Are Hospitalized Patients with Chronic Lung Disease and COVID-19 Infection at a Greater Risk of Dying? Single Cohort Experience

Abstract

Background: Given the devastating impact that COVID-19 can have on the lung, it is reasonable to fear for patients with underlying chronic lung conditions. Recent studies have shown that there is an excess risk of contracting the infection, as well as developing severe symptoms and worst outcomes for some of these conditions. We present a single center experience of the characteristics and outcomes of patients admitted due to with confirmed SARS-CoV-2 infection and chronic lung disease. Methods: Retrospective medical records review of patients with chronic lung conditions (COPD, asthma, interstitial lung disease, pulmonary hypertension, and lung cancer) and SARS-CoV-2 infection between January 1, 2020 and December 1, 2020 at Beth Israel Deaconess Medical Center, Boston, MA. Patients were identified from our institutional database. Demographics, baseline comorbidities, hospital say, ICU admission, and interventions performed were recorded. Results: 12.405 patients were diagnosed with SARS CoV-2 infection at BIDMC. From the total, 961 (7.8%) patients were admitted for further care with an age of 66 years (IQR 52-78), 464 (48.28%) males, and a BMI of 29.8 kg/m2 ). Regarding the comorbid conditions, 157 subjects (16.3%) had COPD, 157 (16.3%) asthma, 24 (2.50%) pulmonary hypertension, 14 (1.46%) ILD and 18 (1.87%) lung cancer. We found that patients with COPD (23.57% vs 14.68%, p=0.005) as well as lung cancer (38.89% vs 15.69%, p=0.016) died more often after hospital admission. Additionally, a logistic regression model for mortality showed an OR of 1.8 (95%CI 1.2-2.7, p=0.006) for COPD and an OR of 3.42 (95%CI 1.30-8.96, p=90.012) for lung cancer. Conclusion: Our review showed that patients hospitalized due to SARS CoV-2 infection, and a previous diagnosis of COPD or lung cancer, were more likely to die during the hospital stay.

Effect of Preexisting Asthma on the Risk of ICU Admission, Intubation, and Death from COVID-19: A Systematic Review and Meta-Analysis

“…COVID-19 status in all was confirmed by SARS-Cov-2 RT-PCR. Of the nineteen included studies, eight [ 15 , 16 , 18 , 24 , 27 , 29 , 30 , and 33 ] were from North America, five [ 17 , 22 , 26 , 28 , and 31 ] from Asia, five [ 19 – 21 , 23 , and 25 ] from Europe, and one [ 32 ] from South America. Eighteen [ and 15 – – 33 ] were cohort studies, while one [ 21 ] was cross-sectional.…”

“…Few studies reported in favor of poor prognosis of COVID-19 in asthmatic patients [ 18 , 22 , 26 , 28 , 31 ]. However, other scientific observations have reported conflicting results [ 15 – 17 , 19 – 21 , 23 – 25 , 27 , 29 , 30 , 32 , 33 ]. Our meta-analysis did not identify asthma as a significant risk factor in producing high severity and mortality from SARS-CoV-2.…”