Clinical Characteristics and Prognosis of COPD Patients Hospitalized with SARS-CoV-2

Abstract

María Gómez Antúnez,1 Antonio Muiño Míguez,1 Alejandro David Bendala Estrada,1 Guillermo Maestro de la Calle,2 Daniel Monge Monge,3 Ramón Boixeda,4 Javier Ena,5 Carmen Mella Pérez,6 Juan Miguel Anton Santos,7 Carlos Lumbreras Bermejo2 On behalf of the SEMI-COVID-19 Network1Internal Medicine Department, Gregorio Marañón University Hospital, Madrid, Spain; 2Internal Medicine Department, 12 de Octubre University Hospital, Madrid, Spain; 3Internal Medicine Department, Segovia Hospital Complex, Segovia, Spain; 4Internal Medicine Department, Mataró Hospital, Mataró, Barcelona, Spain; 5Internal Medicine Department, Marina Baixa Hospital, Villajoyosa, Alicante, Spain; 6Internal Medicine Department, Ferrol University Hospital Complex, Ferrol, A Coruña, Spain; 7Internal Medicine Department, Infanta Cristina University Hospital, Parla, Madrid, SpainCorrespondence: María Gómez AntúnezInternal Medicine Department, Gregorio Marañón University Hospital, Doctor Esquerdo 46, Madrid 28007, SpainTel [phone]Email [email protected]: To describe the characteristics and prognosis of patients with COPD admitted to the hospital due to SARS-CoV-2 infection.Methods: The SEMI-COVID registry is an ongoing retrospective cohort comprising consecutive COVID-19 patients hospitalized in Spain since the beginning of the pandemic in March 2020. Data on demographics, clinical characteristics, comorbidities, laboratory tests, radiology, treatment, and progress are collected. Patients with COPD were selected and compared to patients without COPD. Factors associated with a poor prognosis were analyzed.Results: Of the 10,420 patients included in the SEMI-COVID registry as of May 21, 2020, 746 (7.16%) had a diagnosis of COPD. Patients with COPD are older than those without COPD (77 years vs 68 years) and more frequently male. They have more comorbidities (hypertension, hyperlipidemia, diabetes mellitus, atrial fibrillation, heart failure, ischemic heart disease, peripheral vascular disease, kidney failure) and a higher Charlson Comorbidity Index (2 vs 1, p< 0.001). The mortality rate in COPD patients was 38.3% compared to 19.2% in patients without COPD (p< 0.001). Male sex, a history of hypertension, heart failure, moderate–severe chronic kidney disease, presence of cerebrovascular disease with sequelae, degenerative neurological disease, dementia, functional dependence, and a higher Charlson Comorbidity Index have been associated with increased mortality due to COVID-19 in COPD patients. Survival was higher among patients with COPD who were treated with hydroxychloroquine (87.1% vs 74.9%, p< 0.001) and with macrolides (57.9% vs 50%, p< 0.037). Neither prone positioning nor non-invasive mechanical ventilation, high-flow nasal cannula, or invasive mechanical ventilation were associated with a better prognosis.Conclusion: COPD patients admitted to the hospital with SARS-CoV-2 infection have more severe disease and a worse prognosis than non-COPD patients.Keywords: SARS-CoV-2, coronavirus, COVID-19, COPD

Keywords

• sars-cov-2
• coronavirus
• covid-19
• copd