COVID-19 in COPD: A growing concern.
COVID-19 in COPD: A growing concern.
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DOI：
10.1016/j.eclinm.2020.100546
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发表时间：
2020-09
影响因子：
15.1
通讯作者：
Sin DD
中科院分区：
文献类型：
--
作者：
Sin DD
截至2020年8月24日，全球已有2300多万人感染了导致2019年冠状病毒病(新冠肺炎)大流行的严重急性呼吸综合征冠状病毒2(SARS-CoV-2)[1]。病死率在0.5%到1%之间，大多数人死于与弥漫性肺泡损伤、血管血栓形成或肺水肿相关的呼吸衰竭[2]。到目前为止，全世界已有813,000人死于这种疾病[1]。慢性阻塞性肺疾病是一种常见的呼吸道疾病，影响着45岁以上人群中约10%的人[3]，它是否是新冠肺炎的危险因素仍存在相当大的争论。最近对流行病学文献的回顾显示，COPD在COVID-194患者中的患病率很高(1.1±38%)。然而，这些以前的研究可能受到了几个重要的方法学限制，包括样本量小和确证偏差。这项由Attaway等人进行的研究。解决了其中的一些限制，并提供了重要的数据，填补了知识的关键空白[5]。使用庞大而强大的克利夫兰诊所新冠肺炎登记，调查人员提取了患者特征的数据，包括他们中心所有实验室确认的新冠肺炎病例的共病情况。在接受新冠肺炎检测的15,586名有症状的患者中，有1319人(9.2%)患有慢性阻塞性肺疾病。有趣的是，在调整协变量后，研究人员发现COPD患者和非COPD患者的SARS-CoV-2阳性率没有显著差异。然而，感染该病毒的COPD患者(与非COPD患者相比)的住院率(调整后的优势比为1.36)、ICU住院率(调整后的优势比为1.20)和有创机械通气(调整后的优势比为1.49)显著高于非COPD患者。这些数据与管礼明等人的数据非常一致，他们在1590名来自中国的575家医院的实验室确认住院患者中显示，慢性阻塞性肺疾病患者
As of August 24, 2020, over 23 million people around the world have been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for the coronavirus disease 2019 (COVID-19) pandemic [1]. The case-fatality rate is between 0.5% and 1% with most dying from respiratory failure related to diffuse alveolar damage, vascular thrombosis or pulmonary edema [2]. To date, 813,000 individuals worldwide have succumbed to the disease [1].There is considerable debate on whether (or not) chronic obstructive pulmonary disease (COPD), a common airway disease that affects~ 10% of individuals over 45 years of age [3], is a risk factor for COVID-19. A recent review of the epidemiological literature revealed wideranging prevalence (1.1 À38%) of COPD among patients with COVID-194. However, these previous studies may have suffered from several important methodological limitations including small sample sizes and ascertainment bias. The study by Attaway et al. addresses some of these limitations and provides important data that fill in critical gaps in knowledge [5]. Using a large and robust Cleveland Clinic COVID-19 registry, the investigators abstracted data on patient characteristics including co-morbidities on all laboratory confirmed cases of COVID-19 at their center. Of the 15,586 symptomatic patients, who were tested for COVID-19, 1319 (9.2%) had COPD. Interestingly, after adjustment for covariates, the investigators found no significant differences in the rate of SARS-CoV-2 positivity between COPD and non-COPD patients. However, significantly higher rates of hospitalization (adjusted odds ratio of 1.36), ICU admissions (adjusted odds ratio of 1.20) and invasive mechanical ventilation (adjusted odds ratio of 1.49) were observed in COPD patients infected with the virus (versus non-COPD patients). These data are remarkably consistent with those by Guan et al., who in 1590 laboratory confirmed hospitalised patients from 575 hospitals in China showed that COPD patients
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