Clinical outcomes in patients with COPD hospitalized with SARS-CoV-2 versus non- SARS-CoV-2 community-acquired pneumonia

Abstract

Background Patients with chronic obstructive pulmonary disease (COPD) have poor outcomes in the setting of community-acquired pneumonia (CAP) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The primary objective is to compare outcomes of SARS-CoV-2 CAP and non-SARS-CoV-2 CAP in patients with COPD. The secondary objective is to compare outcomes of SARS-CoV-2 CAP with and without COPD. Methods In this analysis of two observational studies, three cohorts were analyzed: (1) patients with COPD and SARS-CoV-2 CAP; (2) patients with COPD and non-SARS-CoV-2 CAP; and (3) patients with SARS-CoV-2 CAP without COPD. Outcomes included length of stay, ICU admission, cardiac events, and in-hospital mortality. Results Ninety-six patients with COPD and SARS-CoV-2 CAP were compared to 1129 patients with COPD and non-SARS-CoV-2 CAP. 536 patients without COPD and SARS-CoV-2 CAP were analyzed for the secondary objective. Patients with COPD and SARS-CoV-2 CAP had longer hospital stay (15 vs 5 days, p < 0.001), 4.98 higher odds of cardiac events (95% CI: 3.74–6.69), and 7.31 higher odds of death (95% CI: 5.36–10.12) in comparison to patients with COPD and non-SARS-CoV-2 CAP. In patients with SARS-CoV-2 CAP, presence of COPD was associated with 1.74 (95% CI: 1.39–2.19) higher odds of ICU admission and 1.47 (95% CI: 1.05–2.05) higher odds of death. Conclusion In patients with COPD and CAP, presence of SARS-CoV-2 as an etiologic agent is associated with more cardiovascular events, longer hospital stay, and seven-fold increase in mortality. In patients with SARS-CoV-2 CAP, presence of COPD is associated with 1.5-fold increase in mortality.

Impact of comorbidities on hospitalised Syrian patients with COVID-19: a retrospective study

“…Other previous studies illustrated that a history of multiple comorbidities was linked to an increased death rate among patients with COVID-19. 61 63 69 This current study revealed that hypertension, obesity, malignancy and COPD were related to a lower survival rate among patients with COVID-19. A study reported a lower probability of survival time among the hypertensive group compared with the non-hypertensive group.…”

“…The significant impact COPD has on COVID-19-infected patients has been observed in systematic reviews and retrospective studies. [57][58][59][60][61] A study from China suggested that COVID-19-infected patients with pre-existing COPD are more vulnerable to acute exacerbation of COPD and subsequent respiratory failure, which is the main culprit for unfavourable clinical outcomes. 62 COVID-19 uses the ACE2 as the cellular entry receptor.…”

Synergistic Detrimental Effects of Cigarette Smoke, Alcohol, and SARS-CoV-2 in COPD Bronchial Epithelial Cells

“…Patients hospitalized for COVID-19 between March and May 2020 with COPD had more severe disease and worse prognoses than non-COPD patients [ 20 ]. COPD increased mortality by 1.5-fold in patients with pneumonia, where SARS-CoV-2 was the etiological agent [ 56 ]. Furthermore, patients with COPD and COVID-19 pneumonia had more cardiovascular events, longer hospital stays, and a 7-fold increase in mortality compared to non-COVID-19 pneumonia [ 56 ].…”

“…COPD increased mortality by 1.5-fold in patients with pneumonia, where SARS-CoV-2 was the etiological agent [ 56 ]. Furthermore, patients with COPD and COVID-19 pneumonia had more cardiovascular events, longer hospital stays, and a 7-fold increase in mortality compared to non-COVID-19 pneumonia [ 56 ].…”

A COVID–19-járvány hatása a leggyakoribb légzőszervi megbetegedések lefolyására

“…Egy másik vizsgálat szerint a COPD-ben és SARS-CoV-2 okozta tüdőgyulladásban szenvedő betegek esetén jelentősen hosszabb a kórházi tartózkodás ideje (15 vs. 5 nap, p<0,001), és nagyobb a szívbetegségek előfordulásának (OR = 4,98, 95% CI: 3,74-6,69), valamint a halálozás bekövetkeztének (OR = 7,31, 95% CI: 5,36-10,12) valószínűsége, mint azon COPD-betegeknél, akik nem kapták el a SARS-CoV-2-fertőzést. Továbbá megállapítható, hogy SARS-CoV-2 okozta tüdőgyulladás esetén a COPD fennállása növeli az intenzív osztályos kezelés (OR = 1,74; 95% CI: 1,39-2,19) és a halálozás (OR = 1,47; 95% CI: 1,05-2,05) valószínűségét [16]. Egyre több bizonyíték van arra vonatkozóan is, hogy az asztma fenotípusai és a társbetegségek fontos tényezők a SARS-CoV-2-fertőzés kockázatának és a betegség súlyosságának értékelésében.…”