Division of Pulmonary and Allergy, Department of Internal Medicine, Konkuk University Hospital, School of Medicine.
Department of Internal Medicine, Hanyang University College of Medicine.
Tohoku J Exp Med. 2022 Mar;256(3):209-214. doi: 10.1620/tjem.256.209.
Insufficient data are available on comprehensive evaluation of demographics, symptoms or signs, laboratory findings, and disease course in patients with coronavirus disease 2019 (COVID-19) and chronic obstructive pulmonary disease (COPD). We aimed to evaluate whether COPD patients are more prone to severe COVID-19 compared with those without COPD. We also investigate the clinical characteristics and disease course of COVID-19 in patients with COPD versus those without COPD. Patients were selected from a Korean nationwide cohort of 5,628 patients with confirmed COVID-19 and who had completed treatment or quarantine by April 30, 2020; 3,673 patients aged 40 years or older were included in this study. COPD was diagnosed using patient reports of physician-diagnosed COPD. During the study period, all patients with COVID-19 in Korea were hospitalized following the national health policy. Of the study participants, 38 (1.0%) had COPD. Regarding initial symptoms, COPD patients with COVID-19 showed greater sputum production (50.0% vs. 29.8%, p < 0.01) and dyspnea (36.8% vs. 14.9%, p < 0.01) than those without COPD. In addition, patients with COPD were more likely to receive oxygen therapy or non-invasive ventilation (29.0% vs. 13.7%, p = 0.01) and had a higher mortality (21.1% vs. 6.4%, p < 0.01) than those without COPD. After adjusting for age, sex, body mass index, and comorbidities, COPD patients showed increased risk of severe COVID-19 compared with those without COPD. Our nationwide study showed that COVID-19 patients with COPD have higher symptomatic burden and more severe disease course than those without COPD.
关于 2019 年冠状病毒病（COVID-19）和慢性阻塞性肺疾病（COPD）患者的人口统计学、症状或体征、实验室发现和疾病过程的综合评估，可用数据有限。我们旨在评估 COPD 患者是否比无 COPD 患者更容易发生严重 COVID-19。我们还研究了 COPD 患者与无 COPD 患者 COVID-19 的临床特征和疾病过程。患者从韩国一个全国性的 5628 例确诊 COVID-19 患者队列中选择，这些患者在 2020 年 4 月 30 日前已完成治疗或隔离；本研究纳入了 3673 名年龄在 40 岁及以上的患者。COPD 是根据患者报告的医生诊断 COPD 来诊断的。在研究期间，韩国所有 COVID-19 患者均根据国家卫生政策住院。在研究参与者中，有 38 例（1.0%）患有 COPD。关于首发症状，COVID-19 合并 COPD 的患者痰量较多（50.0%比 29.8%，p < 0.01）和呼吸困难（36.8%比 14.9%，p < 0.01）的比例较高。此外，与无 COPD 的患者相比，COPD 患者更可能接受氧疗或无创通气（29.0%比 13.7%，p = 0.01），死亡率更高（21.1%比 6.4%，p < 0.01）。在调整年龄、性别、体重指数和合并症后，与无 COPD 的患者相比，COPD 患者发生严重 COVID-19 的风险增加。我们的全国性研究表明，COVID-19 合并 COPD 的患者症状负担更高，疾病过程更严重。
