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三级政府新冠病毒转诊中心中新冠病毒检测呈阳性的慢性阻塞性肺疾病(COPD)患者的临床特征及转归

Clinical Profile and Outcomes of COVID-19 Positive Patients with Chronic Obstructive Pulmonary Disease (COPD) in a Tertiary Government COVID-19 Referral Center.

作者信息

Ditching Mary Bianca Doreen F, Santiaguel Joel M

机构信息

Division of Pulmonary Medicine, Philippine General Hospital, University of the Philippines Manila.

出版信息

Acta Med Philipp. 2025 Jan 15;59(1):41-47. doi: 10.47895/amp.vi0.8578. eCollection 2025.

Abstract

INTRODUCTION

It is anticipated that Chronic Obstructive Pulmonary Disease (COPD) has greater risk in acquiring COVID-19 infection and poorer outcome. However, current worldwide data are conflicting.

OBJECTIVES

This study primarily aims to compare the outcomes of COVID-19 patients with COPD and those without COPD in terms of length of hospital stay (LOS), recovery or mortality, treatment received, and predictors of mortality.

METHODS

This is a retrospective cohort chart review of 1,017 admitted adult COVID-19 patients from July to December 2020. Age, gender, smoking status, current control and medications for COPD, COVID-19 severity, symptoms, treatment, and outcomes of the two study groups were compared.

RESULTS

Prevalence rate of COPD was 3.8%. COVID-19 patients with COPD were older (median age of 69 vs 54, p<0.001), male (87% vs 50%, p<0.001), hypertensive (72% vs 48%, p=0.004), and with tuberculosis (31% vs 11%, p=0.002). COVID-19 patients with COPD more commonly needed oxygen therapy, High Flow Nasal Cannula, Mechanical Ventilation, Tocilizumab, Convalescent Plasma Therapy and Dexamethasone, and had longer LOS. Significant risk factors for mortality are malignancy, investigational therapies, smoking, and older age. There was no difference in survival rates between the two groups.

CONCLUSION

COPD increases the risk for severe COVID-19 and lengthens LOS.

摘要

引言

预计慢性阻塞性肺疾病(COPD)患者感染2019冠状病毒病(COVID-19)的风险更高,预后更差。然而,目前全球数据存在矛盾。

目的

本研究主要旨在比较COPD合并COVID-19患者和非COPD合并COVID-19患者在住院时间(LOS)、康复或死亡率、接受的治疗以及死亡预测因素方面的结果。

方法

这是一项对2020年7月至12月收治的1017例成年COVID-19患者进行的回顾性队列图表审查。比较了两个研究组的年龄、性别、吸烟状况、COPD的当前控制情况和用药情况、COVID-19严重程度、症状、治疗及结果。

结果

COPD患病率为3.8%。COPD合并COVID-19患者年龄更大(中位年龄69岁对54岁,p<0.001)、男性比例更高(87%对50%,p<0.001)、高血压患病率更高(72%对48%,p=0.004)以及结核病患病率更高(31%对11%,p=0.002)。COPD合并COVID-19患者更常需要氧疗、高流量鼻导管吸氧、机械通气、托珠单抗、康复血浆治疗和地塞米松,且住院时间更长。死亡的显著危险因素为恶性肿瘤、试验性治疗、吸烟和高龄。两组生存率无差异。

结论

COPD增加了重症COVID-19的风险并延长了住院时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0720/11779669/e78ff4dd913c/AMP-59-1-8578-g001.jpg

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