Introduction:

COPD exacerbation rates fell early in the COVID-19 pandemic in the UK, but more recent trends, as social mixing returns, are unclear.

Aims and objectives:

To quantify COPD exacerbations during and beyond the COVID-19 pandemic.

Methods:

We used the Optimum Patient Care Research Database (OPCRD) to calculate monthly COPD exacerbations rates from Jan 2017 to Dec 2022.

Results:

Data for 15,074,114 patient-months were analyzed. COPD exacerbations surged yearly in winter before COVID-19, peaking in Jan (Figure 1). COPD exacerbation rates decreased in Apr 2020 (0.076 events per patient per month (PPM), vs 0.111 events PPM in Apr 2019). There was no surge in 2020-21 winter. The 2021-22 winter surge remained blunted, though slightly higher than in 2020-21. COPD exacerbation rates in 2022 were slightly higher before winter than in 2021, and increased substantially during 2022-23 winter to reach pre-pandemic levels (Dec 2022: 0.146 events PPM).

Conclusions:

These were the first data showing that as the COVID-19 pandemic concludes and social mixing increases, COPD exacerbation rates are trending back to pre-pandemic levels in the UK. These highlight the public health importance of COPD exacerbations and the need to reduce such risk, and may impact future trials and research.