Aim
This study aims to understand how the COVID-19 pandemic affected people admitted to hospital with pneumonia that was not caused by COVID-19.
Researchers will compare patients admitted before, during and after the pandemic to understand whether there were changes in the number of hospital admissions, the care patients received, the severity of illness, and patient outcomes.
The study will also explore whether some patients developed COVID-19 during their hospital stay.
Background
Pneumonia is a serious lung infection and one of the most common reasons for emergency hospital admission in the UK. It particularly affects older adults and people with existing health conditions and can sometimes be life-threatening.
During the COVID-19 pandemic, measures such as social distancing, face coverings and reduced social contact were introduced to reduce the spread of coronavirus. These measures also reduced the spread of many other infections that can cause pneumonia.
Previous research using PIONEER data found that hospital admissions for pneumonia fell by around 40% during the winter of 2020/21 compared with the winter before the pandemic. However, despite fewer people being admitted, patients with pneumonia were almost twice as likely to die.
Researchers could not identify an obvious explanation for this increase. Patients admitted during the pandemic appeared to have similar ages, existing health conditions and levels of illness severity to those admitted before the pandemic.
These findings raise important questions about whether the pandemic changed when people sought medical help, how quickly treatment was provided, or how healthcare services were delivered during a period of exceptional pressure on the NHS.
Research
This study will use information routinely recorded in electronic health records at Queen Elizabeth Hospital Birmingham.
Researchers will compare patients admitted with community-acquired pneumonia during three periods:
- Before the COVID-19 pandemic.
- During the pandemic.
- After the most severe phase of the pandemic.
The study will examine:
- Changes in the number of pneumonia admissions.
- Differences in the tests, treatments and specialist reviews patients received.
- How severely ill patients were when they arrived at hospital.
- Length of hospital stay and complications.
- Survival following admission.
- Whether patients developed COVID-19 during their hospital stay.
By comparing these periods, researchers hope to better understand the wider impact of the pandemic on people admitted to hospital with serious respiratory infections that were not caused by COVID-19.
Patient and Public Involvement
Patients and members of the public have been involved in this programme of research from an early stage.
People with experience of pneumonia, alongside carers and patient groups, have helped researchers identify the questions and outcomes that matter most to patients and their families.
Their feedback influenced the design of this study, including the decision to investigate whether some patients may have developed COVID-19 while in hospital.
Patients and public contributors will continue to work with the research team throughout the project, helping to guide the research and share the findings with patients, healthcare professionals and the wider public.
Approval
This project was unanimously supported by the PIONEER Data Trust Committee.
Project Lead
Dr Frances Grudzinska, Clinical Research Fellow, University of Birmingham
