Study of respiratory disorders at a tertiary care hospital in Sri Lanka during lockdown

Abstract

COVID-19 is a rapidly spreading new viral infection causing an unprecedented global pandemic. Sudden lockdowns and curfews imposed throughout countries and continents have caused a significant impact on global health systems. As the scientific community focused its attention on the pandemic, the prevalence and patterns of other medical illness including respiratory illnesses went largely neglected. This study was designed to determine the pattern of respiratory disorders at Teaching Hospital Batticaloa, Sri Lanka during the lockdown period, specifically looking at the prevalence of age, gender, place of admission and pattern of respiratory disorders among admitted patients with respiratory conditions. It was a cross sectional descriptive study done retrospectively among all the patients with non-COVID related respiratory illnesses admitted to medical wards and intensive care units (ICU) of Teaching Hospital Batticaloa, Sri Lanka during a one month period of first lockdown (11.03.2020 to 10.04.2020) due to COVID-19. They were compared with the patients of respiratory illnesses admitted one month (11.02.2020 to 10.03.2020) prior to the lockdown. Our study revealed 215 admissions before the lockdown and 86 admissions during lockdown with respiratory diseases. Total number of admission before lockdown was 2340 and during the lockdown this number reduced to 1376. Age distribution demonstrated that the highest number of patients (about 25%) admitted with respiratory illnesses during both study periods was within the age of 61-70 years. Gender distribution confirmed that male admissions were higher before lockdown (58%) and female admissions were slightly higher during lockdown (51%). The study showed that inward admission was 212 and 78 before and during lockdown and ICU admission was 3 and 8 before and during lockdown respectively. Further analysis revealed ICU admissions had increased and ward admission has been reduced during lockdown. Most common respiratory disorders among admitted patients before and during lockdown were lower respiratory tract infections, exacerbation of chronic obstructive pulmonary disease (COPD) and exacerbation of asthma. Therefore these three diseases were analysed separately. It showed there was a significant reduction of these three cases during lock down. These findings were closely related to the available data from other countries. In conclusion, the number of admissions to the hospitals with respiratory disorders during COVID-19 lockdown was significantly reduced. Exacerbations of asthma and COPD and lower respiratory tract infections were the common disorders during lockdown even though there was less number of patients. More females within the age group of 61-70 years were admitted. Interestingly a higher number of admissions to the ICU were noted during lockdown. We assume that less exposure to allergens and triggering factors during lockdown and wearing face masks and practicing good healthy hygienic measures may contribute to the reduction in number. Moreover late presentation with more severe disease status may be contributing for higher ICU admissions. However, these assumptions and explanations need further studies to prove.