Critically ill COVID-19 patients with obstructive pulmonary diseases: Characteristics, risk factors and outcome

Abstract

other hand, it is known that COPD patients are at high risk of mortality from respiratory infections, such as influenza and community acquired pneumonia (CAP) 9,10 . However, the prevalence of COPD among COVID-19 patients was lower than expected 11 . This paradox can be explained by the fact that COPD patients, similarly to patients with other respiratory or smoking-associated conditions, have ABSTRACT INTRODUCTION Asthma and chronic obstructive pulmonary disease (COPD) are the commonest respiratory diseases. The aim of the present study is to describe the clinical characteristics and outcomes of critically ill COVID-19 patients with obstructive pulmonary disease. METHODS We conducted an observational study of severe COVID-19 patients admitted to the intensive care unit of the 1st Respiratory Medicine Department of the University of Athens at Sotiria Hospital, Greece, from 27 August 2020 to 10 November 2021. RESULTS Among 297 patients, 24 (8.1%) had a previous diagnosis of asthma and 18 (6.1%) of COPD. Compared to patients without obstructive disease, asthmatics were younger, suffered from less severe disease on admission, and experienced similar adverse events and outcomes. None of the asthmatics had symptoms suggestive of exacerbation during their hospitalization. In contrast, COPD patients were older, with more severe disease, had more comorbidities, required more frequently mechanical ventilation, and continuous renal replacement therapy. Finally, mortality in COPD patients was greater. CONCLUSIONS Although asthmatic patients with severe COVID-19 do not seem to differ from the non-asthmatics regarding disease course and outcomes, COVID-19 patients with COPD are at increased risk of poor outcomes.