Impact of social isolation due to the COVID-19 pandemic on health status and activities of daily living in individuals with chronic obstructive pulmonary disease
DOI:
https://doi.org/10.1590/Keywords:
Chronic Obstructive Pulmonary Disease, COVID-19, Symptom AssessmentAbstract
During the COVID-19 pandemic, social isolation measures were implemented, which may have intensified physical inactivity among individuals with chronic obstructive
pulmonary disease (COPD). Such inactivity potentially affected their health and functional status and performance of activities of daily living (ADL). This study aimed to evaluate the health and functional status of individuals with COPD during the pandemic and to examine the association between health status, functional status, and ADL performance. This longitudinal study assessed health status using the COPD
Assessment Test (CAT) and functional status using the London Chest Activity of Daily Living (LCADL) scale during strict social isolation (visit 1) and after the relaxation of
restrictions (visit 2). Changes in ADL performance between visits were recorded using a questionnaire developed by the authors. A total of 30 individuals with COPD were included (mean age: 69±7 years). Overall, no statistically significant differences were observed between visits in health status (15 [8–22] versus 13 [7–20] points; p=0.58) or functional status (LCADL total score: 17 [15–21] versus 17 [15–21] points; p=0.85). However, 15 individuals (50%) showed worsening health status (11 [6–25] versus 19 [12–29] points, p=0.0001; delta: 5 [2–6] points). This worsening was not correlated
with functional status at visit 2 (LCADL personal care: p≥0.41) but was associated with a reduced frequency of performing household tasks on a daily basis (Fisher’s exact
test=9.09; p=0.006). Overall, individuals with COPD showed no changes in health and functional status. However, half of the participants experienced worsening health status, which was associated with a reduced frequency of performing household tasks.
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References
1. Global Initiative for Chronic Obstructive Lung Disease. Global
strategy for the diagnosis, management, and prevention of
chronic obstructive lung disease [Internet]. 2022 [cited 2026 Mar
4]. Available from: https://goldcopd.org/2023-gold-report-2/
2. Sociedade Brasileira de Pneumologia e Tisiologia. Consenso
Brasileiro sobre Doença Pulmonar Obstrutiva Crônica II – DPOC.
J Bras Pneumol [Internet]. 2004 [cited 2026 Mar 4];30(Suppl
5):S1-42. Available from: http://www.jornaldepneumologia.
com.br/details-supp/40
3. Gershon AS, Warner L, Cascagnette P, Victor JC, To T. Lifetime
risk of developing chronic obstructive pulmonary disease: a
longitudinal population study. Lancet. 2011;378(9795):991-6.
doi: 10.1016/S0140-6736(11)60990-2
4. Pitta F, Troosters T, Spruit MA, Probst VS, Decramer M, et al.
Characteristics of physical activities in daily life in chronic
obstructive pulmonary disease. Am J Respir Crit Care Med.
2005;171(9):972-7. doi: 10.1164/rccm.200407-855OC
5. Ramon MA, Ter Riet G, Carsin AE, Gimeno-Santos E, Agustí A, et
al. The dyspnoea-inactivity vicious circle in COPD: development
and external validation of a conceptual model. Eur Respir J.
2018;52(3):1800079. doi: 10.1183/13993003.00079-2018
6. Hale T, Angrist N, Goldszmidt R, Kira B, Petherick A, et al. A
global panel database of pandemic policies (Oxford COVID-19
Government Response Tracker). Nat Hum Behav. 2021;5(4):529-
38. doi: 10.1038/s41562-021-01079-8
7. Farias HSD. O avanço da covid-19 e o isolamento social como
estratégia para redução da vulnerabilidade. Rev Bras Geograf
Econ. 2020;9(17). doi: 10.4000/espacoeconomia.11357
8. Ahmed MZ, Ahmed O, Aibao Z, Hanbin S, Siyu L, et al. Epidemic
of covid-19 in China and associated Psychological Problems.
Asian J Psychiatr. 2020;51:102092. doi: 10.1016/j.ajp.2020.102092
9. Malta DC. A pandemia da covid-19 e as mudanças no estilo
de vida dos brasileiros adultos: um estudo transversal.
Epidemiol Serv Saúde. 2020;29(4):e2020407. doi: 10.1590/
S1679-49742020000400026
10. Li L, Li Q, Huang L. Air quality changes during the covid-19
lockdown over the Yangtze River delta region: an insight into
the impact of human activity pattern changes on air pollution
variation. Sci Total Environ. 2020;732:139282. doi: 10.1016/j.
scitotenv.2020.139282
11. Pitta F, Probst VS, Kovelis D, Segretti NO, Mt Leoni A, et al.
Validation of the Portuguese version of the London Chest
Activity of Daily Living Scale (LCADL) in chronic obstructive
pulmonary disease patients. Rev Port Pneumol. 2008;14(1):27-
47. doi: 10.1016/S0873-2159(15)30217-8
12. Silva GPF, Morano MTAP, Viana CMS. Portuguese-language
version of the COPD Assessment Test: validation for use
in Brazil. J Bras Pneumol. 2013;39(4):402-8. doi: 10.1590/
S1806-37132013000400002
13. Hernandes NA, Teixeira DC, Probst VS, Brunetto F, Ramos EMC,
et al. Profile of the level of physical activity in the daily lives of
patients with COPD in Brazil. J Bras Pneumol. 2009;35(10):949-
56. doi: 10.1590/s1806-37132009001000002
14. Chen P, Mao L, Nassis GP, Harmer P, Ainsworth BE, et al.
Wuhan coronavirus (2019-nCoV): the need to maintain regular
physical activity while taking precautions. J Sport Health Sci.
2020;9(2):103-4. doi: 10.1016/j.jshs.2020.02.001
15. Chu DK, Akl EA, Duda S, Solo K, Yaacoub S, et al. Physical
distancing, face masks, and eye protection to prevent person-toperson
transmission of SARS-CoV-2 and covid-19: a systematic
review and meta-analysis. J Vasc Surg. 2020;395(10242):1973-
87. doi: 10.1016/j.jvs.2020.07.040
16. Kahnert K, Lutter JI, Welte T, Alter P, Behr J, et al. Impact of
the covid-19 pandemic on the behaviour and health status
of patients with COPD: results from the German COPD cohort COSYCONET. ERJ Open Res. 2021;7(3):00242-2021.
doi: 10.1183/23120541.00242-2021
17. Scarlata S, Cardaci V, Santangelo C, Matarese M, Cesari M,et
al. Distancing measures in covid-19 pandemic: loneliness,
more than physical isolation, affects health status and
psycho-cognitive wellbeing in elderly patients with Chronic
Obstructive Pulmonary Disease. COPD. 2021;18(4):443-8. doi:
10.1080/15412555.2021.1941834
18. Fettes L, Bayly J, Bruin LM, Patel M, Ashford S, et al. Relationships
between prolonged physical and social isolation during the
covid-19 pandemic, reduced physical activity and disability in
activities of daily living among people with advanced respiratory
disease. Chron Respir Dis. 2021;8. doi: 10.1177/14799731211035822
19. Zhou Z, Zhou A, Zhao Y, Chen P. Evaluating the Clinical COPD
Questionnaire: a systematic review. Respirology. 2017;22(2):251-
62. doi: 10.1111/resp.12970
20. González J, Moncusí-Moix A, Benitez ID, Santisteve S, Monge
A, et al. Clinical consequences of covid-19 lockdown in patients
with COPD: results of a pre-post study in Spain. Chest.
2021;160(1):135-8. doi: 10.1016/j.chest.2020.12.057
21. Souza GF, Sarmento A, Moreira GL, Gazzotti MR, Jardim
JR, et al. The Glittre ADL-Test differentiates COPD patients
with and without Self-reported functional limitation. COPD.
2020;17(2):143-9. doi: 10.1080/15412555.2020.1716707
22. Ferreira CA, Cukier A. Evaluating COPD from the perspective
of the patient. J Bras Pneumol. 2006;32(2):vii-viii. doi: 10.1590/
s1806-37132006000200001
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Copyright (c) 2026 Thais Moçatto Tofoli, André Vinicius Santana, Andréa Daiane Fontana, Fabio Pitta, Nidia Aparecida Hernandes
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