Respiratory Interventions, Hospital Utilization, and Clinical Outcomes of Persons with COPD and COVID-19

Abstract

Ahmad A Elshafei,1,2 Stephani A Flores,2 Ramandeep Kaur,3 Ellen A Becker3 1Department of Quality Operations & Population Health, Advocate Health, Green Bay, WI, USA; 2Department of Respiratory Care, Rush University Medical Center Chicago, IL, USA; 3Department of Cardiopulmonary Sciences, Rush University, Chicago, IL, USACorrespondence: Ahmad A Elshafei, Department of Quality Operations & Population Health, Advocate Health, Green Bay, WI, USA, Email [email protected]: Coronavirus disease 2019 (COVID-19) impacted outcomes of persons with chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD). This study investigated the differences in respiratory interventions, hospital utilization, smoking status, and 30-day readmission in those with COPD and COVID-19 based on hospital survival status.Methods: A retrospective cross-sectional study was conducted from February 2020 to October 2020 and included persons with COPD and COVID-19 infection. We examined respiratory interventions, hospital utilization and outcomes, and 30-day hospital readmission. Chi-square test analysis was used to assess categorical variables, and t-test or Mann–Whitney was used to analyze continuous data based on normality.Results: Ninety persons were included in the study, 78 (87%) were survivors. The most common comorbidity was hypertension 71 (78.9%) (p = 0.003). Twenty-two (24%) persons were intubated, from whom 12 (15%) survived (p < 0.001). There were 25 (32.1%) and 12 (100%), (p < 0.001) persons who required an ICU admission from the survivor and non-survivor groups, respectively. Among the survivor group, fifteen (19%) persons required 30-day hospital readmission.Conclusion: Persons with COPD and COVID-19 had a lower mortality rate (13%) compared to other studies in the early pandemic phase. Non-survivors had increased ICU utilization, endotracheal intubation, and more frequent application of volume control mode. Discharging survivors to long-term acute care facilities may reduce 30-day hospital readmissions.Keywords: chronic obstructive pulmonary disease, COVID-19, COPD, respiratory interventions, hospital utilization, hospital readmission, comorbidities

Keywords

• chronic obstructive pulmonary disease covid-19 copd respiratory interventions hospital utilization hospital readmission comorbidities