Department of Chest Diseases, Istanbul Medeniyet University, Medical Faculty, Istanbul, Turkey.
Department of Chest Diseases, Yedikule Chest Disease and Chest Surgery Research and Training Hospital, Istanbul, Turkey.
Int J Chron Obstruct Pulmon Dis. 2024 Apr 4;19:851-858. doi: 10.2147/COPD.S440099. eCollection 2024.
Several studies have shown that the risk of mortality due to COVID-19 is high in patients with COPD. However, evidence on factors predicting mortality is limited.
Are there any useful markers to predict mortality in COVID-19 patients with COPD?.
A total of 689 patients were included in this study from the COPET study, a national multicenter observational study investigating COPD phenotypes consisting of patients who were followed up with a spirometry-confirmed COPD diagnosis. Patients were also retrospectively examined in terms of COVID-19 and their outcomes.
Among the study patients, 105 were diagnosed with PCR-positive COVID-19, and 19 of them died. Body mass index (p= 0.01) and ADO (age, dyspnoea, airflow obstruction) index (p= 0.01) were higher, whereas predicted FEV (p< 0.001) and eosinophil count (p= 0.003) were lower in patients who died of COVID-19. Each 0.755 unit increase in the ADO index increased the risk of death by 2.12 times, and each 0.007 unit increase in the eosinophil count decreased the risk of death by 1.007 times. The optimum cut-off ADO score of 3.5 was diagnostic with 94% sensitivity and 40% specificity in predicting mortality.
Our study suggested that the ADO index recorded in the stable period in patients with COPD makes a modest contribution to the prediction of mortality due to COVID-19. Further studies are needed to validate the use of the ADO index in estimating mortality in both COVID-19 and other viral respiratory infections in patients with COPD.
多项研究表明，COVID-19 患者的 COPD 死亡率较高。然而，预测死亡率的证据有限。
COPD 患者 COVID-19 死亡率的预测因素有哪些？
本研究纳入了来自 COPET 研究的 689 例患者，这是一项全国多中心观察性研究，研究 COPD 表型，包括通过肺量计确诊的 COPD 患者。还回顾性检查了 COVID-19 及其结局。
研究患者中，105 例经 PCR 确诊为 COVID-19 阳性，其中 19 例死亡。死亡患者的 BMI（p=0.01）和 ADO（年龄、呼吸困难、气流阻塞）指数（p=0.01）较高，而预测 FEV（p<0.001）和嗜酸性粒细胞计数（p=0.003）较低。ADO 指数每增加 0.755 单位，死亡风险增加 2.12 倍，嗜酸性粒细胞计数每增加 0.007 单位，死亡风险降低 1.007 倍。ADO 评分的最佳截断值为 3.5，预测死亡率的敏感性为 94%，特异性为 40%。
本研究表明，COPD 患者稳定期记录的 ADO 指数对 COVID-19 死亡率的预测有一定的贡献。需要进一步的研究来验证 ADO 指数在评估 COVID-19 和其他病毒性呼吸道感染患者死亡率方面的作用。
