Winners and losers: Managing chronic respiratory patients during the COVID-19 pandemic

The COVID-19 pandemic and resulting changes in living conditions, lifestyle but also healthcare organization have very much affected the people with chronic respiratory diseases. Since early 2020 much has been learnt about the risk of COVID-19 increased severity and potential complications as well as other dangers conveyed by SARS-Cov2 in this population to allow better and safer healthcare provision. Yet, the pandemic-related shift in focus of healthcare resources has led to disruption of care for chronic health conditions with potentially grave results. In parallel, the fear of being infected caused patients reluctance to appear at the clinics This resulted for example in a substantial decrease in ER visits and hospitalizations for COPD and asthma exacerbations with shift towards outpatient care but also in a significant change in the profile of newly diagnosed lung cancer patients towards more advanced stages. Likewise, the steps taken to mitigate the spread of the virus effectively increased patients’ social isolation and had a negative impact on their psychological well-being. On the other hand, due to the movement restriction and a significant slowdown of social and economic activities, air quality has improved in many regions. Therefore, the well-known harmful impact of air pollution on chronic respiratory conditions for example the risk of asthma and COPD exacerbations was further decreased. And finally, the COVID19 pandemics reaffirmed the importance of surveillance and prevention for communicable airborne diseases, and the fundamental importance of vaccination for the medical care for patients with chronic respiratory conditions.