The differing experiences of people living with COPD during the Covid-19 pandemic: An interview study

Introduction: The Covid-19 pandemic and its restrictions affected millions of people globally, including those living with chronic obstructive pulmonary disease (COPD). However, little is known about the views of people with COPD and their carers on how it affected their lives and their responses to symptom worsening. Methods: Semi-structured interviews were conducted by phone in a multicentre qualitative study. Participants were recruited purposively in primary and secondary care. Interviews were audio-recorded and analysed using reflexive thematic analysis. Descriptive data are presented as mean [SD] unless stated. Results: 40 COPD patients were interviewed (21 female; 28 white; age 69 [8.1] years, COPD duration 11.3 [8.3] years, median [range] number of exacerbations in the past year 1.5 [0-9]). Seven carers (6 female, 6 white) were interviewed. Two themes were identified: i) Lives interrupted: manageable for some, whilst very difficult for others, ii) Inequitable access to clinicians affects help-seeking for worsened symptoms. These experiences of people with COPD during the pandemic restrictions highlight how the ongoing inequity in living conditions and access to clinicians greatly affects the health and the response to exacerbations of those living with COPD. The Breathing Space concept describes how well people can live with breathlessness, one of the key symptoms of COPD. These data suggest the importance of incorporating a further factor related to the context that people live in to the Breathing Space concept, so that it has greater explanatory power. Discussion: The pandemic and its restrictions had a differential effect on people living with COPD and their carers. This was due to their degree of social support, their physical environment and their access to and relationship with their clinicians. All of these factors continue to affect the lives of people with COPD and affect their health and responses to exacerbations.