Clinical Courses and Outcomes of Patients with Chronic Obstructive Pulmonary Disease During the COVID-19 Epidemic in Hubei, China.
Clinical Courses and Outcomes of Patients with Chronic Obstructive Pulmonary Disease During the COVID-19 Epidemic in Hubei, China.
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DOI：
10.2147/copd.s265004
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发表时间：
2020
影响因子：
2.8
通讯作者：
Hu K
中科院分区：
文献类型：
--
作者：
Hu W;Dong M;Xiong M;Zhao D;Zhao Y;Wang M;Wang T;Liu Z;Lu L;Hu K
在本研究中，我们调查了 COVID-19 爆发期间 COPD 患者的急性加重和结局，并评估了确诊为 COVID-19 的 COPD 患者的患病率和死亡率。对 2019 年 12 月至 2020 年 3 月中国湖北省 COVID-19 大流行期间前瞻性招募的 489 名慢性阻塞性肺病患者的病情进行了回顾性随访。此外，还对821例确诊的COVID-19出院患者的特征进行了回顾性分析。在489名随访入组的COPD患者中，2例确诊为COVID-19，97例病情加重，其中32例住院，14例死亡。与1年前收集的6个月随访结果相比，该队列的307例中，489例COPD患者近4个月的病情加重率和住院率均下降，而死亡率则显着上升（2.86% vs 0.65%，p=0.023）。在 821 名 COVID-19 患者中，37 例 (4.5%) 患有慢性阻塞性肺病 (COPD)。在 180 例确诊死亡病例中，19 例（10.6%）合并慢性阻塞性肺病。与不伴 COPD 的 COVID-19 死亡相比，伴 COPD 的 COVID-19 死亡的冠状动脉疾病和/或脑血管疾病的发生率更高。高龄、低 BMI 和低肺功能参数是患有慢性阻塞性肺病 (COPD) 的 COVID-19 患者全因死亡的危险因素。我们的研究结果表明，在 COVID-19 大流行期间，COPD 患者急性加重和住院治疗的情况并不常见。然而，患有慢性阻塞性肺病的 COVID-19 患者全因死亡的风险较高。
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. 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. 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. 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.