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LETTER TO EDITOR
Year : 2020  |  Volume : 9  |  Issue : 10  |  Page : 5384-5385  

Has respiratory emergencies changed during lockdown implemented for COVID-19 pandemic?


Department of Pulmonary Medicine, AIIMS, Patna, Bihar, India

Date of Submission20-Jul-2020
Date of Acceptance19-Aug-2020
Date of Web Publication30-Oct-2020

Correspondence Address:
Dr. Deependra K Rai
Department of Pulmonary Medicine, AIIMS, Patna, Bihar
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jfmpc.jfmpc_1485_20

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How to cite this article:
Rai DK, Karmakar S. Has respiratory emergencies changed during lockdown implemented for COVID-19 pandemic?. J Family Med Prim Care 2020;9:5384-5

How to cite this URL:
Rai DK, Karmakar S. Has respiratory emergencies changed during lockdown implemented for COVID-19 pandemic?. J Family Med Prim Care [serial online] 2020 [cited 2020 Dec 1];9:5384-5. Available from: https://www.jfmpc.com/text.asp?2020/9/10/5384/299351



Sir,

Coronavirus disease (COVID-19) is an infectious disease caused by novel coronavirus named as SARS Cov-2. It originated in the city of Wuhan, the capital of Hubei province of China in December 2019 and has been declared a pandemic by the World Health Organization.[1],[2] The disease has now spread in more than 200 countries and even our country, India has been badly affected. More than 11 lacs cases and almost 20,000 deaths have occurred till date (20th July 2020). Our Honorable Prime Minister announced a “Janta curfew” on 22nd March 2020. Thereafter, a nationwide “Lockdown” was ordered which has been effective in slowing down the growth rate of pandemic.

The unprecedented COVID-19 pandemic has seriously impacted people with pre-existing health conditions and has adversely affected the management of other diseases. Lockdown not only helped in containment of COVID-19 infection but reducing air pollution as evident by a bettering in the air quality index. The short-term effects of air pollution include reduction in pulmonary function, worsening of respiratory symptoms, non-infectious exacerbations of chronic obstructive pulmonary disease (COPD), bronchial asthma (BA), and an increase in respiratory mortality.[3],[4],[5] Patna is among one of the most polluted cities of India and air quality index is generally more than 300 in month of April–May 2020. Air quality index of Patna during lockdown period was generally less than 100 which is considered as satisfactory. Our hypothesis was that with betterment of air quality, we should expect a reduction in hospital admission for diseases like exacerbation of COPD/BA. So, we compared the morbidity and mortality due to respiratory emergencies in same period of 2020 with 2019.

Primary objective of the study was to comparison of number of episodes' and type respiratory emergency in period of lockdown to same period last year.


  Materials and Methods Top


This was retrospective analysis of all the patients admitted in Pulmonary Medicine department for diseases other than COVID-19 through Emergency visits in month of April–May 2020. Sociodemographic and clinical details were recorded from case file available in hospital record system. We compared this data with same period for previous year, that is, 2019.


  Results Top


A total of 41 patients were admitted in the period of lockdown between April and May 2020, which is 37.8% less, compared to same period of last year. There was reduction in admission for patients with COPD (25.7% vs. 17.0%) and asthma (6% vs. 4.8%) compared to previous year but this difference was statistically not significant and this could be due to short period of evaluation which might not reflect the actual number of patients [Table 1]. There were more cases of lower respiratory tract infection/pneumonia and post-tuberculosis sequel that were admitted in lockdown period compared to previous year for same period. There were lesser deaths among admitted patient (4.87%) in 2019 as compared to 2020 (9.8%) for the same period. In 2019, out of the 6 patients who died, 2 were patients of lung cancer and 1 each was patient of sepsis, acute respiratory distress syndrome, chronic obstructive lung disease, and interstitial lung disease.
Table 1: Comparison of respiratory emergencies in 2019 with 2020

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We infer that air pollution is a major public health hazard, particularly in developing countries and is associated with hospitalizations from respiratory diseases.[6]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al.; China Novel Coronavirus Investigating and Research Team. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020;382:727-33.  Back to cited text no. 1
    
2.
Burki TK. Coronavirus in China. Lancet Respir Med 2020;8:238.  Back to cited text no. 2
    
3.
Lagorio S, Forastiere F, Pistelli R, Iavarone I, Michelozzi P, FanoV, et al. Air pollution and lung function among susceptible adult subjects: A panel study. Environ Health 2006;5:11.  Back to cited text no. 3
    
4.
Schwartz J. Air pollution and hospital admissions for respiratory disease. Epidemiology 1996;7:20-8.  Back to cited text no. 4
    
5.
Atkinson RW, Anderson HR, Sunyer J, Ayres J, Baccini M, Vonk JM, et al. Acute effects of particulate air pollution on respiratory admissions: results from APHEA 2 project. Air Pollution and Health: a European Approach. Am J Respir Crit Care Med. 2001;164(10 Pt 1):1860-6.  Back to cited text no. 5
    
6.
Medina-Ramón M, Zanobetti A, Schwartz J. The effect of ozone and PM10 on hospital admissions for pneumonia and chronic obstructive pulmonary disease: A national multicity study. Am J Epidemiol 2006;163:579-88.  Back to cited text no. 6
    



 
 
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