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Publications

Journal Article Ahead of print

PubMed: 42435914 DOI: 10.1016/j.rmed.2026.109029

Have Pulmonary Function Testing Rates Recovered Post-COVID-19 Pandemic?: A Population-based Study.

Respir Med

Authors: Javier Silva-Valencia, Karen Tu, Krystle Amog, Rahim Moineddin, Debra A Butt, Jessica Gronsbell, Braden O'Neill, Anthony Train, Andrea S Gershon

Affiliations

  • Research and Innovation, North York General Hospital, Toronto, ON, Canada.
  • Research and Innovation, North York General Hospital, Toronto, ON, Canada; Department of Family and Community Medicine, Institute for Health Policy, Management and Evaluation, University of Toronto, ON, Canada.
  • Research and Innovation, North York General Hospital, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, ON, Canada.
  • Department of Family and Community Medicine, Dalla Lana School of Public Health, University of Toronto, ON, Canada.
  • Research and Innovation, North York General Hospital, Toronto, ON, Canada; Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, ON, Canada.
  • Research and Innovation, North York General Hospital, Toronto, ON, Canada; Departments of Statistical Sciences, Family and Community Medicine, Computer Science, University of Toronto, ON, Canada.
  • Research and Innovation, North York General Hospital, Toronto, ON, Canada; BC Psychosis Program, University of British Columbia Hospital, Vancouver Coastal Health, BC, Canada.
  • Research and Innovation, North York General Hospital, Toronto, ON, Canada; Department of Family Medicine, Queen's University, ON, Canada.
  • Research and Innovation, North York General Hospital, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, ON, Canada; Department of Medicine, Sunnybrook Health Sciences Centre, ON, Canada; Department of Medicine, University of Toronto, ON, Canada.

Abstract

BACKGROUND

Pulmonary Function Tests are critical in diagnosing and managing respiratory conditions such as chronic obstructive pulmonary disease and asthma. However, because they generate aerosols, they were restricted in laboratories and offices during the COVID-19 pandemic to prevent virus spread.

OBJECTIVE

To determine whether Pulmonary Function Test capacity had returned to pre-pandemic levels overall and across demographic groups in a large North American cohort.

METHODS

We conducted a population cohort study in individuals aged 7 and older from 2015 to 2023 in Ontario, Canada, using provincial health administrative data. Incidence rate ratios (IRR) were used to compare observed rates to rates that would have been expected if the pandemic had never occurred and to assess whether test utilization returned to pre-pandemic levels. Subgroup analyses were conducted across various demographic characteristics.

MAIN FINDINGS

There were 8,302,872 tests performed on 2,683,844 people during the study period. As of December 2023, testing rates were still 27% lower than they were prior to the pandemic (IRR 0.73, 95% CI 0.63 - 0.87). Recovery was lower in males (IRR 0.72, 95%CI 0.62-0.86), those aged 18-65 (IRR 0.68, 95%CI 0.59-0.82), urban residents (IRR 0.72, 95%CI 0.62-0.86), and individuals of lower socioeconomic status (IRR 0.68, 95%CI 0.59-0.81).

CONCLUSION

More than three years after the pandemic onset, pulmonary function test rates in Ontario still have not recovered to pre-pandemic levels, with certain groups more affected than others. These findings suggest persistent reductions in PFT utilization and disparities in care for people with respiratory conditions.

MeSH

Research Design, Incidence, Aged, Covid-19, Pandemics, Demography