Clinical outcomes in patients with COPD hospitalized with SARS-CoV-2 versus non- SARS-CoV-2 community-acquired pneumonia - 25/01/22
, Nishita Tripathi a, Thomas R. Chandler a, Stephen Furmanek a, Jose Bordon b, Julio A. Ramirez a, Rodrigo Cavallazzi c
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Abstract |
Background |
Patients with chronic obstructive pulmonary disease (COPD) have poor outcomes in the setting of community-acquired pneumonia (CAP) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The primary objective is to compare outcomes of SARS-CoV-2 CAP and non-SARS-CoV-2 CAP in patients with COPD. The secondary objective is to compare outcomes of SARS-CoV-2 CAP with and without COPD.
Methods |
In this analysis of two observational studies, three cohorts were analyzed: (1) patients with COPD and SARS-CoV-2 CAP; (2) patients with COPD and non-SARS-CoV-2 CAP; and (3) patients with SARS-CoV-2 CAP without COPD. Outcomes included length of stay, ICU admission, cardiac events, and in-hospital mortality.
Results |
Ninety-six patients with COPD and SARS-CoV-2 CAP were compared to 1129 patients with COPD and non-SARS-CoV-2 CAP. 536 patients without COPD and SARS-CoV-2 CAP were analyzed for the secondary objective. Patients with COPD and SARS-CoV-2 CAP had longer hospital stay (15 vs 5 days, p < 0.001), 4.98 higher odds of cardiac events (95% CI: 3.74–6.69), and 7.31 higher odds of death (95% CI: 5.36–10.12) in comparison to patients with COPD and non-SARS-CoV-2 CAP. In patients with SARS-CoV-2 CAP, presence of COPD was associated with 1.74 (95% CI: 1.39–2.19) higher odds of ICU admission and 1.47 (95% CI: 1.05–2.05) higher odds of death.
Conclusion |
In patients with COPD and CAP, presence of SARS-CoV-2 as an etiologic agent is associated with more cardiovascular events, longer hospital stay, and seven-fold increase in mortality. In patients with SARS-CoV-2 CAP, presence of COPD is associated with 1.5-fold increase in mortality.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Pneumonia caused by SARS-CoV-2 tends to be more dangerous in patients with COPD than when caused by other pathogens. |
• | In patients with pneumonia caused by SARS-CoV-2, the presence of COPD is associated with increased risk of death. |
• | Co-existence of COPD and SARS-CoV-2 increases the risk of developing more cardiovascualar events and longer hospital stays. |
Keywords : Respiratory tract infections, Cardiovascular events, Mortality, ICU admission, Viral pneumonia, COVID-19
Plan
Vol 191
Article 106714- janvier 2022 Retour au numéro
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