Advertorial: Chronic obstructive pulmonary disease (COPD) and COVID-19

At the moment, we are being overwhelmed with information about Covid-19 – how to protect ourselves from illness and safeguard society in general from overloading the healthcare system.

It is not surprising that for many of us this might be a source of anxiety!

For those of us living with COPD, it might be even more concerning, since we are generally conscious that we need to avoid getting colds or ‘flu to prevent exacerbation. Some might feel frightened that they are at especially high risk of severe disease or even death.¹ 

The good news is that this does not seem to be the case with regards to Covid-19.Studies of patients with Covid-19 severe enough to be admitted to hospital do not suggest that people with COPD are at increased risk of catching the virus.^2,3   

Furthermore, the vast majority of people who do become infected do not develop any symptoms at all, or, if they do, experience only mild illness before making a full recovery. This is probably true also for people with COPD.^1,4,5 

In fact, compared to what one might expect from the general population, there have been surprisingly few people with COPD among the patients with severe Covid-19.²  The reasons for this are uncertain.

One hypothesis is that medications used to prevent exacerbation of COPD might be protective against coronavirus infection, or at least reduce the severity of the disease.⁶ While this may or may not be true, it is important to stress that stopping COPD medicines during the coronavirus pandemic can worsen lung function and cause a worsening of symptoms.⁶

Nevertheless, COPD is a disease which itself is associated with risk of periodic worsening of symptoms. If they are severe enough, it can necessitate hospitalisation, and viral infections are an important trigger of these exacerbations.

Unfortunately, people with COPD, who do contract Covid-19 and who are hospitalised are at high risk of more severe disease.⁷  It may be that such people have fewer reserves to cope with the effects of severe disease on the lungs, or their poorly functioning immune systems might make them more susceptible to develop inflammation and severe lung disease.⁶

Therefore, people with COPD are advised, as best they can, to take precautions to avoid becoming infected with Covid-19 and to ensure that their COPD remains properly managed.^6,7 

Here are some precautions experts are advising people with COPD to take at this time:

1. Avoid infection

The best way to avoid being exposed to the virus is to stay at home. You are less likely to need to leave the house to go shopping if you keep enough medicine, food and other essential supplies to last you a few weeks.⁴ 

Alternatively, you could ask someone else to shop for you, or shop online and have it delivered. Ask your doctor if non-urgent medical appointments may be done over the telephone, so you do not have to visit their rooms. The South African government has encouraged employers to allow people with medical conditions to work from home.⁸

If you need to go out, try to stay at least two metres from other people. Keep your hands clean with soap and water or a hand sanitiser that contains at least 60% alcohol. Avoid touching your face and clean and disinfect frequently touched surfaces at home.⁹

2. Practise wearing a mask before you go out if you need to.

The purpose of wearing a mask is not to protect the wearer, but rather others from the wearer’s germs. That is why everybody needs to wear one while they are around other people. For people with respiratory conditions, wearing a mask may feel strange at first.

You might feel anxious, especially if you feel like you can’t breathe. Find a mask that fits comfortably and is not too restrictive over your nose and mouth. Alternatively, consider other options, such as a scarf or buff, which might be more comfortable.

Allow your body to adjust to having something covering your face by practising at first while sitting watching TV, and then walking about the house and outside. If you really feel you cannot manage, speak to your healthcare provider about assistance.10

3. Keep on taking your COPD medication as usual!

Do not stop or change your usual treatment plan without first getting medical advice.^4,6  

4. Recognise symptoms that require attention

You know your COPD best and can probably recognise when you are having a bad day. However, if you experience any of the following symptoms, you should immediately go to your doctor or the hospital emergency department: severe shortness of breath, difficulty performing any normal activity or sleeping because of breathing, fever or chills, confusion or drowsiness, chest pains, or blood in your sputum.¹¹

5. Stay in touch with other people

Being alone or feeling isolated can really start to get us down. Even if we can’t be with them in person, keeping in touch with friends and family by telephone or video call can help keep our spirits up.

And remember: nothing lasts forever! It won’t be long before we can settle back to safely spending time together. The important thing is to stay safe until then.

<sup>References
1. Russell R. Covid-19 and COPD: A personal reflection. In J COPD 2020; 15: 883-884.
2. Halpin DMG, Faner R, Sibila O, et al. Do chronic respiratory diseases or their treatment affect the risk of SARS-CoV-2 infection? Lancet Respir Med 2020. Published Online April 3, 2020. https://doi.org/10.1016/S2213-2600(20)30167-3
3. Zhang J-j, Dong X, Cao Y-y, et al. Clinical characteristics of 140 patients infected with SARSCoV- 2 in Wuhan, China. Allergy 2020. Published online.  DOI: 10.1111/all.14238
4. European Lung Foundation. COVID-19 AND LUNG DISEASE Q&A. 14 May 2020. https://www.europeanlung.org/covid-19/covid-19-information-and-resources/covid-19-info. Accessed 26 May 2020.
5. Pascarella G, Strumia A, Piliego C, et al. COVID-19 diagnosis and management: a comprehensive review. J Intern Med. Published online Apr 29, 2020. doi: 10.1111/joim.13091. 
6. Halpin DMG, Singh D, Hadfield RM. Inhaled corticosteroids and COVID-19: a systematic review and clinical perspective. Eur Respir J 2020; 55: 2001009. https://doi.org/10.1183/13993003.01009-2020.
7. Alqahtani JS, Oyelade T, Aldhahir AM, et al. Prevalence, Severity and Mortality associated with COPD and Smoking in patients with COVID-19: A Rapid Systematic Review and Meta-Analysis. PLoS ONE 15(5): e0233147. https://doi.org/10.1371/journal.pone.0233147
8. Department of Health. Alert Level 3 Infographics & Guidelines. Special measures for the most vulnerable. May 24, 2020. https://sacoronavirus.co.za/2020/05/24/alert-level-3-infographics-guidelines. Accessed 26 May 2020.
9. American Lung Association. Preventing COVID. https://www.lung.org/lung-health-diseases/lung-disease-lookup/covid-19/prevention. Accessed 26 May 2020.
10. American Lung Association. Steps you can take to get used to wearing a mask. https://www.lung.org/lung-health-diseases/lung-disease-lookup/covid-19/faq. Accessed 26 May 2020.
11. American Lung Association. COPD Action Plan. https://www.lung.org/getmedia/c7657648-a30f-4465-af92-fc762411922e/copd-action-plan.pdf.pdf. Accessed 26 May 2020.</sup>

ZA2006049260 05/2022