L11 SARS-CoV-2: Survival and length of stay in COPD phenotypes

Abstract

<h3>Introduction and objectives</h3> Individuals with Chronic Obstructive Pulmonary Disease (COPD) have increased risk of severe pneumonia and poor outcomes when they develop severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Hoffmann 2020). We hypothesised that there would be a difference in survival and length of stay between COPD phenotypes with SARS-CoV-2 infections requiring hospital admission. <h3>Methods</h3> Observational retrospective analysis of individuals admitted to a teaching hospital was performed on during the first peak of the SARS-CoV-2 pandemic (1st March to 30th June 2020). Individuals with COPD were identified and grouped into phenotypes; frequent exacerbators (≥2 severe exacerbations in the last 12 months), emphysema-predominant, chronic bronchitis (cough and sputum production) and eosinophilic-predominant (plasma eosinophil count ≥ 300 cells/µL). Overall survival and length of stay for all phenotypes was compared using Kaplan-Meier methodology. <h3>Results</h3> 508 individuals were admitted to hospital with SARS-CoV-2 infection during this time period. 55 (11%) of these individuals had a diagnosis of COPD. Survival was significantly lower in all individuals with SARS-CoV-2 infection (34%) compared to individuals with SARS-CoV-2 infection and co-existing COPD (58%) (p = 0.0003). There was no difference between baseline characteristics (age, gender and smoking status) between all COPD phenotypes. There was no significant difference in survival between all 4 phenotypes; median survival for frequent exacerbators, emphysema-predominant, chronic bronchitis and eosinophilia-predominant (113 vs 7 vs 39 vs 36 respectively), X2 (2) = 3.9, p = 0.3; figure 1A. There was no difference in length of stay between all commers 13 days and individuals with COPD 12.5 days (p = 1.0). There was no significant difference in length of stay between all 4 phenotypes; median length of stay for frequent exacerbators, emphysema-predominant, chronic bronchitis and eosinophilia-predominant (12 vs 9 vs 13 vs 14 respectively), X2 (2) = 3.0, p = 0.4; figure 1B. <h3>Conclusions</h3> These data do not support the hypothesis that COPD phenotype would result in a difference in a difference in survival and length of stay. Further study should investigate factors which predict survival of SARS-CoV-2 infection in individuals with co-existent COPD in a larger population.