Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Rev Clin Esp (Barc). 2023 May;223(5):298-309. doi: 10.1016/j.rceng.2023.04.002. Epub 2023 Apr 5.
This work aimed to compare the characteristics, progress, and prognosis of patients with COPD hospitalized due to COVID-19 in Spain in the first wave with those of the second wave.
This is an observational study of patients hospitalized in Spain with a diagnosis of COPD included in the SEMI-COVID-19 registry. The medical history, symptoms, analytical and radiological results, treatment, and progress of patients with COPD hospitalized in the first wave (from March to June 2020) versus those hospitalized in the second wave (from July to December 2020) were compared. Factors associated with poor prognosis, defined as all-cause mortality and a composite endpoint that included mortality, high-flow oxygen therapy, mechanical ventilation, and ICU admission, were analyzed.
Of the 21,642 patients in the SEMI-COVID-19 Registry, 6.9% were diagnosed with COPD: 1128 (6.8%) in WAVE1 and 374 (7.7%) in WAVE2 (p = 0.04). WAVE2 patients presented less dry cough, fever and dyspnea, hypoxemia (43% vs 36%, p < 0.05), and radiological condensation (46% vs 31%, p < 0.05) than WAVE1 patients. Mortality was lower in WAVE2 (35% vs 28.6%, p = 0.01). In the total sample, mortality and the composite outcome of poor prognosis were lower among patients who received inhalation therapy.
Patients with COPD admitted to the hospital due to COVID-19 in the second wave had less respiratory failure and less radiological involvement as well as a better prognosis. These patients should receive bronchodilator treatment if there is no contraindication for it.
本研究旨在比较西班牙因 COVID-19 住院的 COPD 患者在第一波和第二波期间的特征、进展和预后。
这是一项对西班牙 SEMI-COVID-19 登记处中诊断为 COPD 的住院患者进行的观察性研究。比较了第一波（2020 年 3 月至 6 月）和第二波（2020 年 7 月至 12 月）住院的 COPD 患者的病史、症状、分析和影像学结果、治疗和进展。分析了与不良预后相关的因素，定义为全因死亡率和包括死亡率、高流量氧疗、机械通气和 ICU 入院在内的复合终点。
在 SEMI-COVID-19 登记处的 21642 名患者中，有 6.9%被诊断为 COPD：波 1 中有 1128 例（6.8%），波 2 中有 374 例（7.7%）（p=0.04）。波 2 患者的干咳、发热和呼吸困难、低氧血症（43%比 36%，p<0.05）和影像学冷凝（46%比 31%，p<0.05）较波 1 患者少。波 2 的死亡率较低（35%比 28.6%，p=0.01）。在总样本中，接受吸入治疗的患者死亡率和预后不良的复合结局较低。
因 COVID-19 住院的 COPD 患者在第二波期间呼吸衰竭和影像学受累较少，预后较好。如果没有禁忌证，这些患者应接受支气管扩张剂治疗。
