COVID-19 and chronic obstructive pulmonary disease (COPD): link, precautions, tips

Chronic obstructive lung disease (COPD) is a respiratory disease in which airflow to the lungs is affected. COPD can be life-threatening, and it is not fully reversible with treatment. According to the Global Burden of Disease study, there were as many as 251 million cases of COPD reported in 2016 worldwide, and about 3.17 million deaths were caused by the disease the previous year.

In India alone, the prevalence of this disease is considerably high, with approximately 6.4% of the population reportedly suffering from this illness. With time, the prevalence of the disease has only increased: according to a study published in The Lancet in 2018, the number of cases in India was reported to have been 28.1 million in 1990, but had risen to 55.3 million by 2016.

While chronic respiratory diseases are usually clubbed together for categorisation, COPD includes three progressive conditions in the lungs: chronic bronchitis, emphysema and irreversible asthma. The primary causes of COPD are exposure to pollutants and chemicals and smoking addiction. (Read more: COVID-19 and smoking)

Uncontrolled asthma and a family history of the disease are some risk factor for COPD. People living with COPD may develop comorbidities, including heart disease, depression or diabetes.

Now the new coronavirus infection, COVID-19, is posing another challenge for people living with COPD for at least two reasons:

Research has shown that people with chronic illnesses are more likely to be severely sick and even die if they contract COVID-19. COPD is, of course, a chronic condition that requires lifelong drug therapy and lifestyle management.
COVID-19 is a respiratory illness that often affects the lungs. In people with COPD, the health of their lungs is already compromised.

Doctors and medical researchers are, of course, acutely aware that COVID-19 has a bigger impact on people who are already sick—especially those living with conditions that affect the heart, blood vessels and lungs, or with illnesses which cause inflammation such as diabetes and Kawasaki disease. A letter to the peer-reviewed journal Respiratory Medicine pointed out that those suffering from COPD were five times more likely to get the severe symptoms of COVID-19 infection. (Read more: Complications of severe COVID-19 infection)

How COVID-19 affects COPD patients
COVID-19 prevention for COPD patients

How COVID-19 affects COPD patients

A meta-analysis of seven different studies published in The Lancet looked at how COVID-19 affected patients with existing COPD symptoms. Another study, done in China in early 2020 arrived at a case fatality rate of about 2.3% of all COVID-19 cases, but those diagnosed with COPD or other chronic respiratory diseases had a significantly higher case fatality rate of 6.3%.

COPD is diagnosed with the help of a spirometry test, which looks at how deeply a person can breathe to get a sense of how fast air can move in and out of the lungs of the patient. Whereas the new COVID-19 infection is due to the presence of the virus—the test for it is done after taking nasal or throat swabs, samples of which are studied under using the sophisticated RT-PCR test to determine the presence of the virus.

Much like the symptoms of COPD, even COVID-19 patients have presented with pneumonia-like symptoms such as shortness of breath, persistent cough or excessive sputum or mucus production.

Existing lung damage can make it difficult for the lungs to ward off infections, which is why patients with underlying conditions such as COPD are advised to remain indoors as much as possible, or in less-polluted areas, irrespective of COVID-19. (Read more: COVID-19 prevention tips for the elderly and those with lifelong diseases)

Patients with COPD are often advised to use external devices to assist with their breathing such as nebulisers to inhale their medications—nebulisers can generate respiratory aerosols.

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COVID-19 prevention for COPD patients

According to the American Lung Association, people with chronic respiratory diseases such as asthma or COPD, or even lung cancer, have been advised to exercise extra caution towards their health.

Those with chronic respiratory illnesses are also advised to keep taking their regular medications, closely monitor their health and report any changes to their healthcare specialist.

Global health authorities had identified those living with comorbidities or even senior citizens above the age of 65 to be at a higher risk of contracting severe symptoms of the disease due to their weakened immune systems. Governments, as a result, have imposed restrictions on the movement of their citizens, with senior citizens advised to remain indoors for as long as possible, and get their regular health check-ups via video conferencing or over the telephone to minimise the chances of infection.

Some general advice for people to avoid infection include:

Practise extreme physical distancing as much as possible, i.e., maintaining two metres or six-feet distance from others.
Remain at home unless you need urgent medical care or attention. Even then, wear a mask when you step out.
Avoid touching your face
Wash your hands with soap and water, periodically and for 20 seconds each time.
Cover your coughs and sneezes with tissue paper or your elbow.
Maintain good personal hygiene.
Keep a regular supply of home supplies to avoid stepping out regularly.
Get items delivered where possible but insist on a contactless delivery, and disinfect the containers of the supplies before taking the contents out of their packaging.
Clean and disinfect surfaces such as doorknobs, computers, mobile phones, TV remotes regularly
Smokers, who have a higher risk of suffering from chronic respiratory diseases such as COPD, are also advised to avoid smoking as it will allow the respiratory system to become stronger, especially against a new disease such as COVID-19.