Clinical Evaluation of Chronic Obstructive Pulmonary Disease Patients Hospitalized with COVID-19 Pneumonia

Abstract

Background: Coronavirus disease 2019 (COVID-19) has been a challenging viral respiratory tract infection since 2019 and may contribute to higher mortality in patients with chronic obstructive pulmonary disease (COPD). Methods: We analyzed the clinical data of 98 patients hospitalized with a diagnosis of COVID-19 and who had a previous diagnosis of COPD. They are grouped regarding GOLD ABCD stages, reported as follows whether in pandemic wards or intensive care units (ICU). The clinical outcomes were noted as a live hospital discharge or inhospital mortality. Results: A total of 76 patients (77.6%) were in the pandemic wards, 22 (22.4%) were in the ICU. Around 81 (82.7%) patients survived, 17 (17.3%) were deceased. We grouped them as GOLD A and GOLD B and GLOD C, and GOLD D. Procalcitonin (PCT) level was higher and arterial oxygen partial pressure (PaO2 in mm Hg) to fractional inspired oxygen (PaO2/FiO2) level was lower in the group of GOLD C and GOLD D than in GOLD A and GOLD B (p < 0.005). There was no statistically significant difference in inhospital mortality between these two groups (p = 0.098). While in the univariate model, hemoglobin (Hgb), urea, troponin, PCT, PaO2/FiO2, saturation%, and respiratory rate was observed to be significantly different; in the multivariate model, only a significant independent (p < 0.05) effect of PaO₂/FiO2 were observed in distinguishing patients who survived or deceased. Conclusion: Global Initiative for Chronic Obstructive Lung Disease (GOLD) ABCD groups are staging COPD patients in favor of predicting hospitalization and mortality. However, when COPD patients are hospitalized with COVID-19 pneumonia, different clinical factors and indices should be considered due to the heterogeneity and complexity of COPD. Keywords: Chronic obstructive pulmonary disease, Coronavirus disease 2019, Mortality. Indian Journal of Respiratory Care (2023): 10.5005/jp-journals-11010-1006