Post-lockdown impact of the COVID-19 pandemic on patients affected by chronic diseases in Europe

Alexis Astruc, Bruno Halioua, Jean Zetlaoui, Meryem Harrizi, Alexis Bombezin--Domino, Lise Radoszycki

Keywords: primary care, COVD-19, chronic diseases

Background:

Patients with Chronic Medical Conditions (CMC) require regular access to healthcare professionals and have to take long-term treatments. The COVID-19 pandemic may affect their clinical outcomes.

Research questions:

What is the impact of the COVID-19 epidemic on patients with CMC in Europe?

Method:

This observational cross-sectional study was conducted using an online questionnaire available on a social network of patients (Carenity) from June 3rd, 2020 to October 7th, 2020. It included adult patients from France, Germany, Italy, Spain and the United Kingdom, with any CMC.

Results:

2,861 patients were included, 75% woman (n=2 136), with a mean age of 54 years old, and most frequently affected by asthma (22%, n=619), type 2 diabetes (16%, n=467), chronic obstructive pulmonary disease (12%, n=332). 89% (n=2538) of them were taking a long-term treatment. 17% (n=433) modified their treatment intake, 30% (n=132) of whom without notifying their doctor. Consultations were strongly impacted: from the start of the epidemic, 30% (n=872) of patients had difficulty in finding an available doctor, and 28% (n=794) consulted their doctor less frequently since end of lockdown (45%, n=1287, during lockdown). 75% (n=2135) of patients had long-planned medical consultations or procedures canceled because of the epidemic. Of those, 63% (n=1343) could not reschedule all of them. 39% (n=1109) feel their health status have deteriorated because their disease management was modified during lockdown. 34% (n=973) of patients used tele-consultation: 80% (n=782) of them deemed it satisfactory and 59% (n=570) were willing to use it for their future CMC follow-up. Patients also reported lacking information, mainly regarding treatment-related risks, and precautions when returning to work. 46% (n=1316) were not satisfied with the information they received.

Conclusions:

COVID-related changes in CMC patients’ behavior and medical care may have health consequences. They should be closely monitored to make sure CMC patients are not the collateral victims of the epidemic.

Points for discussion:

Implications on treatment intake and difficulty in finding an available doctor / Long-planned medical consultations or procedures canceled because of the epidemic

Originality of this real-life patient study

Limitations regarding the lack of access to non-hospitalized patients or patients unable to complete an online questionnaire

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