Effect of COVID-19 on Bronchiectasis Exacerbation Rates: A Retrospective U.S. Insurance Claims Study.

Area of Science:

• Pulmonary Medicine
• Epidemiology
• Health Services Research

Background:

• Bronchiectasis is a chronic lung disease characterized by irreversible bronchial dilation, inflammation, and scarring.
• Impaired mucociliary clearance in bronchiectasis increases susceptibility to respiratory infections and exacerbations.
• Previous research indicated a reduction in bronchiectasis exacerbations during the COVID-19 pandemic in a UK cohort.

Purpose of the Study:

• To investigate the impact of the COVID-19 pandemic on bronchiectasis exacerbation frequency in a U.S. commercially insured population.
• To test the hypothesis that U.S. patients with bronchiectasis experienced fewer exacerbations during the pandemic.

Main Methods:

• Retrospective observational cohort study utilizing deidentified health insurance claims data (Optum Clinformatics Data Mart).
• Inclusion criteria: U.S. patients aged 18+ with bronchiectasis; exclusion of other significant respiratory conditions.
• Comparison of bronchiectasis exacerbation rates in the year preceding the pandemic versus the first year of the pandemic.

Main Results:

• A statistically significant decrease in the median number of exacerbations per patient per year was observed (1 vs. 0; P < 0.01).
• The proportion of patients experiencing zero exacerbations increased substantially during the first year of the pandemic (57% vs. 24%; P < 0.01).
• Findings were consistent in a U.S. population-based study using ICD codes for bronchiectasis.

Conclusions:

• The rate of bronchiectasis exacerbations was significantly reduced during the first year of the COVID-19 pandemic compared to the preceding two years.
• This reduction suggests a potential public health benefit of pandemic-related measures on exacerbation frequency in bronchiectasis patients.
• Further research is warranted to understand the mechanisms behind this observed decrease in exacerbations.