Study of respiratory disorders at a tertiary care hospital in Sri Lanka during lockdown.

International Journal of Research and Scientific Innovation (IJRSI) | Volume IX, Issue III, March 2022 | ISSN 2321–2705

Effects Study of respiratory disorders at a tertiary care hospital in Sri Lanka during lockdown.

Mayurathan Pakkiyaretnam, Vaithehi Rajeevan Francis, George Rajeevan Francis
Faculty of Health-Care sciences, Eastern University Sri Lanka, Teaching Hospital Batticaloa, Sri Lanka

Abstract
COVID-19 is a rapidly spreading new viral infection causing an unprecedented global pandemic. Sudden lockdowns and curfews imposed throughout countries and continents have caused a significant impact on global health systems. As the scientific community focused its attention on the pandemic, the prevalence and patterns of other medical illness including respiratory illnesses went largely neglected. This study was designed to determine the pattern of respiratory disorders at Teaching Hospital Batticaloa, Sri Lanka during the lockdown period, specifically looking at the prevalence of age, gender, place of admission and pattern of respiratory disorders among admitted patients with respiratory conditions. It was a cross sectional descriptive study done retrospectively among all the patients with non-COVID related respiratory illnesses admitted to medical wards and intensive care units (ICU) of Teaching Hospital Batticaloa, Sri Lanka during a one month period of first lockdown (11.03.2020 to 10.04.2020) due to COVID-19. They were compared with the patients of respiratory illnesses admitted one month (11.02.2020 to 10.03.2020) prior to the lockdown. Our study revealed 215 admissions before the lockdown and 86 admissions during lockdown with respiratory diseases. Total number of admission before lockdown was 2340 and during the lockdown this number reduced to 1376. Age distribution demonstrated that the highest number of patients (about 25%) admitted with respiratory illnesses during both study periods was within the age of 61-70 years. Gender distribution confirmed that male admissions were higher before lockdown (58%) and female admissions were slightly higher during lockdown (51%). The study showed that inward admission was 212 and 78 before and during lockdown and ICU admission was 3 and 8 before and during lockdown respectively. Further analysis revealed ICU admissions had increased and ward admission has been reduced during lockdown. Most common respiratory disorders among admitted patients before and during lockdown were lower respiratory tract infections, exacerbation of chronic obstructive pulmonary disease (COPD) and exacerbation of asthma. Therefore these three diseases were analysed separately. It showed there was a significant reduction of these three cases during lock down. These findings were closely related to the available data from other countries. In conclusion, the number of admissions to the hospitals with respiratory disorders during COVID-19 lockdown was significantly reduced. Exacerbations of asthma and COPD and lower respiratory tract infections were the common disorders during lockdown even though there was less number of patients. More females within the age group of 61-70 years were admitted. Interestingly a higher number of admissions to the ICU were noted during lockdown. We assume that less exposure to allergens and triggering factors during lockdown and wearing face masks and practicing good healthy hygienic measures may contribute to the reduction in number. Moreover late presentation with more severe disease status may be contributing for higher ICU admissions. However, these assumptions and explanations need further studies to prove.

Keywords: COVID-19, Before Lockdown, During Lockdown, Respiratory Disorders, Pandemic

Introduction

COVID-19 is a rapidly spreading viral infection. It was first isolated in Wuhan, China in December 2019 from a patient with pneumonia. It is an RNA virus and is named as SARS CoV 2 (Severe Acute Respiratory Syndrome Corona Virus-2). Soon the disease spread almost all parts of the world and became a pandemic. The disease mainly spreads from an infected person via respiratory droplets while coughing, sneezing, speaking, singing or even breathings [1]. Around 80% of infected people are asymptomatic or may develop mild to moderate respiratory illness. Severe form of disease affects mainly older people with underlying chronic diseases such as diabetes mellitus, chronic lung diseases, chronic kidney diseases and malignancies. It is estimated that about 1-3% may die eventually due to critical illness [2].
In Sri Lanka, the first COVID-19 infection was confirmed on 11th of March 2020. Up to 31st December 2021, the disease affected about 293 million people and caused 5.45 million deaths globally including 586746 confirmed cases and 14962 deaths in Sri Lanka [3].
Due to the rapid spread of this pandemic disease, curfews and lockdowns were imposed almost all over the world even in Sri Lanka. Moreover, the public was instructed to follow healthy hygienic measures such as wearing face mask, social distancing of at least one meter and frequent hand washing. The first lockdown was imposed in Sri Lanka for one month from 11.03.2020 to 10.04.2020 since confirmation of the first case of COVID-19 [3].

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