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Impact of COVID-19 on People with Asthma: A Mixed Methods Analysis from a UK Wide Survey

27 Pages Posted: 26 Mar 2021

See all articles by Keir E.J. Philip

Keir E.J. Philip

Government of the United Kingdom - Royal Brompton and Harefield NHS Foundation Trust; NIHR Imperial Clinical Research Facility - NIHR Imperial Biomedical Research Centre; Imperial College London - National Heart and Lung Institute (NHLI)

Sara C. Buttery

Imperial College London - National Heart and Lung Institute (NHLI)

Parris Williams

Imperial College London - National Heart and Lung Institute (NHLI)

Bavithra Vijayakumar

Imperial College London - National Heart and Lung Institute (NHLI)

James Tonkin

Imperial College London - National Heart and Lung Institute (NHLI)

Andrew Cumella

Asthma UK and British Lung Foundation Partnership

Lottie Renwick

Asthma UK and British Lung Foundation Partnership

Lizzie Ogden

Asthma UK and British Lung Foundation Partnership

Jennifer K. Quint

Imperial College London - National Heart and Lung Institute (NHLI)

Sebastian L. Johnston

Imperial College London - National Heart and Lung Institute (NHLI)

Michael I. Polkey

Imperial College London - National Heart and Lung Institute (NHLI)

Nicholas S. Hopkinson

Imperial College London - National Heart and Lung Institute (NHLI)

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Abstract

Background: The impact of COVID-19 on people with asthma is a concern, with evidence that they are more likely to require intensive care if hospitalised. However, data regarding longer-term impacts is limited.

Methods: Using data from an online UK-wide survey of 4,500 people with asthma (Median age 50-59 years, 81% female), conducted by the Asthma UK-British Lung Foundation partnership in October 2020, we undertook a mixed methods analysis of the characteristics and experience of those reporting that they had had COVID-19.

Findings: The COVID-19 group (n=471, 10·5%) reported increased inhaler use and worse asthma management, compared to those not reporting COVID-19, but did not differ by gender, ethnicity, or household income. Among the COVID-19 group, 56·1% reported having long-COVID, 20·2% were ‘unsure’. Those with long-COVID were more likely than those without long-COVID to describe: their breathing as worse or much worse after their initial illness (73·7% Vs 34·8%, P<0·001), increased inhaler use (67·8% Vs 34·8%, P<0·001), and worse or much worse asthma management (59·6% Vs 25·6%, P<0·001). Having long-COVID was not associated with age, gender, ethnicity, UK nation or household income. Analysis of free text survey responses identified three key themes: 1) variable COVID-19 severity, duration, and recovery; 2) Symptom overlap and interaction between COVID-19 and asthma; 3) Barriers to accessing healthcare.

Interpretation: Persisting symptoms are common in people with asthma following COVID-19. Measures are needed to ensure appropriate healthcare access including clinical evaluation and investigation, to distinguish between COVID-19 symptoms and asthma.

Funding: KEJP was supported by the Imperial College Clinician Investigator Scholarship. KEJP would like to acknowledge the National Institute for Health Research (NIHR) Biomedical Research Centre based at Imperial College Healthcare NHS Trust and Imperial College London for their support. No other authors have anything to declare.

Declaration of Interest: None to declare.

Ethical Approval: Ethical approval for this study was granted by the Imperial College Research Governance and Integrity Team (RGIT) (ICREC Ref: 20IC6625).

Keywords: asthma, COVID-19, coronavirus, long-COVID, patient experience

Suggested Citation

Philip, Keir E.J. and Buttery, Sara C. and Williams, Parris and Vijayakumar, Bavithra and Tonkin, James and Cumella, Andrew and Renwick, Lottie and Ogden, Lizzie and Quint, Jennifer K. and Johnston, Sebastian L. and Polkey, Michael I. and Hopkinson, Nicholas S., Impact of COVID-19 on People with Asthma: A Mixed Methods Analysis from a UK Wide Survey (3/25/2021). Available at SSRN: https://ssrn.com/abstract=3813368 or http://dx.doi.org/10.2139/ssrn.3813368

Keir E.J. Philip (Contact Author)

Government of the United Kingdom - Royal Brompton and Harefield NHS Foundation Trust ( email )

Sydney Street
London, SW3 6NP
United Kingdom

NIHR Imperial Clinical Research Facility - NIHR Imperial Biomedical Research Centre ( email )

London
United Kingdom

Imperial College London - National Heart and Lung Institute (NHLI) ( email )

Emmanuel Kaye Building
London, SW3 6LR
United Kingdom

Sara C. Buttery

Imperial College London - National Heart and Lung Institute (NHLI)

Emmanuel Kaye Building
London, SW3 6LR
United Kingdom

Parris Williams

Imperial College London - National Heart and Lung Institute (NHLI)

Emmanuel Kaye Building
London, SW3 6LR
United Kingdom

Bavithra Vijayakumar

Imperial College London - National Heart and Lung Institute (NHLI)

Emmanuel Kaye Building
London, SW3 6LR
United Kingdom

James Tonkin

Imperial College London - National Heart and Lung Institute (NHLI)

Emmanuel Kaye Building
London, SW3 6LR
United Kingdom

Andrew Cumella

Asthma UK and British Lung Foundation Partnership

London
United Kingdom

Lottie Renwick

Asthma UK and British Lung Foundation Partnership

Lizzie Ogden

Asthma UK and British Lung Foundation Partnership

Jennifer K. Quint

Imperial College London - National Heart and Lung Institute (NHLI)

Emmanuel Kaye Building
London, SW3 6LR
United Kingdom

Sebastian L. Johnston

Imperial College London - National Heart and Lung Institute (NHLI)

Emmanuel Kaye Building
London, SW3 6LR
United Kingdom

Michael I. Polkey

Imperial College London - National Heart and Lung Institute (NHLI)

Emmanuel Kaye Building
London, SW3 6LR
United Kingdom

Nicholas S. Hopkinson

Imperial College London - National Heart and Lung Institute (NHLI)

Emmanuel Kaye Building
London, SW3 6LR
United Kingdom