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

IF 0.2 Q4 RESPIRATORY SYSTEM

Indian Journal of Respiratory Care Pub Date : 2023-03-14 DOI:10.5005/jp-journals-11010-1006

M. Ozkarafakili, A. Melekoğlu, E. Altınbilek

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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

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慢性阻塞性肺疾病合并COVID-19肺炎住院患者临床评价

自2019年以来，2019冠状病毒病(COVID-19)一直是一种具有挑战性的病毒性呼吸道感染，可能导致慢性阻塞性肺疾病(COPD)患者的死亡率升高。方法:对98例诊断为COVID-19且既往诊断为COPD的住院患者的临床资料进行分析。它们按照GOLD ABCD分期进行分组，无论是在大流行病房还是重症监护病房(ICU)，报告如下。临床结果记录为活出院或住院死亡率。结果:大流行病房76例(77.6%)，重症监护病房22例(22.4%)。81例(82.7%)患者存活，17例(17.3%)患者死亡。我们将其分为GOLD A、GOLD B、GOLD C和GOLD D组。GOLD C和GOLD D组降钙素原(PCT)水平高于GOLD A和GOLD B组，动脉氧分压(PaO2/FiO2)水平低于GOLD A和GOLD B组(p < 0.005)。两组住院死亡率差异无统计学意义(p = 0.098)。而在单变量模型中，血红蛋白(Hgb)、尿素、肌钙蛋白、PCT、PaO2/FiO2、饱和度%和呼吸速率存在显著差异;在多变量模型中，PaO₂/FiO2仅在区分患者存活或死亡方面具有显著的独立作用(p < 0.05)。结论:全球慢性阻塞性肺疾病倡议(GOLD) ABCD组对COPD患者进行分期，有利于预测住院和死亡率。然而，COPD患者合并COVID-19肺炎住院时，由于COPD的异质性和复杂性，需要考虑不同的临床因素和指标。关键词:慢性阻塞性肺疾病，2019冠状病毒病，死亡率中国呼吸医学杂志(2010):10.5005/jp- Journal -11010-1006

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来源期刊

Indian Journal of Respiratory Care RESPIRATORY SYSTEM-

自引率

66.70%

发文量

审稿时长

16 weeks