Chronic respiratory conditions

The COVID‑19 pandemic had substantial impacts on hospital activity generally. The range of social, economic, business and travel restrictions, including restrictions on, or suspension of, some hospital services, and associated measures in other health-care services to support physical distancing in Australia, resulted in an overall decrease in hospital activity between 2019–20 and 2020–21. As a result, the hospitalisation rates for asthma and COPD in these years were the lowest recorded in the last 10 years (AIHW 2022).

For more information on how the pandemic has affected the population’s health in the context of longer-term trends, see 'Changes in the health of Australians during the COVID‑19 period’ in Australia’s health 2022: data insights.

Emergency department presentations for asthma and COPD were also affected by the pandemic, decreasing from March (when the national lockdown started) to May 2020 (from 26 to 11 and 17 to 13 presentations per 100,000 population, respectively).

In June 2020, emergency department presentations increased again as restrictions began to ease across the country (to 19 presentations per 100,000 population for asthma and to 14 presentations per 100,000 population for COPD) (Figure 1).

During the COVID 19 pandemic (as at 31 October 2022), chronic respiratory conditions were certified as a pre-existing condition in 18% of the deaths with a chronic condition mentioned, the third highest of all chronic conditions (ABS 2022).

Age-standardised mortality rates due to COPD (as the underlying cause of death) decreased from 23 per 100,000 population in 2019 to 19 per 100,000 in 2020. By 2022 rates had increased to 22 per 100,000 population. Mortality rates due to asthma changed little over the same time period (Figure 2).

While the long-term impact of COVID‑19 on the respiratory system is still being assessed, evidence shows that COVID‑19 does not directly impact the risk of increasing asthma severity and vice versa (Lee et al. 2020; Lieberman-Cribbin et al. 2020; Mather et al. 2021). However, there is increasing evidence showing that COPD patients with COVID‑19 have greater risk of mortality, severity of infection and higher likelihood of requiring Intensive Care Unit (ICU) support than those without COPD (Cazzola et al. 2021; Clark et al. 2021; Wells 2021).

For more information, see ‘The impact of a new disease: COVID‑19 from 2020, 2021 and into 2022’ in Australia’s health 2022: data insights.