner of the Albert E. Lasker Award in Medical Research.  With an operating budget of more than $1.2 billion, the School of BOB体育 works closely in partnership with the University of Maryland Medical Center and Medical System to provide research-intensive, academic and clinically based care for nearly 2 million patients each year. The School of BOB体育 has nearly $600 million in extramural funding, with most of its academic departments highly ranked among all medical schools in the nation in research funding.  As one of the seven professional schools that make up the University of Maryland, Baltimore campus, the School of BOB体育 has a total population of nearly 9,000 faculty and staff, including 2,500 students, trainees, residents, and fellows. The combined School of BOB体育 and Medical System (鈥淯niversity of Maryland BOB体育鈥�) has an annual budget of over $6 billion and an economic impact of nearly $20 billion on the state and local community. The School of BOB体育, which ranks as the 8th highest among public medical schools in research productivity (according to the Association of American Medical Colleges profile) is an innovator in translational medicine, with 606 active patents and 52 start-up companies.  In the latest U.S. News & World Report ranking of the Best Medical Schools, published in 2021, the UM School of BOB体育 is ranked #9 among the 92 public medical schools in the U.S., and in the top 15 percent (#27) of all 192 public and private U.S. medical schools.  The School of BOB体育 works locally, nationally, and globally, with research and treatment facilities in 36 countries around the world. Visit medschool.umaryland.edu

About the University of Maryland Medical System

The University of Maryland Medical System (UMMS) is a university-based regional health care system focused on serving the health care needs of Maryland, bringing innovation, discovery and research to the care we provide and educating the state's future physician and health care professionals through our partnership with the University of Maryland School of BOB体育 and University of Maryland, Baltimore professional schools (Nursing, Pharmacy, Social Work and Dentistry) in Baltimore. As one of the largest private employers in the State, the health system's more than 29,500 employees and 4,000 affiliated physicians provide primary and specialty care in more than 150 locations, including 13 hospitals and 9 University of Maryland Urgent Care centers. The UMMS flagship academic campus, the University of Maryland Medical Center in downtown Baltimore, is recognized regionally and nationally for excellence and innovation in specialized care. Our acute care and specialty rehabilitation hospitals serve urban, suburban and rural communities and are located in 13 counties across the State. For more information, visit .