• Philip Keir E J KEJ http://orcid.org/0000-0001-9614-3580 National Heart and Lung Institute, Imperial College London, London, UK. k.philip@imperial.ac., Bradley Lonergan, Andrew Cumella, Joe Farrington-Douglas, Michael Laffan, and Nicholas S Hopkinson.
• National Heart and Lung Institute, Imperial College London, London, UK. k.philip@imperial.ac.uk.
• BMC Pulm Med. 2020 Dec 9; 20 (1): 319.

BackgroundThe COVID-19 pandemic is having profound psychological impacts on populations globally, with increasing levels of stress, anxiety, and depression being reported, especially in people with pre-existing medical conditions who appear to be particularly vulnerable. There are limited data on the specific concerns people have about COVID-19 and what these are based on.MethodsThe aim of this study was to identify and explore the concerns of people with long-term respiratory conditions in the UK regarding the impact of the COVID-19 pandemic and how these concerns were affecting them. We conducted a thematic analysis of free text responses to the question "What are your main concerns about getting coronavirus?", which was included in the British Lung Foundation/Asthma UK (BLF-AUK) partnership COVID-19 survey, conducted between the 1st and 8th of April 2020. This was during the 3rd week of the UK's initial 'social distancing measures' which included advice to stay at home and only go outside for specific limited reasons.Results7039 responses were analysed, with respondents from a wide range of age groups (under 17 to over 80), gender, and all UK nations. Respondents reported having asthma (85%), COPD (9%), bronchiectasis (4%), interstitial lung disease (2%), or 'other' lung diseases (e.g. lung cancer) (1%). Four main themes were identified: (1) vulnerability to COVID-19; (2) anticipated experience of contracting COVID-19; (3) pervasive uncertainty; and (4) inadequate national response.ConclusionsThe COVID-19 pandemic is having profound psychological impacts. The concerns we identified largely reflect contextual factors, as well as their subjective experience of the current situation. Hence, key approaches to reducing these concerns require changes to the reality of their situation, and are likely to include (1) helping people optimise their health, limit risk of infection, and access necessities; (2) minimising the negative experience of disease where possible, (3) providing up-to-date, accurate and consistent information, (4) improving the government and healthcare response.

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