Clinical Courses and Outcomes of Patients with Chronic Obstructive Pulmonary Disease During the COVID-19 Epidemic in Hubei, China

Int J Chron Obstruct Pulmon Dis. 2020 Sep 23:15:2237-2248. doi: 10.2147/COPD.S265004. eCollection 2020.

Abstract

Purpose: In this study, we investigated the acute exacerbation and outcomes of COPD patients during the outbreak of COVID-19 and evaluated the prevalence and mortality of COPD patients with confirmed COVID-19.

Methods: A prospectively recruited cohort of 489 COPD patients was retrospectively followed-up for their conditions during the COVID-19 pandemic from December 2019 to March 2020 in Hubei, China. In addition, the features of 821 discharged patients with confirmed COVID-19 were retrospectively analyzed.

Results: Of the 489 followed-up enrolled COPD patients, 2 cases were diagnosed as confirmed COVID-19, and 97 cases had exacerbations, 32 cases of which were hospitalized, and 14 cases died. Compared with the 6-month follow-up results collected 1 year ago, in 307 cases of this cohort, the rates of exacerbations and hospitalization of the 489 COPD patients during the last 4 months decreased, while the mortality rate increased significantly (2.86% vs 0.65%, p=0.023). Of the 821 patients with COVID-19, 37 cases (4.5%) had pre-existing COPD. Of 180 confirmed deaths, 19 cases (10.6%) were combined with COPD. Compared to COVID-19 deaths without COPD, COVID-19 deaths with COPD had higher rates of coronary artery disease and/or cerebrovascular diseases. Old age, low BMI and low parameters of lung function were risk factors of all-cause mortality for COVID-19 patients with pre-existing COPD.

Conclusion: Our findings imply that acute exacerbations and hospitalizations of COPD patients were infrequent during the COVID-19 pandemic. However, COVID-19 patients with pre-existing COPD had a higher risk of all-cause mortality.

Trial registration: ClinicalTrials.gov NCT03182309.

Keywords: COPD; COVID-19; SARS-CoV-2; chronic obstructive pulmonary disease; exacerbation; mortality; novel coronavirus; novel coronavirus pneumonia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19
  • COVID-19 Testing
  • China / epidemiology
  • Clinical Laboratory Techniques / methods
  • Comorbidity
  • Coronavirus Infections* / diagnosis
  • Coronavirus Infections* / epidemiology
  • Coronavirus Infections* / mortality
  • Coronavirus Infections* / therapy
  • Diagnosis, Differential
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Mortality
  • Outcome and Process Assessment, Health Care
  • Pandemics*
  • Pneumonia, Viral* / epidemiology
  • Pneumonia, Viral* / mortality
  • Pneumonia, Viral* / therapy
  • Pulmonary Disease, Chronic Obstructive* / diagnosis
  • Pulmonary Disease, Chronic Obstructive* / epidemiology
  • Pulmonary Disease, Chronic Obstructive* / physiopathology
  • Pulmonary Disease, Chronic Obstructive* / therapy
  • Risk Factors
  • Symptom Flare Up*

Associated data

  • ClinicalTrials.gov/NCT03182309

Grants and funding

This work was supported by the National Key Research and Development Program of China (project number: 2016YFC1304403), the Science and Technology Key Project on Novel Coronavirus Pneumonia, Hubei Province (project number: 2020FCA002).