The Impact of the COVID-19 Pandemic on Exacerbations and Symptoms in Bronchiectasis: A Prospective Study

Abstract

The underlying mechanisms leading to bronchiectasis symptoms and exacerbations are poorly understood. Recent data suggests that daily symptoms such as cough and sputum are linked to airway bacterial load and corresponding neutrophilic inflammation. In contrast, recent data suggests bronchiectasis exacerbations arise due to changes in the interactions between pathogens in the airway microbiome that may be disrupted by viral infections. Respiratory viruses can be identified during exacerbations in up to 50% of bronchiectasis patients. The COVID-19 pandemic resulted in the introduction of social distancing and mitigation measures that have reduced person to person interactions worldwide. This has reduced the circulation of respiratory viruses such as influenza and rhinovirus which are commonly identified in exacerbations of bronchiectasis. The
COVID-19 pandemic therefore represents a “natural experiment” to test the hypothesis that many bronchiectasis exacerbations are related to external exposures while daily chronic symptoms such as cough and sputum are more “intrinsic”. In this study we therefore hypothesised that social distancing during 2020 would be associated with reduced reported exacerbations but no change in
chronic symptoms typically experienced during stable state.

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This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives Licence 4.0 (http://creativecommons.org/licences/by-nc-nd/4.0/).

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DOI

https://doi.org/10.1164/rccm.202105-1137LE

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https://discovery.dundee.ac.uk/en/publications/9287bad9-89ba-4979-94d4-c763a4e544ca