Real-World COPD Management Over 3 Years at the Community Health Service Center of Shanghai During the COVID-19 Pandemic in China

Figures & data

Figure 1 Flow chart of COPDMIC operations.

Table 1 Baseline Demographics and Disease Characteristics of the Overall Population

Overall Population = 468		Baseline Data
Age (years), mean (SD)		75.3 ± 8.8
Male, No. (%)		306 (65.4)
Lung function	FEV1(L), mean (SD)	1.62 ± 0.88
	FEV1,% predicted
	GOLD 1, No. (%)	31 (6.6)
	GOLD 2, No. (%)	236 (50.4)
	GOLD 3, No. (%)	170 (36.3)
	GOLD 4, No. (%)	31 (6.6)
	FVC(L), mean (SD)	2.18 ± 0.99
	FEV1/FVC, %(SD)	51.6 ± 11.8
ABCD assessment	A, No. (%)	62 (13.2)
	B, No. (%)	224 (47.9)
	C, No. (%)	3 (0.6)
	D, No. (%)	179 (38.2)
Smoking status, No. (%)		190 (40.6)

Notes: GOLD1: FEV1 >80% predicted, GOLD 2:50% ≤ FEV1 <80% predicted.GOLD3: 30%≤ FEV1 <50% predicted, GOLD4:FEV <30% predicted. All values refer to post-bronchodilator.

Table 2 Variability in CAT, mMRC, Emergency and Inpatient Visits in COPD Patients, 2018–2020

N = 468	Year	Average Value (95% Confidence Interval)	ANOVA			Welch
			Sum of Squares	F price	p value	Levene Statistic	p value
COPDMIC
CAT questionnaire*mean (SD)	2018	14.02 (13.34–14.71)	196.557	1.644	0.194	0.295	0.181
	2019	13.27 (12.60–1.95)
	2020	13.19 (12.45–13.94)
mMRC score, mean(SD)^c	2018	1.41 (1.33–1.48)	8.343	5.481	0.004	5.447	0.004
	2019	1.30 (1.22–1.38)
	2020	1.22 (1.14–1.30)
Emergencies, mean (SD) (times)	2018	1.28 (1.14–1.42)	15.554	0.783	0.458	0.568	0.568
	2019	1.79 (0.68–2.89)
	2020	1.31 (1.13–1.50)
Number of hospitalisation, mean (SD) (times)	2018	1.43 (1.33–1.53)	14.311	2.36	0.096	7.524	0.001
	2019	1.78 (1.35–2.20)
	2020	1.40 (1.27–1.52)
MICHC
Emergencies, means (SD) (times)*^b	2018	2.84 (2.32–3.36)	60.189	3.594	0.029	3.578	0.03
	2019	3.47 (2.83–4.10)
	2020	2.42 (1.97–2.87)
Number of hospitalisation per capita, mean (SD) (times)^a,b	2018	1.69 (1.46–1.92)	11.884	3.378	0.036	3.048	0.05
	2019	2.10 (1.80–2.41)
	2020	1.63 (1.33–1.93)

Notes: *Indicates uneven variance, subject to Welch test correction value. ^aIndicates the difference between 2018 and 2019, ^bIndicates the difference between 2019 and 2020, and ^cIndicates the difference between 2018 and 2020.

Figure 2 COPDMIC 2018–2020 overview of CAT, mMRC, emergency and hospitalisation of COPD patients.

Figure 3 MICHC2018–2020 overview of CAT, mMRC, emergency and hospitalisation of COPD patients.

Table 3 Comparison of Study Indicators in (GOLD1–2)

N = 201	Years	Average Value (95% Confidence Interval)	ANOVA			Welch
			Sum of Squares	F price	p value	Levene Statistic	p value
COPDMIC
Emergencies, mean (SD)	2018	1. 33 (1.07–1.58)	0.444	0.509	0.602	0.47	0.628
	2019	1.21 (1.09–1.33)
	2020	1.20 (0.99–1.41)
Hospital stay per capita, mean (SD)*^b	2018	1.57 (1.41–1.73)	3.764	3.788	0.024	5.424	0.006
	2019^a	1.46 (1.31–1.61)
	2020	1.27 (1.15–1.39)
CAT*	2018	13.30 (12.42–14.18)	176.287	1.456	0.234	3.689	0.026
	2019	14.14 (13.23–15.04)
	2020	13.04 (12.01–14.06)
mMRC^a,c	2018	1.26 (1.16–1.36)	7.74	5.207	0.006	3.491	0.031
	2019	1.45 (1.34–1.55)
	2020	1.22 (1.11–1.33)
MICHC
Emergencies, mean (SD)*^a,b	2018	3.36 (2.62–4.09)	45.353	3.628	0.029	3.116	0.048
	2019^b	2.30 (1.85–2.74)
	2020	2.39 (1.73–3.05)
Hospital stays per capita, mean (SD)*,^a,b	2018^b	2.16 (1.74–2.57)	15.584	5.599	0.004	6.354	0.008
	2019^a	1.61 (1.34–1.87)
	2020	1.33 (1.12–1.54)

Notes: *Indicates uneven variance, subject to Welch test correction value. ^aIndicates the difference between 2018 and 2019, ^bIndicates the difference between 2019 and 2020, and ^cIndicates the difference between 2018 and 2020.

Table 4 Comparison of Study Indicators in (GOLD 3–4)

N = 267	Years	Average Value (95% Confidence Interval)	ANOVA			Welch
			Sum of Squares	F price	p value	Levene Statistic	p value
COPDMIC
Emergencies, mean (SD)	2018	1.36 (1.08–1.63)	1.632	1.175	0.312	2.086	0.131
	2019	1.14 (1.01–1.26)
	2020	1.38 (1.11–1.64)
Hospital stay per capita, mean (SD)	2018	1.40 (1.27–1.54)	1.5	1.033	0.358	1.212	0.301
	2019	1.58 (1.35–1.81)
	2020	1.56 (1.32–1.79)
CAT	2018	13.87 (12.81–14.94)	43.944	0.372	0.689	0.375	0.687
	2019	13.23 (12.18–14.29)
	2020	13.40 (12.31–14.48)
mMRC	2018	1.35 (1.24–1.47)	2.511	1.598	0.203	1.604	0.202
	2019	1.35 (1.22–1.48)
	2020	1.21 (1.09–1.34)
MICHC
Emergencies, mean (SD)	2018	3.49 (2.49–4.49)	41.761	1.911	0.152	2.512	0.087
	2019	3.65 (2.45–4.85)
	2020	2.45 (1.82–3.08)
Hospital stays per capita, mean (SD)	2018	1.81 (1.39–2.23)	1.51	0.339	0.713	1.51	0.339
	2019	2.04 (1.58–2.51)
	2020	2.04 (1.40–2.68)

Table 5 Overview of Drug Treatment from 2018 to 2020

Years	Receive drug Treatment (N)	Proportion of the total Study Population (%)	Use of Branching Agent (N)	Proportion of Total Drug Treatment (%)	Consistent with the Guideline Recommendations (N)	Proportion of the Total (%)
2018	122	26.06	117	95.90	53	43.44
2019	153	32.69	140	91.50	78	50.08
2020	32	6.84	32	100	23	71.87

Table 6 Comparison of Study Indicators in the Bronchodilator Group

N = 204	Years	Average Value (95% Confidence Interval)	ANOVA			Welch
			Sum of Squares	F price	p value	Levene Statistic	p value
COPDMIC
Emergencies, mean (SD)	2018	1.19 (1.10–1.29)	0.648	0.775	0.463	0.47	0.628
	2019	1.25 (1.06–1.44)
	2020	1.38 (0.91–1.84)
Hospital stay per capita, mean (SD)	2018	1.44 (1.30–1.58)	8.107	4.054	0.003	5.424	0.006
	2019	1.77 (1.51–2.03)
	2020	1.26 (1.09–1.43)
CAT	2018	14.59 (13.55–15.63)	444.337	3.747	0.024	3.689	0.026
	2019	13.20 (12.18–14.22)
	2020	12.54 (11.41–13.67)
mMRC	2018	1.47 (1.35–1.59)	5.218	3.445	0.033	3.491	0.031
	2019	1.50 (1.38–1.62)
	2020	1.29 (1.17–1.41)
MICHC
Emergencies, mean (SD)	2018	2.86 (2.14–3.58)	36.648	3.142	0.046	4.2	0.018
	2019	3.24 (2.46–4.02)
	2020	2.08 (1.65–2.50)
Hospital stays per capita, mean (SD)	2018	1.83 (1.48–2.19)	12.514	3.257	0.042	3.3	0.042
	2019	2.41 (1.87–2.95)
	2020	1.59 (1.24–1.94)

Table 7 Comparison of Study Indicators in the Non-Bronchodilator Group

N = 264	Years	Average Value (95% Confidence Interval)	ANOVA			Welch
			Sum of Squares	F price	p value	Levene Statistic	p value
COPDMIC
Emergencies, mean (SD)	2018	1.40 (1.11–1.70)	27.96	0.743	0.478	0.666	0.516
	2019	2.26 (0.17–4.35)
	2020	1.28 (1.12–1.44)
Hospital stay per capita, mean (SD)	2018	1.42 (1.28–1.56)	7.269	0.755	0.471	0.577	0.563
	2019	1.78 (1.09–2.48)
	2020	1.28 (1.12–1.44)
CAT	2018	13.64 (12.72–14.55)	19.131	0.166	0.847	0.156	0.855
	2019	13.75 (12.86–14.63)
	2020	14.01 (13.03–14.99)
mMRC	2018	1.54 (1.45–1.64)	1.703	1.666	0.19	1.724	0.18
	2019	1.42 (1.33–1.52)
	2020	1.51 (1.41–1.61)
MICHC
Emergencies, mean (SD)	2018	2.82 (2.06–3.58)	28.414	1.318	0.27	1.13	0.327
	2019	3.65 (2.68–4.62)
	2020	2.80 (1.98–3.61)
Hospital stays per capita, mean (SD)	2018	1.55 (1.26–1.84)	3.617	1.131	0.325	1.119	0.332
	2019	1.89 (1.54–2.25)
	2020	1.67 (1.17–2.16)