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COPD IN THE TIME OF CORONAVIRUS

People with Chronic Obstructive Pulmonary Disease (COPD) have a higher risk of severe illness from COVID 19 due to their existing lung problems. WOW speaks with Dr. Rakshya Pandey to know how COVID 19 may affect people with COPD, symptoms to look out for, and extra precautions people with COPD can take.

Dr. Rakshya is a Senior Consultant in Respiratory and Critical Care Medicine at HAMS Hospital. She completed her MBBS from Manipal College of Medical Sciences, Nepal in 2002 and Doctor of Medicine (MD) in Internal Medicine from the UK. She also worked there in the National Health System (NHS) for five years. After that, she completed specialist training in respiratory and critical care medicine in Singapore and worked there as a Consultant before returning back to Nepal. Having a special interest in interstitial lung disease and Interventional Pulmonology she has started a comprehensive Pulmonary Rehabilitation Program at HAMS.

How dangerous is COVID 19 for people with COPD?

COPD patients may experience an increased problem in their respiratory symptoms when they get COVID 19. Depending on their baseline COPD control, patients may have more severe symptoms than those who don’t have COPD.

COPD patients are at higher risk of developing severe COVID 19 infection than those without COPD. Therefore it is important to seek medical help early.

How does COVID 19 affect people with COPD? What are the symptoms to look out for?

Chronic Obstructive Pulmonary Disease is a chronic disease of the lungs that causes narrowing of the airways or the breathing pipe. This is mostly caused by tobacco smoking and biomass (firewood burning) exposure in our country.

Any person can get COVID 19. But patients with COPD may have more severe symptoms if they get COVID 19 since they already have a respiratory compromise. COVID 19 is an added insult to the body that may lead to a worsening of their COPD symptoms. COPD patients may present with similar symptoms of new-onset fever, worsening cough, or breathlessness. The oxygen level in their body may be low and their fingertips or tongue may appear bluish. They may have one or more of the common symptoms of COVID 19.

What extra precautions can people with COPD take?

COPD patients should continue to take their inhalers and other medicines regularly as prescribed. They need to take all preventive measures circulated by the government to decrease their risk of getting COVID 19. They must stop smoking. Eating a nutritious and balanced diet is mandatory. They also have to engage in home based exercise like brisk walk, upper and lower body strengthening exercises as far as possible. They should avoid crowded areas and stay away from infected people. It is also important to take care of mental health during this time as there may be increased anxiety and fear. It is vital to share the feeling of anxiety with loved ones so that they have emotional support. If they develop fever or a new increase in cough and breathlessness, then the family should immediately contact the doctor and visit if required. One important thing is we should not forget to inform the hospital before the patient’s visit so that the necessary precautions are taken.

How can one manage COPD symptoms during the pandemic?

Mild COPD symptoms can be managed at home by taking extra medicines prescribed by the doctor. They can also do a phone consultation with the doctor if the facility is available in the hospital. In the case of severe symptoms, immediate medical help may be needed. So, we need to take the patient to hospital as soon as possible. If there is a history of contact with someone who has a fever and flu-like symptoms or someone who has been suspected or diagnosed with COVID 19, then it is important to evaluate if the symptoms are related to COVID 19. We have to contact the doctor or visit the hospital for a check up. We need to inform the hospital before the visit so that necessary measures are taken to keep others from being exposed to the suspected patient. Then it is up to the doctor if the patient needs to be tested for COVID 19 or not.

COPD patients are at higher risk of severe disease than general population therefore management depends on patient’s condition.

How is COVID 19 treated?

There is no specific treatment available for COVID 19 yet. However, many kinds of research are ongoing worldwide. For mild symptoms of fever and cough, taking paracetamol and cough mixture as directed by the doctor may be enough. Supplemental oxygen is given if there is a decrease in oxygen level in the patient’s body. For more severe disease, the patient would be monitored in the Intensive Care Unit (ICU) and more aggressive treatment is given based on current evidence and guidelines. COPD patients with COVID 19 infection must continue all of their regular inhalers and medicines in addition to the treatment given for COVID 19. Vaccines for COVID 19 are being tested. However, it may take several months for them to be available for widespread use.