Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Sep:26:100515.
doi: 10.1016/j.eclinm.2020.100515. Epub 2020 Aug 26.

SARS-CoV-2 infection in the COPD population is associated with increased healthcare utilization: An analysis of Cleveland clinic's COVID-19 registry

Amy A Attaway  1 , Joe Zein  1   2 , Umur S Hatipoğlu  1
Affiliations

SARS-CoV-2 infection in the COPD population is associated with increased healthcare utilization: An analysis of Cleveland clinic's COVID-19 registry

Amy A Attaway et al. EClinicalMedicine. 2020 Sep.

Abstract

Background: We sought to determine whether COPD conferred a higher risk for healthcare utilization in terms of hospitalization and clinical outcomes due to COVID-19.

Methods: A cohort study with covariate adjustment using multivariate logistic regression was conducted at the Cleveland Clinic Health System in Ohio and Florida. Symptomatic patients aged 35 years and older who were tested for SARS-CoV-2 between March 8 and May 13, 2020 were included.

Findings: 15,586 individuals tested for COVID-19 at the Cleveland Clinic between March 8, 2020 and May 13, 2020 met our inclusion criteria. 12.4% of COPD patients (164/1319) tested positive for COVID-19 compared to 16.6% (2363/14,267) of the non-COPD population. 48.2% (79/164) of COVID-19 positive COPD patients required hospitalization and 45.6% (36/79) required ICU admission. After adjustment for covariates, rates of COVID-19 infection were not significantly different than the non-COPD population (adj OR 0.97; CI: 0.89-1.05), but COPD patients had increased healthcare utilization as demonstrated by risk for hospitalization (adj OR 1.36; CI: 1.15-1.60), ICU admission (OR 1.20; CI: 1.02-1.40), and need for invasive mechanical ventilation (adj OR 1.49; CI: 1.28-1.73). Unadjusted risk for in-hospital mortality was higher in the COPD population (OR 1.51; CI: 1.14-1.96). After adjusting for covariates however, the risk for in-hospital mortality was not significantly different than the non-COPD population (adj OR 1.08: CI: 0.81-1.42).

Interpretation: Our analysis demonstrated that COPD patients with COVID-19 had a higher risk for healthcare utilization, although adjusted in-hospital mortality risk was not different than the non-COPD patients with COVID-19.

Keywords: COPD; COVID-19; SARS-CoV-2.

PubMed Disclaimer

Conflict of interest statement

We declare no conflict of interest.

Figures

Fig. 1
Fig. 1
flowchart of patients included in our analysis.
Fig. 2
Fig. 2
Association of COPD with results of COVID-19 testing, hospital admission, intensive care unit (ICU) admission, invasive and non-invasive ventilation, and in-hospital mortality. Adjusted analysis with multivariate logistic regression. Odds ratio for positive CV-19 test positivity represents the odds for the entire cohort. Odds ratio for hospitalization represents odds for the CV-19 positive cohort. Odds ratio for ICU admission, non-invasive and invasive mechanical ventilation, and in-hospital mortality represent the odds for the hospitalized cohort.
See this image and copyright information in PMC

References

    1. Zhang J.J., Dong X., Cao Y.Y., Yuan Y.D., Yang Y.B., Yan Y.Q. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. 2020;75:1730–1741. doi: 10.1111/all.14238. Epub 2020/02/23PubMed PMID: 32077115. - DOI - PubMed
    1. Qingxian C., Fengjuan C., Fang L., Xiaohui L., Tao W., Qikai W., et al. Obesity and COVID-19 severity in a designated hospital in Shenzhen, China. Preprint at SSRN 2020. https://doiorg/102139/ssrn3556658. - PubMed
    1. Garg S., Kim L., Whitaker M., O'Halloran A., Cummings C., Holstein R. Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019 - COVID-NET, 14 states, March 1-30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(15):458–464. doi: 10.15585/mmwr.mm6915e3. Epub 2020/04/17PubMed PMID: 32298251. - DOI - PMC - PubMed
    1. Alqahtani J.S., Oyelade T., Aldhahir A.M., Alghamdi S.M., Almehmadi M., Alqahtani A.S. Prevalence, severity and mortality associated with COPD and smoking in patients with COVID-19: a rapid systematic review and meta-analysis. PLoS ONE. 2020;15(5) doi: 10.1371/journal.pone.0233147. Epub 2020/05/12PubMed PMID: 32392262. - DOI - PMC - PubMed
    1. Lee N., Allen Chan K.C., Hui D.S., Ng E.K., Wu A., Chiu R.W. Effects of early corticosteroid treatment on plasma SARS-associated Coronavirus RNA concentrations in adult patients. J Clin Virol. 2004;31(4):304–309. doi: 10.1016/j.jcv.2004.07.006. Epub 2004/10/21PubMed PMID: 15494274PubMed Central PMCID: PMCPMC7108318. - DOI - PMC - PubMed