Clinical Outcomes of COVID-19 Infection among Patients with Chronic Obstructive Pulmonary Disease: Findings from the Philippine CORONA Study

BACKGROUND

The global pandemic caused by the coronavirus disease 2019 (COVID-19) resulted in many deaths from fulminant respiratory failure. Chronic obstructive pulmonary disease (COPD) is the leading cause of morbidity and mortality worldwide. There has been great concern regarding the impact of COPD on the COVID-19 illness.

METHODS

Data from the Philippine CORONA study were analyzed to determine the association of COPD and COVID-19 in terms of mortality, disease severity, respiratory failure, mechanical ventilation, and lengths of stay in the intensive care unit (ICU) and hospital.

RESULTS

A total of 10,881 patients were included in this study, and 156 (1.4%) patients had been diagnosed with COPD. A majority of COVID-19 patients with COPD had other existing comorbidities: hypertension, diabetes mellitus, chronic cardiac disease, and chronic kidney disease. COPD patients were 2.0× more likely to present with severe to critical COVID-19 disease. COVID-19 patients with COPD in our study have a 1.7× increased mortality, 1.6× increased respiratory failure, and 2.0× increased risk for ICU admission. Smokers with COVID-19 were 1.8× more likely to present with more severe disease and have a 1.9× increased mortality.

CONCLUSION

Our study supports the growing evidence that COPD among COVID-19 patients is a risk factor for higher mortality, more severe form of COVID-19, higher ICU admission, and higher respiratory failure needing ventilatory support.

Clinical Profile and Outcomes of COVID-19 Positive Patients with Chronic Obstructive Pulmonary Disease (COPD) in a Tertiary Government COVID-19 Referral Center

Introduction

It is anticipated that Chronic Obstructive Pulmonary Disease (COPD) has greater risk in acquiring COVID-19 infection and poorer outcome. However, current worldwide data are conflicting.

Objectives

This study primarily aims to compare the outcomes of COVID-19 patients with COPD and those without COPD in terms of length of hospital stay (LOS), recovery or mortality, treatment received, and predictors of mortality.

Methods

This is a retrospective cohort chart review of 1,017 admitted adult COVID-19 patients from July to December 2020. Age, gender, smoking status, current control and medications for COPD, COVID-19 severity, symptoms, treatment, and outcomes of the two study groups were compared.

Results

Prevalence rate of COPD was 3.8%. COVID-19 patients with COPD were older (median age of 69 vs 54, p<0.001), male (87% vs 50%, p<0.001), hypertensive (72% vs 48%, p=0.004), and with tuberculosis (31% vs 11%, p=0.002). COVID-19 patients with COPD more commonly needed oxygen therapy, High Flow Nasal Cannula, Mechanical Ventilation, Tocilizumab, Convalescent Plasma Therapy and Dexamethasone, and had longer LOS. Significant risk factors for mortality are malignancy, investigational therapies, smoking, and older age. There was no difference in survival rates between the two groups.

Conclusion

COPD increases the risk for severe COVID-19 and lengthens LOS.