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. 2020 Oct 12;9(10):3259.
doi: 10.3390/jcm9103259.

Characteristics and Prognosis of COVID-19 in Patients with COPD

Desirée Graziani  1 , Joan B Soriano  2   3   4 , Carlos Del Rio-Bermudez  5 , Diego Morena  1 , Teresa Díaz  5 , María Castillo  1 , Miguel Alonso  1 , Julio Ancochea  2   3   4 , Sara Lumbreras  6 , José Luis Izquierdo  1   7
Affiliations

Characteristics and Prognosis of COVID-19 in Patients with COPD

Desirée Graziani et al. J Clin Med. .

Abstract

Patients with Chronic Obstructive Pulmonary Disease (COPD) have a higher prevalence of coronary ischemia and other factors that put them at risk for COVID-19-related complications. We aimed to explore the impact of COVID-19 in a large population-based sample of patients with COPD in Castilla-La Mancha, Spain. We analyzed clinical data in electronic health records from 1 January to 10 May 2020 by using Natural Language Processing through the SAVANA Manager® clinical platform. Out of 31,633 COPD patients, 793 had a diagnosis of COVID-19. The proportion of patients with COVID-19 in the COPD population (2.51%; 95% CI 2.33-2.68) was significantly higher than in the general population aged >40 years (1.16%; 95% CI 1.14-1.18); p < 0.001. Compared with COPD-free individuals, COPD patients with COVID-19 showed significantly poorer disease prognosis, as evaluated by hospitalizations (31.1% vs. 39.8%: OR 1.57; 95% CI 1.14-1.18) and mortality (3.4% vs. 9.3%: OR 2.93; 95% CI 2.27-3.79). Patients with COPD and COVID-19 were significantly older (75 vs. 66 years), predominantly male (83% vs. 17%), smoked more frequently, and had more comorbidities than their non-COPD counterparts. Pneumonia was the most common diagnosis among COPD patients hospitalized due to COVID-19 (59%); 19% of patients showed pulmonary infiltrates suggestive of pneumonia and heart failure. Mortality in COPD patients with COVID-19 was associated with older age and prevalence of heart failure (p < 0.05). COPD patients with COVID-19 showed higher rates of hospitalization and mortality, mainly associated with pneumonia. This clinical profile is different from exacerbations caused by other respiratory viruses in the winter season.

Keywords: COPD; COVID-19; prevalence; prognosis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Patient Flowchart. Flowchart depicting the total number (%) of patients with available electronic health records (EHRs) during the study period (1 January 2019–10 May 2020), the number of patients with COPD seen during this period, the number of patients diagnosed with COVID-19, and of those, the number of deaths after diagnosis. All percent values are computed in relation to the level immediately above. * Patients aged > 40 years.
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