COVID-19 related concerns of people with long-term respiratory conditions: a qualitative study

  1. Keir E. J. Philip
  2. Bradley Lonergan
  3. Andrew Cumella
  4. Joe Farrington-Douglas
  5. Michael Laffan
  6. Nicholas S. Hopkinson

Reviewed by

Read the full article

Listed in

Log in to save this article

Abstract

Background

The COVID-19 pandemic is having profound psychological impacts on populations globally, with increasing levels of stress, anxiety, and depression being reported, especially in people with pre-existing medical conditions who appear to be particularly vulnerable. There are limited data on the specific concerns people have about COVID-19 and what these are based on.

Methods

The aim of this study was to identify and explore the concerns of people with long-term respiratory conditions in the UK regarding the impact of the COVID-19 pandemic and how these concerns were affecting them. We conducted a thematic analysis of free text responses to the question “What are your main concerns about getting coronavirus?”, which was included in the British Lung Foundation/Asthma UK (BLF-AUK) partnership COVID-19 survey, conducted between the 1st and 8th of April 2020. This was during the 3rd week of the UK’s initial ‘social distancing measures’ which included advice to stay at home and only go outside for specific limited reasons.

Results

7039 responses were analysed, with respondents from a wide range of age groups (under 17 to over 80), gender, and all UK nations. Respondents reported having asthma (85%), COPD (9%), bronchiectasis (4%), interstitial lung disease (2%), or ‘other’ lung diseases (e.g. lung cancer) (1%). Four main themes were identified: (1) vulnerability to COVID-19; (2) anticipated experience of contracting COVID-19; (3) pervasive uncertainty; and (4) inadequate national response.

Conclusions

The COVID-19 pandemic is having profound psychological impacts. The concerns we identified largely reflect contextual factors, as well as their subjective experience of the current situation. Hence, key approaches to reducing these concerns require changes to the reality of their situation, and are likely to include (1) helping people optimise their health, limit risk of infection, and access necessities; (2) minimising the negative experience of disease where possible, (3) providing up-to-date, accurate and consistent information, (4) improving the government and healthcare response.

Article activity feed

  1. Version published to 10.1186/s12890-020-01363-9
  2. ScreenIT

    SciScore for 10.1101/2020.06.19.20128207: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Some limitations should be noted. Although the survey included a large number of respondents with diverse demographic characteristics, it is unlikely that the sample is representative of all people in the UK with long-term respiratory conditions. Of note, the high proportion of women, and people with asthma (Table 1), suggests these groups are overrepresented. Due to the use of AUK-BLF mailing lists and social media for dissemination the survey link, respondents may also be more engaged with their condition than the average person. Additionally, though our study does not compare concerns between genders, female gender has frequently been reported as being related to increased levels of reported anxiety and depression in relation to COVID-19(1, 2, 8, 9), though not in all studies (4). This is a point of note, given due to the higher representation of females in our sample. Furthermore, a degree of selection bias is likely to exist, as surveys were completed online, necessitating a degree of computer literacy. People without concerns are less likely to be represented in these data, as they were drawn from responses to the question “What are your main concerns about getting coronavirus?”, rather than a more neutral wording. This was because the purpose of the survey was to help AUK-BLF identify concerns among their beneficiaries to support internal decision making. Finally, more information on participants would have been useful, for example socio-economic status, previous healt...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.06.19.20128207v1 on medRxiv