{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T07:12:42Z","timestamp":1777101162483,"version":"3.51.4"},"reference-count":46,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T00:00:00Z","timestamp":1748476800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005847","name":"Health and Medical Research Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005847","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Evidence Based Medicine"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>This study aimed to investigate COVID\u201019's indirect influence on chronic respiratory disease (CRD) patients for two years since the COVID\u201019 pandemic began.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using population\u2010based data in Hong Kong, we included CRD patients diagnosed from January 2011 to December 2021. Interrupted Time Series Analysis were applied to assess mortality, complications, and healthcare utilization rates during the \u201cpre\u2010COVID\u201019 pandemic\u201d (January 2012\u2013January 2020), \u201cinitial COVID\u201019 pandemic\u201d (February 2020\u2013February 2021), and \u201cpost\u2010initial COVID\u201019 pandemic\u201d (March 2021\u2013December 2021) periods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 587,049 patients with CRD, all\u2010cause mortality had an increasing trend during the post\u2010initial COVID\u201019 pandemic period (incidence rate ratio (95% CI): 1.019 (1.005, 1.034); <jats:italic>p<\/jats:italic> = 0.007), compared with pre\u2010COVID\u201019 pandemic period. Nonrespiratory mortality had an increasing trend in the initial COVID\u201019 pandemic period (1.020 (1.006, 1.033); <jats:italic>p<\/jats:italic> = 0.004) and was higher than the pre\u2010pandemic level in the post\u2010initial COVID\u201019 pandemic. We observed abrupt declines in the incidence rates of asthma exacerbation, acute exacerbation of chronic obstructive pulmonary disease, pneumonia, and acute respiratory failure in the first month of initial COVID\u201019 pandemic period, remaining below pre\u2010COVID\u201019 pandemic levels throughout the initial pandemic period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The disruption of usual healthcare impacts mortality rates among patients with CRD without COVID\u201019, particularly nonrespiratory mortality. Contingency plans on continuing follow\u2010up and monitoring of CRD patients are needed, for example, teleconsultations, shared primary care, and tele\u2010reminders on red\u2010flag symptoms for patients with CRD, when healthcare services may be disrupted during public health crises.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jebm.70039","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T23:53:32Z","timestamp":1748562812000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Indirect Impact of COVID\u201019 Pandemic on Mortality, Complications, and Healthcare Utilization Among Patients With Chronic Respiratory Diseases in Hong Kong: An Interrupted Time Series Analysis"],"prefix":"10.1111","volume":"18","author":[{"given":"Qi","family":"Kang","sequence":"first","affiliation":[{"name":"Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty 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