Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam, 13620, Korea.
BMC Pulm Med. 2021 Jan 6;21(1):12. doi: 10.1186/s12890-020-01387-1.
The impact of underlying chronic respiratory diseases (CRDs) on the risk and mortality of patients with coronavirus disease 2019 (COVID-19) remains controversial. We aimed to investigate the effects of CRDs on the risk of COVID-19 and mortality among the population in South Korea.
The NHIS-COVID-19 database in South Korea was used for data extraction for this population-based cohort study. Chronic obstructive pulmonary disease (COPD), asthma, interstitial lung disease (ILD), lung cancer, lung disease due to external agents, obstructive sleep apnea (OSA), and tuberculosis of the lungs (TB) were considered CRDs. The primary endpoint was a diagnosis of COVID-19 between January 1st and June 4th, 2020; the secondary endpoint was hospital mortality of patients with COVID-19. Multivariable logistic regression modeling was used for statistical analysis.
The final analysis included 122,040 individuals, 7669 (6.3%) were confirmed as COVID-19 until 4 June 2020, and 251 patients with COVID-19 (3.2%) passed away during hospitalization. Among total 122,040 individuals, 36,365 individuals were diagnosed with CRD between 2015 and 2019: COPD (4488, 3.6%), asthma (33,858, 27.2%), ILD (421, 0.3%), lung cancer (769, 0.6%), lung disease due to external agents (437, 0.4%), OSA (550, 0.4%), and TB (608, 0.5%). Among the CRDs, patients either with ILD or OSA had 1.63-fold (odds ratio [OR] 1.63, 95% confidence interval [CI] 1.17-2.26; P = 0.004) and 1.65-fold higher (OR 1.65, 95% CI 1.23-2.16; P < 0.001) incidence of COVID-19. In addition, among patients with COVID-19, the individuals with COPD and lung disease due to external agents had 1.56-fold (OR 1.56, 95% CI 1.06-2.2; P = 0.024) and 3.54-fold (OR 3.54, 95% CI 1.70-7.38; P < 0.001) higher risk of hospital mortality.
Patients with OSA and ILD might have an increased risk of COVID-19. In addition, COPD and chronic lung disease due to external agents might be associated with a higher risk of mortality among patients with COVID-19. Our results suggest that prevention and management strategies should be carefully performed.
慢性呼吸系统疾病（CRD）对 2019 年冠状病毒病（COVID-19）患者的风险和死亡率的影响仍存在争议。我们旨在调查 CRD 对韩国人群 COVID-19 风险和死亡率的影响。
本研究为基于人群的队列研究，使用韩国国民健康保险服务-新冠肺炎数据库进行数据提取。慢性阻塞性肺疾病（COPD）、哮喘、间质性肺疾病（ILD）、肺癌、外因所致肺部疾病、阻塞性睡眠呼吸暂停（OSA）和肺结核（TB）被视为 CRD。主要终点是 2020 年 1 月 1 日至 6 月 4 日确诊 COVID-19；次要终点是 COVID-19 患者的住院死亡率。采用多变量逻辑回归模型进行统计学分析。
最终分析纳入 122040 人，截至 2020 年 6 月 4 日，7669 人（6.3%）确诊 COVID-19，251 名 COVID-19 患者（3.2%）住院期间死亡。在 122040 人中，36365 人在 2015 年至 2019 年间被诊断为 CRD：COPD（4488，3.6%）、哮喘（33858，27.2%）、ILD（421，0.3%）、肺癌（769，0.6%）、外因所致肺部疾病（437，0.4%）、OSA（550，0.4%）和 TB（608，0.5%）。在 CRD 中，ILD 或 OSA 患者 COVID-19 的发病率分别高出 1.63 倍（比值比[OR] 1.63，95%置信区间[CI] 1.17-2.26；P=0.004）和 1.65 倍（OR 1.65，95% CI 1.23-2.16；P<0.001）。此外，在 COVID-19 患者中，COPD 和外因所致肺部疾病患者的住院死亡率分别高出 1.56 倍（OR 1.56，95% CI 1.06-2.2；P=0.024）和 3.54 倍（OR 3.54，95% CI 1.70-7.38；P<0.001）。
OSA 和 ILD 患者可能有更高的 COVID-19 风险。此外，COPD 和外因所致肺部疾病可能与 COVID-19 患者的死亡率升高有关。我们的研究结果表明，应谨慎实施预防和管理策略。
