Kim Sang Hyuk, Kim Jong Seung, Kim Min Ji, Jin Sorin, Kim Bo-Guen, Moon Seong Mi, Yang Bumhee, Moon Ji-Yong, Min Kyung Hoon, Choi Hayoung, Lee Hyun
Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine, Gyeongju, Republic of Korea.
Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
ERJ Open Res. 2025 Jun 30;11(3). doi: 10.1183/23120541.00866-2024. eCollection 2025 May.
Individuals with bronchiectasis have an increased risk of exacerbation by coronavirus 2019 (COVID-19), even after recovery from COVID-19. However, the impact of COVID-19 severity on severe exacerbation and mortality remains uncertain in this population.
We enrolled 48 342 individuals diagnosed with bronchiectasis between 1 January 2015 and 7 October 2020 from Korea National Health Insurance Service. Of these individuals, 2711 with bronchiectasis were identified as also having recovered from COVID-19. A COVID-19 and matched cohort (n=2711 for both) were established after 1:1 propensity matching. The exposure was COVID-19 (non-severe and severe), and outcomes were severe exacerbation of bronchiectasis and death following the COVID-19 recovery date.
During a median follow-up of 70 days (interquartile range (IQR), 31-216 days) for severe exacerbation and a median of 71 days (IQR, 32-129 days) for death, including 14 days of recovery time after COVID-19, the incidence of severe exacerbation and death were 402.2/10 000 person-years and 342.9/10 000 person-years in the COVID-19 cohort. Although the COVID-19 cohort did not show higher risk of severe exacerbation, the cohort exhibited a significantly higher risk of mortality (adjusted hazard ratio (aHR) 1.46, 95% confidence interval (CI) 1.06-2.01) compared with the matched cohort. In a stratified analysis, the severe COVID-19 cohort showed a significantly higher risk of severe exacerbation (aHR 2.38, 95% CI 1.25-4.51) and mortality (aHR 2.99, 95% CI 2.08-4.28) compared with the matched cohort.
The risk of severe exacerbation and mortality in individuals with bronchiectasis was increased after recovery from COVID-19, particularly in those who experienced severe COVID-19.
支气管扩张症患者感染2019冠状病毒病（COVID-19）后病情加重的风险增加，即便从COVID-19中康复也是如此。然而，在这一人群中，COVID-19严重程度对严重病情加重和死亡率的影响仍不确定。
我们从韩国国民健康保险服务中心纳入了2015年1月1日至2020年10月7日期间被诊断为支气管扩张症的48342名个体。在这些个体中，2711名支气管扩张症患者也被确定已从COVID-19中康复。在进行1:1倾向匹配后，建立了一个COVID-19组和一个匹配队列（两组均为n = 2711）。暴露因素为COVID-19（非重症和重症），结局为COVID-19康复日期之后支气管扩张症的严重病情加重和死亡。
在对严重病情加重进行的中位随访70天（四分位间距（IQR），31 - 216天）以及对死亡进行的中位随访71天（IQR，32 - 129天）期间，包括COVID-19后的14天康复时间，COVID-19组中严重病情加重和死亡的发生率分别为402.2/10000人年和342.9/10000人年。虽然COVID-19组未显示出更高的严重病情加重风险，但与匹配队列相比，该队列的死亡风险显著更高（调整后风险比（aHR）1.46，95%置信区间（CI）1.06 - 2.01）。在分层分析中，与匹配队列相比，重症COVID-19组的严重病情加重风险（aHR 2.38，95% CI 1.25 - 4.51）和死亡风险（aHR 2.99，95% CI 2.08 - 4.28）显著更高。
支气管扩张症患者从COVID-19康复后，严重病情加重和死亡的风险增加，尤其是那些经历过重症COVID-19的患者。
