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. 2021 Apr 27;8(2):255-268.
doi: 10.15326/jcopdf.2020.0200.

Impact of Chronic Obstructive Pulmonary Disease and Emphysema on Outcomes of Hospitalized Patients with Coronavirus Disease 2019 Pneumonia

Robert M Marron  1 , Matthew Zheng  1 , Gustavo Fernandez Romero  1 , Huaqing Zhao  2 , Raj Patel  3 , Ian Leopold  3 , Ashanth Thomas  3 , Taylor Standiford  3 , Maruti Kumaran  3 , Nicole Patlakh  1 , Jeffrey Stewart  1 , Gerard J Criner  1 ; and the Temple University COVID-19 Research Group
Affiliations

Impact of Chronic Obstructive Pulmonary Disease and Emphysema on Outcomes of Hospitalized Patients with Coronavirus Disease 2019 Pneumonia

Robert M Marron et al. Chronic Obstr Pulm Dis. .

Abstract

Background: Comorbid disease is a risk factor for severe coronavirus disease 2019 (COVID-19) infection. However, initial rates of chronic obstructive pulmonary disease (COPD) in case series were low and severity of COVID-19 in COPD patients was variable.

Methods: We performed a retrospective study of patients admitted with COVID-19 and evaluated outcomes in those with and without COPD and/or emphysema. Patients were identified as having COPD if they had a diagnosis in the medical record and a history of airflow-obstruction on spirometry, or a history of tobacco use and prescribed long-acting bronchodilator(s). Computed tomography scans were evaluated by radiologists. Propensity matching was performed for age, body mass index (BMI), and serologic data correlated with severity of COVID-19 disease (D-dimer, C-reactive protein, ferritin, fibrinogen, absolute lymphocyte count, lymphocyte percentage, and lactate dehydrogenase).

Results: Of 577 patients admitted with COVID-19, 103 had a diagnosis of COPD and/or emphysema. The COPD/emphysema cohort was older (67 versus 58, p<0.0001) than the other cohort and had a lower BMI. Among unmatched cohorts those with COPD/emphysema had higher rates of intensive care unit (ICU) admission (35% versus 24.9%, p=0.036) and maximal respiratory support requirements, with more frequent invasive mechanical ventilation (21.4% versus 11.8%), but no significant difference in mortality. After propensity-matching there was no difference in ICU admission, maximal respiratory support requirements, or mortality. Univariate and multivariate regression analyses yielded similar results.

Discussion: Our propensity-matched retrospective cohort study suggests that patients hospitalized with COVID-19 who have COPD and/or emphysema may not have worse outcomes than those without these comorbid conditions.

Keywords: COVID-19; chronic obstructive pulmonary disease; comorbidities; copd; coronavirus 2019; emphysema; outcomes.

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Conflict of interest statement

None of the authors report any financial compensation, financial relationships, intellectual properties, or any other relationships that are relevant to this manuscript or that could have affected its composition.

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