Concern over COPD patients weight loss during pandemic

Evidence of COVID-19 related weight gain in the general population disguises the different impacts of the pandemic lockdowns on at-risk patient groups, Australian researchers say.

A Melbourne study has found the city’s prolonged lockdowns were associated with weight loss in a large group of patients with COPD.

The study comprised 3,691 patients with COPD presenting at Monash Health for their regular pulmonary function testing between January 2013 and March 2022.

Height and weight were assessed at each of the 14,809 presentations. Mean BMI in the group was 28 kg/m2 and mean age 70 years.

The study found highly significant changes in weight gain trajectory (p <0.001) when comparing the pre-COVID period (before April 2020) to the two years of COVID lockdowns in Melbourne (April 2020 – March 2022).

It found that prior to April 2020, the age and sex adjusted average monthly weight gain was 0.022 kg per month compared to weight loss of 0.032 kg per month after the introduction of lockdowns.

“The change in weight in these subjects could reflect healthier eating habits with loss of fat, or more concerningly may be arising from loss of muscle mass with decreased exercise or malnutrition.”

The study, published in the Internal Medicine Journal [link here], said weight loss was a concern given low BMI was a strong predictor of mortality in COPD patients with a higher rate of exacerbations and reduced exacerbation-free survival.

“Lack of regular exercise and access to in-person pulmonary rehabilitation programs during the lockdown period may have a role in weight loss by reducing muscle mass.

“Furthermore, nutrition is a crucial contributor to BMI that may have deteriorated during lockdown in COPD patients,” it said.

The investigators, including Head of Monash’s Inflammatory Respiratory Disease Research Group Dr Paul King, said patients in this cohort may benefit from screening for sarcopenia.

However there were no clearly accepted guidelines on how to do this in COPD subjects.

“In COPD subjects who have confirmed sarcopenia, therapeutic interventions targeting exercise training and nutrition should be considered, they said.

“Pulmonary rehabilitation specifically targets these areas and patients with sarcopenia should be referred for assessment.”

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