Effect of quarantine ?n hospital admissions for asthma/COPD exacerbations: association with air pollution

Introduction: Imposed quarantines for COVID-19 modifies viral infections and air pollution, major triggers of asthma/COPD exacerbations (A/CE).There is concern that fear for COVID19 infection raises a medical avoidance behavior. Aim: To study the rate of hospital admissions for A/CE during the first imposed quarantine in Athens. Methods: Retrospective, observational study of all consecutive patients hospitalized with acute A/CE during the 8-week quarantine and comparison with the relative period before and after quarantine as well as the respective 2019 period. Patient population characteristics and air pollutants concentration (CO, NO, NO2, O3 PM2.5, PM10, SO2and benzene) were recorded. Results: 153 hospitalizations were recorded. A reduction in hospitalization for A/CE- more prominent in asthmatics- was observed during the quarantine compared to either the pre-post quarantine period or the respective 2019 periods (fig). Concentration of air pollutants was reduced during quarantine and positively correlated with the reduction in hospital admissions. Although first wave quarantine (March 9th- May 3rd) co insists with pollination period of spring pollens, hospitalizations for asthma were reduced, reflecting adherence to quarantine measures. During Quarantine asthmatics were younger and exhibited less frequent respiratory failure at admission, whereas patients with COPD presented higher blood eosinophils. Conclusion: Admissions for A/CE decreased during the Quarantine, a finding more prominent in asthmatics. We believe that improvement in air quality may have contributed to the observed reduction of exacerbations.