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

Weihua Hu, Minglin Dong, Mengqing Xiong, Dong Zhao, Yang Zhao, Mengmei Wang, Tao Wang, Zhenlian Liu, Li Lu, Ke Hu, Weihua Hu, Minglin Dong, Mengqing Xiong, Dong Zhao, Yang Zhao, Mengmei Wang, Tao Wang, Zhenlian Liu, Li Lu, Ke Hu

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.

Conflict of interest statement

Dong M and Xiong M contributed equally with Hu W. All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were declared.

© 2020 Hu et al.

Figures

Figure 1
Figure 1
Flow chart of the follow-up design and process.

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