Reduction in Hospitalizations for Respiratory Diseases during the First COVID-19 Wave in Greece

Respiration. 2021;100(7):588-593. doi: 10.1159/000515323. Epub 2021 Apr 7.


Introduction: During the first COVID-19 wave, a considerable decline in hospital admissions was observed worldwide.

Aim: This retrospective cohort study aimed to assess if there were any changes in the number of patients hospitalized for respiratory diseases in Greece during the first CO-VID-19 wave.

Methods: In the present study, we evaluated respiratory disease hospitalization rates across 9 tertiary hospitals in Greece during the study period (March-April 2020) and the corresponding period of the 2 previous years (2018-2019) that served as the control periods. Demographic data and discharge diagnosis were documented for every patient.

Results: Of the 1,307 patients who were hospitalized during the study period, 444 (35.5%) were males with a mean (±SD) age of 66.1 ± 16.6 years. There was a 47 and 46% reduction in all-cause respiratory morbidity compared to the corresponding periods of 2018 and 2019, respectively. The mean incidence rate for respiratory diseases during the study period was 21.4 admissions per day, and this rate was significantly lower than the rate during the same period in 2018 (40.8 admissions per day; incidence rate ratio [IRR], 0.525; 95% confidence interval [CI], 0.491-0.562; p < 0.001) or the rate during 2019 (39.9 admissions per day; IRR, 0.537; 95% CI, 0.502-0.574; p < 0.001). The greatest reductions (%) in the number of daily admissions in 2020 were observed for sleep apnoea (87% vs. 2018 and 84% vs. 2019) followed by admissions for asthma (76% vs. 2018 and 79% vs. 2019) and chronic obstructive pulmonary disease (60% vs. 2018 and 51% vs. 2019), while the lowest reductions were detected in hospitalizations for pulmonary embolism (6% vs. 2018 and 23% vs. 2019) followed by tuberculosis (25% vs. both 2018 and 2019).

Discussion/conclusion: The significant reduction in respiratory admissions in 2020 raises the reasonable question of whether some patients may have avoided seeking medical attention during the COVID-19 pandemic and suggests an urgent need for transformation of healthcare systems during the pandemic to offer appropriate management of respiratory diseases other than COVID-19.

Keywords: COVID-19; First pandemic wave; Health services; Hospital admissions; Severe acute respiratory syndrome coronavirus-2.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Asthma / epidemiology
  • COVID-19 / epidemiology*
  • Cohort Studies
  • Female
  • Greece / epidemiology
  • Hospitalization / trends*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Pulmonary Embolism / epidemiology
  • Respiratory Tract Diseases / epidemiology*
  • Retrospective Studies
  • SARS-CoV-2
  • Sleep Apnea Syndromes / epidemiology
  • Tuberculosis, Pulmonary / epidemiology