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COVID-19 risk and lung conditions: new research supports existing guidance

You might have heard that researchers have been looking into the factors that put a person at greater risk of becoming seriously ill with coronavirus. In this blog, our medical director Nick explains what the research has shown and what it means for people living with lung conditions.

The COVID-19 pandemic has been an anxious time for people with lung conditions. Back in March around 2 million people in the UK were identified as ‘clinically extremely vulnerable’ to the virus. This meant that they were thought to be at a greater risk of developing severe complications if they became infected with SARS-CoV2, the novel coronavirus that causes COVID-19. They were advised to shield: avoiding face-to-face contact with other people as much as possible, with support provided by the government to allow them to do this. 

Decisions about who should be in these groups were based on what was known about the virus at that point and on which groups of people we knew were vulnerable to other viruses like flu.

The clinically extremely vulnerable group included people with severe COPD, severe asthma and other rarer lung conditions including cystic fibrosis and interstitial lung disease. Decisions about who should be in these groups were based on what was known about the virus at that point and on which groups of people were known to be vulnerable to other viruses like flu.

What’s changed since the start of the pandemic?

The British Medical Journal has published new research which looked at GP records from the first half of this year, seeing which groups of people were actually at greatest risk of developing COVID-19 severe enough to require hospitalisation.

The main take away from this research is that people with certain long-term conditions who were shielding in March and April should have been doing so and it was right that they were.

As well as pre-existing illnesses, the research defines the background factors that make a person at greater risk from COVID-19. These are increasing age, black and minority ethnicity, deprivation and obesity.

Does my lung condition put me at greater risk of becoming seriously ill with COVID-19?

Your own level of risk depends on different factors. This makes it difficult to give blanket advice about the level of risk from having a lung condition.

The new research shows that you are more vulnerable if you have COPD, suggesting people with severe COPD should remain in the clinically extremely vulnerable group. And people with pulmonary hypertension, pulmonary fibrosis, cystic fibrosis and bronchiectasis were also at higher risk of serious illness with COVID-19. Additionally, many people with COPD have another long-term health problem (such as heart disease or diabetes) which also increase an individual’s risk.

For people with asthma, the risk of serious illness with COVID-19 appears to be only very slightly increased. But the study also shows that people who need regular or frequent courses of oral steroids are more vulnerable. People with asthma who fall into this group were included in the original guidance to shield.

What should people with lung conditions do now?

For most people with lung conditions there isn’t any immediate change in what you should be doing to protect yourself. The most important thing is to keep doing everything you can to help keep your lung condition under control. Make sure you’re taking any routine or preventer medication regularly as prescribed, checking you are taking any inhalers correctly, stopping smoking and keeping active. You should also make sure you get your flu vaccination, as this can help keep you well and prevent a flare up of your lung condition. 

The most important thing is to keep doing everything you can to help keep your lung condition under control. 

It’s important everyone (not just those with lung conditions) follows the local guidance for the area they live or work in. And everyone needs to carry on washing their hands, wearing a mask and maintaining physical distance from other people: hands, face, space. 

What’s crucial is that people who need to take extra measures to reduce their risk of exposure to coronavirus are supported to do so. At present, even in areas that are very high risk, there’s no advice to shield again. This may change in the future if the chief medical officers and local public health teams think it’s needed.

If you need help with shopping or collecting medicine, you can register with the NHS Volunteer responders or your local COVID-19 Mutual Aid group. Asthma UK and the British Lung Foundation are calling for the government to provide practical and financial support for people in vulnerable groups so that everyone can make the right choices to protect themselves. 

Nick Hopkinson

Dr Nicholas Hopkinson

Dr Nicholas Hopkinson is the Medical Director of the British Lung Foundation and Reader in Respiratory Medicine at Imperial College, London.

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21 October 2020