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Clinical characteristics of COVID-19 infection in chronic obstructive pulmonary disease: a multicenter, retrospective, observational study.
Wu, Fan; Zhou, Yumin; Wang, Zhongfang; Xie, Min; Shi, Zhe; Tang, Zhiqiang; Li, Xiaohe; Li, Xiaochen; Lei, Chunliang; Li, Yimin; Ni, Zhengyi; Hu, Yu; Liu, Xiaoqing; Yin, Wenguang; Cheng, Linling; Ye, Feng; Peng, Jieqi; Huang, Lingmei; Tian, Jia; Zhang, Lingjuan; Mo, Xiaoneng; Zhang, Ying; Hu, Ke; Jiang, Yongliang; Guan, Weijie; Xiang, Jie; Liu, Yingxia; Peng, Yixiang; Wei, Li; Hu, Yahua; Peng, Peng; Wang, Jianming; Liu, Jiyang; Huang, Wei; Chen, Ruchong; Zhao, Jianping; Li, Shiyue; Zhang, Nuofu; Zhao, Jincun; Zhong, Nanshan; Ran, Pixin.
  • Wu F; State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
  • Zhou Y; State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
  • Wang Z; State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
  • Xie M; Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Shi Z; Huizhou First Hospital, Huizhou, China.
  • Tang Z; The Second People's Hospital of Changde City, Changde, China.
  • Li X; Shenzhen Third People's Hospital, Shenzhen, China.
  • Li X; Renmin Hospital of Wuhan University, Wuhan, China.
  • Lei C; Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
  • Li Y; State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
  • Ni Z; Wuhan Jinyintan Hospital, Wuhan, China.
  • Hu Y; Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Liu X; State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
  • Yin W; State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
  • Cheng L; State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
  • Ye F; State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
  • Peng J; State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
  • Huang L; The First people's Hospital of Yueyang, Yueyang, China.
  • Tian J; The Second People's Hospital of Hunan Province, Changsha, China.
  • Zhang L; Huizhou First Hospital, Huizhou, China.
  • Mo X; Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
  • Zhang Y; Shenzhen Third People's Hospital, Shenzhen, China.
  • Hu K; Renmin Hospital of Wuhan University, Wuhan, China.
  • Jiang Y; Department of Respiratory and Critical Care Medicine, Hunan Provincial People's Hospital, Changsha, China.
  • Guan W; State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
  • Xiang J; Wuhan Jinyintan Hospital, Wuhan, China.
  • Liu Y; Shenzhen Third People's Hospital, Shenzhen, China.
  • Peng Y; The Central Hospital of Wuhan, Wuhan, China.
  • Wei L; Wuhan No. 1 Hospital, Wuhan Hospital of Traditional Chinese and Western Medicine, Wuhan, China.
  • Hu Y; Huangshi Central Hospital of Edong Healthcare Group, Affiliated Hospital of Hubei Polytechnic University, Huangshi, China.
  • Peng P; Wuhan Pulmonary Hospital, Wuhan, China.
  • Wang J; Tianyou Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China.
  • Liu J; The First Hospital of Changsha, Changsha, China.
  • Huang W; Jiangling County People's Hospital, Jingzhou, China.
  • Chen R; State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
  • Zhao J; Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Li S; State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
  • Zhang N; State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
  • Zhao J; State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
  • Zhong N; State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
  • Ran P; State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
J Thorac Dis ; 12(5): 1811-1823, 2020 May.
Article in English | MEDLINE | ID: covidwho-596684
ABSTRACT

BACKGROUND:

Coronavirus disease 2019 (COVID-19) has been a global pandemic disease, with more than 4 million cases and nearly 300,000 deaths. Little is known about COVID-19 in patients with chronic obstructive pulmonary disease (COPD). We aimed to evaluate the influence of preexisting COPD on the progress and outcomes of COVID-19.

METHODS:

This was a multicenter, retrospective, observational study. We enrolled 1,048 patients aged 40 years and above, including 50 patients with COPD and 998 patients without COPD, and with COVID-19 confirmed via high-throughput sequencing or real-time reverse transcription-polymerase chain reaction, between December 11, 2019 and February 20, 2020. We collected data of demographics, pathologic test results, radiologic imaging, and treatments. The primary outcomes were composite endpoints determined by admission to an intensive care unit, the use of mechanical ventilation, or death.

RESULTS:

Compared with patients who had COVID-19 but not COPD, those with COPD had higher rates of fatigue (56.0% vs. 40.2%), dyspnea (66.0% vs. 26.3%), diarrhea (16.0% vs. 3.6%), and unconsciousness (8.0% vs. 1.7%) and a significantly higher proportion of increased activated partial thromboplastin time (23.5% vs. 5.2%) and D-dimer (65.9% vs. 29.3%), as well as ground-glass opacities (77.6% vs. 60.3%), local patchy shadowing (61.2% vs. 41.4%), and interstitial abnormalities (51.0% vs. 19.8%) on chest computed tomography. Patients with COPD were more likely to develop bacterial or fungal coinfection (20.0% vs. 5.9%), acute respiratory distress syndrome (ARDS) (20.0% vs. 7.3%), septic shock (14.0% vs. 2.3%), or acute renal failure (12.0% vs. 1.3%). Patients with COPD and COVID-19 had a higher risk of reaching the composite endpoints [hazard ratio (HR) 2.17, 95% confidence interval (CI) 1.40-3.38; P=0.001] or death (HR 2.28, 95% CI 1.15-4.51; P=0.019), after adjustment.

CONCLUSIONS:

In this study, patients with COPD who developed COVID-19 showed a higher risk of admission to the intensive care unit, mechanical ventilation, or death.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study Language: English Journal: J Thorac Dis Year: 2020 Document Type: Article Affiliation country: Jtd-20-1914

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study Language: English Journal: J Thorac Dis Year: 2020 Document Type: Article Affiliation country: Jtd-20-1914