Characteristics and outcomes of patients with copd and COVID-19 in the united states

ABSTRACT

Rationale. Chronic obstructive Pulmonary Disease (COPD) has been associated with severe coronavirus disease 2019 (COVID-19) in Chinese and European cohorts. To date, no studies have evaluated the outcomes of COVID-19 in a selected cohort of patients with COPD in the United States (USA). We hypothesize that patients with COPD infected with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV2) will have higher likelihood of 14-day hospitalization, mechanical ventilation use, and mortality compared to non-COPD SARS-CoV2 positive patients. Methods. We performed a retrospective analysis of electronic health records (EHR) from facilities across the 4 geographical regions of the USA (Optum Covid-19 Biweekly Data). We defined COVID-19 positive as having International Classification of Disease-10 (ICD-10) code of U07.1, or positive laboratory test results. COPD patients are defined by having at least 2-outpatient visits or 1- inpatient visit with any COPD diagnosis codes within a year prior to COVID-19 positive date. Results. We studied a cohort of 150,775 patients with COVID-19 between March and August 2020 in the United States. COPD was identified in 6,056 (4%) patients. The baseline characteristics of the cohort are presented in table 1. The percentage of patients with COPD and COVID-19 admitted to the hospital in 14-days for any cause was greater than that for non-COPD COVID-19 patients (28.7% vs 10.42%, p< 0.0001). The mean length of stay was longer for COPD with COVID-19 individuals than that for non-COPD COVID-19 patients (12.3 days vs 9.0 days, p<0.001). Amongst all hospitalized, the percentage of patients who required ICU was greater for COPD patients with COVID-19 than that for non-COPD patients (26.4% vs 16.11%, p<0.001). In addition, mechanical ventilation use was higher in COPD vs non-COPD COVID-19 patients (26.4% vs 16.11%, p<0.001) Moreover, the percentage of patients who died in 30 days was greater for COPD than that for non-COPD COVID-19 patients (13.6% vs 7.25%, p<0.0001). Discussion. Patients with COPD and COVID-19 have worse outcomes compared to non-COPD COVID-19 patients.