COVID-19 and COPD: how it impacted primary healthcare indicators and what can we learn from it
DOI:
https://doi.org/10.32385/rpmgf.v40i6.13819Palavras-chave:
COPD, COPD management, Primary healthcare, COVID-19Resumo
Introduction: The COVID-19 pandemic brought challenges and difficulties that impacted the healthcare system, namely the routine management and diagnosis of chronic obstructive pulmonary disease (COPD) at primary healthcare (PHC) units.
Objectives: To reflect on the impact of the COVID-19 pandemic on COPD management at PHC.
Methods: We analyzed the publicly available COPD indicators, considering monthly data between Dec/2018 and Feb/2020 (pre-pandemic), Mar/2020, and Jun/2021 (pandemic), and Jul/2021 and Sep/2022 (post-general population vaccination against COVID-19).
Results: Before the pandemic, there was a growing number of COPD patients in PHC, which reversed after the beginning of the pandemic and remained until the end of 2020. A fast increase was observed during 2021, with a significant decrease in early 2022, coincident with the new pandemic peak. This indicator was stabilizing to values slightly lower than before the COVID-19 pandemic. The eligibility of COPD patients for priority COVID-19 vaccination could have led to an increased COPD codification in PHC. However, the proportion of patients with COPD and FEV1 in the previous three years decreased. The COPD and FEV1 indicators were rising after the last most significant peak of cases in Jan-Feb/2022 but in Sep/2022 were not yet reaching pre-pandemic values. In Sep/2021, 47.1% of PHC patients had a registry of at least one surveillance consultation. Only half of PHC patients (51.3%) had a registry one year later.
Conclusions: The analysis of the COPD indicators confirmed the significant impact of COVID-19 on COPD management at PHC. The restrictions of patients’ visits and difficulty in conducting spirometry limited diagnostic opportunities; on the other hand, the pandemic increased population awareness of vaccination and respiratory diseases. Beyond this analysis’s primary objective, these results led us to become aware of the need to better identify, follow, and manage COPD patients.
Downloads
Referências
1. Fundação Portuguesa do Pulmão. Observatório Nacional das Doenças Respiratórias [Internet]. Lisboa: Fundação Portuguesa do Pulmão; 2020. Available from: https://www.fundacaoportuguesadopulmao.org/ficheiros/ondr2020.pdf
2. Vachon B, Giasson G, Gaboury I, Gaid D, De Tilly VN, Houle L, et al. Challenges and strategies for improving COPD primary care services in Quebec: results of the experience of the COMPAS+ quality improvement collaborative. Int J Chron Obstruct Pulmon Dis. 2022;17:259-72.
3. World Health Organization. WHO package of essential noncommunicable (PEN) disease interventions for primary health care [homepage]. Geneva: WHO; 2020. Available from: https://www.who.int/publications/i/item/9789240009226
4. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: 2023 report [homepage]. GOLD; 2023. Available from: https://goldcopd.org/2023-gold-report-2/
5. Crimi C, Impellizzeri P, Campisi R, Nolasco S, Spanevello A, Crimi N. Practical considerations for spirometry during the COVID-19 outbreak: literature review and insights. Pulmonology. 2021;27(5):438-47.
6. Barbosa MT, Morais-Almeida M, Sousa CS, Bousquet J. The ‘Big Five’ lung diseases in CoViD-19 pandemic: a Google trends analysis. Pulmonology. 2021;27(1):71-2.
7. Bárbara C, Rodrigues F, Dias H, Cardoso J, Almeida J, Matos MJ, et al. Chronic obstructive pulmonary disease prevalence in Lisbon, Portugal: the burden of obstructive lung disease study. Rev Port Pneumol. 2013;19(3):96-105.
8. Fundação Portuguesa do Pulmão. Observatório Nacional das Doenças Respiratórias 2022 [Internet]. Lisboa: Fundação Portuguesa do Pulmão; 2022. Available from: https://www.fundacaoportuguesadopulmao.org/ficheiros/ondr_2022.pdf
Downloads
Publicado
Edição
Secção
Licença
Direitos de Autor (c) 2025 Revista Portuguesa de Medicina Geral e Familiar
Este trabalho encontra-se publicado com a Licença Internacional Creative Commons Atribuição-NãoComercial-SemDerivações 4.0.
Os autores concedem à RPMGF o direito exclusivo de publicar e distribuir em suporte físico, electrónico, por meio de radiodifusão ou em outros suportes que venham a existir o conteúdo do manuscrito identificado nesta declaração. Concedem ainda à RPMGF o direito a utilizar e explorar o presente manuscrito, nomeadamente para ceder, vender ou licenciar o seu conteúdo. Esta autorização é permanente e vigora a partir do momento em que o manuscrito é submetido, tem a duração máxima permitida pela legislação portuguesa ou internacional aplicável e é de âmbito mundial. Os autores declaram ainda que esta cedência é feita a título gratuito. Caso a RPMGF comunique aos autores que decidiu não publicar o seu manuscrito, a cedência exclusiva de direitos cessa de imediato.
Os autores autorizam a RPMGF (ou uma entidade por esta designada) a actuar em seu nome quando esta considerar que existe violação dos direitos de autor.