The impact of COVID-19 on patients with chronic obstructive pulmonary disease

Abstract

BACKGROUND: The aim of this study was to evaluate the risk of serious adverse outcomes in patients with chronic obstructive pulmonary disease (COPD) related to COVID-19 by stratifying the comorbidity status.METHODS: This is a prospective cohort study based on 1264 male and female patients, which were 25-75 years old. Nine hundred five (71.5%) patients gave consent to participate. The collected data included demographics, clinical, biochemistry, microbiology information, and the presence of disease. We performed descriptive and multivariate regression analyses to analyze the COVID-19 disease in the context of COPD.RESULTS: There was a significant difference between COPD versus control subjects with respect to age groups, BMI, smoking cigarette, comorbidity, infection, hypertension, stroke, coronary heart failure (CHF), diabetic and cerebral (P<0.001). The highly statistically significant differences were observed between COPD versus control subjects regarding, hemoglobin (P=0.022), HbA1C (P<0.001), glucose (P=0.040), vitamin D (P<0.001), vitamin B12 (P=0.020), triglyceride, uric acid (P<0.001), ferritin (P=0.002), Fe (P=0.004), and TSH (P=0.008), creatine-kinase (CK) (P=0.004), white blood cell (WBC) (P<0.001), hematocrit (P<0.001), monocytes (P<0.001), neutrophil (P<0.001), lymphocyte (P<0.001), platelet (P<0.001), aspartate transaminase-AST (P=0.018), alanine transaminase-ALT (P=0.008), respectively. The multivariate stepwise regression analysis indicated that monocyte (P<0.001), hematocrit (P<0.001), lymphocyte (P<0.001), smoking (yes) (P<0.001), vitamin D (P<0.001), uric acid (P<0.001), diastolic BP (P<0.001), ferritin (P=0.002), infection (yes) (P=0.002), creatine kinase (P=0.006), metabolic syndrome (IDF) (P=0.008) and BMI kg/m2 (P=0.009) can be considered as risk predictors of the COPD among COVID-19 patients after adjusting for age and gender.CONCLUSIONS: This study determined that COPD disease was the most prevalent comorbidity with CHF, hypertension and diabetes disease among COVID-19 patients. Interestingly, the current study revealed that 22.8% of COPD patients stated being smokers. The current study supports the evidence that COPD patients have worse outcomes from COVID-19 and explored the multiple factors responsible.