Division of Pulmonology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, 100 Ilsan-ro, Ilsandong-gu, Goyang, 10444, Republic of Korea.
Graduate School, Yonsei University College of Medicine, Seoul, Republic of Korea.
Sci Rep. 2021 Feb 12;11(1):3735. doi: 10.1038/s41598-021-83226-9.
Underlying chronic respiratory disease may be associated with the severity of coronavirus disease 2019 (COVID-19). This study investigated the impact of chronic obstructive pulmonary disease (COPD) on the risk for respiratory failure and mortality in COVID-19 patients. A nationwide retrospective cohort study was conducted in 4610 patients (≥ 40 years old) infected with COVID-19 between January 20 and May 27, 2020, using data from the Ministry of Health and Welfare and Health Insurance Review and Assessment Service in Korea. The clinical course and various clinical features were compared between COPD and non-COPD patients, and the risks of respiratory failure and all-cause mortality in COPD patients were analyzed using a multivariate logistic regression model. Among 4610 COVID-19 patients, 4469 (96.9%) and 141 (3.1%) were categorized into the non-COPD and COPD groups, respectively. The COPD group had greater proportions of older (≥ 60 years old) (78.0% vs. 45.2%, P < 0.001) and male (52.5% vs. 36.6%, P < 0.001) patients than the non-COPD group. Relatively greater proportions of patients with COPD received intensive critical care (7.1% vs. 3.7%, P = 0.041) and mechanical ventilation (5.7% vs. 2.4%, P = 0.015). Multivariate analyses showed that COPD was not a risk factor for respiratory failure but was a significant independent risk factor for all-cause mortality (OR = 1.80, 95% CI 1.11-2.93) after adjustment for age, sex, and Charlson Comorbidity Index score. Among COVID-19 patients, relatively greater proportions of patients with COPD received mechanical ventilation and intensive critical care. COPD is an independent risk factor for all-cause mortality in COVID-19 patients in Korea.
基础慢性呼吸道疾病可能与 2019 年冠状病毒病（COVID-19）的严重程度有关。本研究调查了慢性阻塞性肺疾病（COPD）对 COVID-19 患者发生呼吸衰竭和死亡的风险的影响。这项全国性回顾性队列研究纳入了 2020 年 1 月 20 日至 5 月 27 日期间卫生部和健康保险审查和评估服务部数据中感染 COVID-19 的 4610 名（≥40 岁）患者，比较了 COPD 患者和非 COPD 患者的临床过程和各种临床特征，并使用多变量逻辑回归模型分析了 COPD 患者发生呼吸衰竭和全因死亡率的风险。在 4610 名 COVID-19 患者中，4469 名（96.9%）和 141 名（3.1%）患者分别归类为非 COPD 组和 COPD 组。与非 COPD 组相比，COPD 组的老年（≥60 岁）患者比例更大（78.0% vs. 45.2%，P<0.001），男性患者比例也更大（52.5% vs. 36.6%，P<0.001）。接受强化重症监护（7.1% vs. 3.7%，P=0.041）和机械通气（5.7% vs. 2.4%，P=0.015）的 COPD 患者比例相对更高。多变量分析显示，COPD 不是呼吸衰竭的危险因素，但在调整年龄、性别和 Charlson 合并症指数评分后，COPD 是 COVID-19 患者全因死亡的独立危险因素（OR=1.80，95%CI 1.11-2.93）。在 COVID-19 患者中，接受机械通气和强化重症监护的 COPD 患者比例相对更高。COPD 是韩国 COVID-19 患者全因死亡的独立危险因素。
