Clinical Characteristics and Prognosis of COPD Patients Hospitalized with SARS-CoV-2.
Clinical Characteristics and Prognosis of COPD Patients Hospitalized with SARS-CoV-2.
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DOI：
10.2147/copd.s276692
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发表时间：
2020
影响因子：
2.8
通讯作者：
SEMI-COVID-19 Network
中科院分区：
文献类型：
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作者：
Gómez Antúnez M;Muiño Míguez A;Bendala Estrada AD;Maestro de la Calle G;Monge Monge D;Boixeda R;Ena J;Mella Pérez C;Anton Santos JM;Lumbreras Bermejo C;SEMI-COVID-19 Network
目的描述因SARS-CoV-2感染入院的慢性阻塞性肺疾病患者的特点及预后。半新冠状病毒登记是一个持续的回顾队列，包括自2020年3月大流行开始以来在西班牙住院的连续新冠肺炎患者。收集有关人口统计学、临床特征、合并症、实验室检查、放射学、治疗和进展的数据。选择COPD患者并与非COPD患者进行比较。分析与预后不良相关的因素。截至2020年5月21日，在Semi-COVID登记的10420名患者中，746人(7.16%)被诊断为COPD。患有COPD的患者比没有COPD的患者年龄更大(77岁比68岁)，而且更多是男性。他们有更多的并发症(高血压、高脂血症、糖尿病、房颤、心力衰竭、缺血性心脏病、外周血管疾病、肾衰竭)和更高的Charlson共病指数(2vs1，p<；0.001)。慢性阻塞性肺病患者的死亡率为38.3%，而非慢性阻塞性肺病患者的死亡率为19.2%(p<；0.001)。男性、高血压、心力衰竭、中、重度慢性肾脏疾病病史、脑血管疾病后遗症、退行性神经疾病、痴呆症、功能依赖和较高的查尔森共病指数与慢性阻塞性肺疾病患者因新冠肺炎而导致的死亡率增加相关。接受羟氯喹和大环内酯类药物治疗的慢性阻塞性肺疾病患者存活率较高(87.1%vs74.9%，p<；0.001)和57.9%vs50%(p<；0.037)。俯卧位或无创机械通气、高流量鼻插管或有创机械通气均与较好的预后相关。入院时感染SARS-CoV-2的COPD患者与非COPD患者相比，病情更重，预后更差。
To describe the characteristics and prognosis of patients with COPD admitted to the hospital due to SARS-CoV-2 infection. 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. 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. COPD patients admitted to the hospital with SARS-CoV-2 infection have more severe disease and a worse prognosis than non-COPD patients.