Abstract
Adults living with chronic respiratory diseases are at higher risk of death due to COVID-19. Our objective was to evaluate the physical and mental health symptoms among US adults living with chronic respiratory conditions. We used data of 10,760 US adults from the nationally representative COVID-19 Impact Survey. Chronic respiratory conditions were self-reported and included asthma (14.7%), chronic obstructive pulmonary disease or COPD (4.7%), and bronchitis/emphysema (11.6%). We used multivariable Poisson regression to evaluate physical health symptoms. We estimated associations of mental health symptoms using multinomial logistic regression. In multivariable models, adults with asthma were more likely to report physical symptoms including runny or stuffy nose, chest congestion, fever, and chills. In addition, adults with COPD were more likely to report several physical symptoms including fever (adjusted prevalence ratio [aPR]: 1.37, 95% confidence interval [CI]: 1.09–1.72), chills (aPR: 2.10, 95% CI: 1.67–2.64), runny or stuffy nose (aPR: 1.78, 95% CI: 1.39–2.27), chest congestion (aPR: 2.14, 95% CI: 1.74–2.61), sneezing (aPR: 1.59, 95% CI: 1.23–2.05), and muscle or body aches (aPR: 1.38, 95% CI: 1.06–1.81). Adults with chronic respiratory conditions are more likely to report physical and mental health symptoms during the COVID-19 pandemic compared to others. Providers should prioritize discussing mental health symptom management as the pandemic continues to be a public health concern in the US.
Highlights
COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)infection, has resulted in over 600,000 deaths in the United States since 20 January 2020, the date of the first confirmed case in the US [1,2]
In our study of adults living with respiratory conditions in the United States, we found that they were more likely to experience several physical health symptoms including fever, runny or stuffy nose, and fatigue or tiredness compared to the general population
Increased mental health symptoms reported during the COVID-19 pandemic among adults with chronic conditions may be due to the existing higher prevalence of depression and anxiety within adults with asthma and chronic obstructive pulmonary disease (COPD) [21]
Summary
COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)infection, has resulted in over 600,000 deaths in the United States since 20 January 2020, the date of the first confirmed case in the US [1,2]. To combat the spread of SARS-CoV-2, the Centers for Disease Control and Prevention (CDC) has promoted uptake and maintenance of preventative behaviors such as hand washing, 6-feet social distancing, utilizing telemedicine, and avoiding non-essential visits to doctor’s offices Adherence to these recommendations may pose a challenge among individuals with chronic respiratory conditions given their increased health care needs and utilization to manage their health compared to the general population [3]. Multiple meta-analyses have demonstrated that respiratory comorbidities are associated with more severe COVID-19 symptoms and/or higher mortality [4,9] This disparate burden may be related to higher angiotensin-converting enzyme 2 receptor expression in individuals with COPD and asthma [10]. The evidence that those with pre-existing respiratory conditions may have worse COVID-19 prognoses is growing [11,12]
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