Department of Respiratory Diseases, Tongji Hospital, Key Lab of Pulmonary Diseases of Health Ministry, Key Site of National Clinical Research Center for Respiratory Disease, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (mainland).
Med Sci Monit. 2020 Sep 4;26:e927212. doi: 10.12659/MSM.927212.
BACKGROUND The rapid worldwide spread of the coronavirus disease 2019 (COVID-19) epidemic has placed patients with pre-existing conditions at risk of severe morbidity and mortality. The present study investigated the clinical characteristics and outcomes of patients with severe COVID-19 and chronic obstructive pulmonary disease (COPD). MATERIAL AND METHODS This study enrolled 336 consecutive patients with confirmed severe COVID-19, including 28 diagnosed with COPD, from January 20, 2020, to April 1, 2020. Demographic data, symptoms, laboratory values, comorbidities, and clinical results were measured and compared in survivors and non-survivors. RESULTS Patients with severe COVID-19 and COPD were older than those without COPD. The proportions of men, of patients admitted to the intensive care unit (ICU) and of those requiring invasive ventilation were significantly higher in patients with than without COPD. Leukocyte and neutrophil counts, as well as the concentrations of NT-proBNP, hemoglobin, D-dimer, hsCRP, ferritin, IL-2R, TNF-alpha and procalcitonin were higher, whereas lymphocyte and monocyte counts were lower, in patients with than without COPD. Of the 28 patients with COPD, 22 (78.6%) died, a rate significantly higher than in patients without COPD (36.0%). A comparison of surviving and non-surviving patients with severe COVID-19 and COPD showed that those who died had a longer history of COPD, more fatigue, and a higher ICU occupancy rate, but a shorter average hospital stay, than those who survived. CONCLUSIONS COPD increases the risks of death and negative outcomes in patients with severe COVID-19.
2019 年冠状病毒病（COVID-19）疫情在全球迅速蔓延，使患有基础疾病的患者面临严重发病和死亡的风险。本研究调查了患有严重 COVID-19 和慢性阻塞性肺疾病（COPD）的患者的临床特征和结局。
本研究纳入了 2020 年 1 月 20 日至 4 月 1 日期间确诊的 336 例连续严重 COVID-19 患者，其中 28 例诊断为 COPD。测量并比较了幸存者和非幸存者的人口统计学数据、症状、实验室值、合并症和临床结果。
患有严重 COVID-19 和 COPD 的患者比没有 COPD 的患者年龄更大。患有 COPD 的患者中男性、入住重症监护病房（ICU）和需要有创通气的患者比例明显高于没有 COPD 的患者。与没有 COPD 的患者相比，患有 COPD 的患者白细胞和中性粒细胞计数以及 NT-proBNP、血红蛋白、D-二聚体、hsCRP、铁蛋白、IL-2R、TNF-α和降钙素原浓度更高，而淋巴细胞和单核细胞计数更低。在 28 例 COPD 患者中，22 例（78.6%）死亡，死亡率明显高于无 COPD 的患者（36.0%）。与存活和非存活的严重 COVID-19 和 COPD 患者相比，死亡患者的 COPD 病史更长、更疲劳、入住 ICU 率更高，但平均住院时间更短。
COPD 增加了严重 COVID-19 患者死亡和不良结局的风险。
