Persistent Respiratory Failure and Re-Admission in Patients with Chronic Obstructive Pulmonary Disease Following Hospitalization for COVID-19

Int J Chron Obstruct Pulmon Dis. 2023 Nov 7:18:2473-2481. doi: 10.2147/COPD.S428316. eCollection 2023.

Abstract

Background: Chronic obstructive pulmonary disease (COPD) has been associated with worse clinical evolution/survival during a hospitalization for SARS-CoV2 (COVID-19). The objective of this study was to learn the situation of these patients at discharge as well as the risk of re-admission/mortality in the following 12 months.

Methods: We carried out a subanalysis of the RECOVID registry. A multicenter, observational study that retrospectively collected data on severe acute COVID-19 episodes and follow-up visits for up to a year in survivors. The data collection protocol includes general demographic data, smoking, comorbidities, pharmacological treatment, infection severity, complications during hospitalization and required treatment. At discharge, resting oxygen saturation (SpO2), dyspnea according to the mMRC (modified Medical Research Council) scale and long-term oxygen therapy prescription were recorded. The follow-up database included the clinical management visits at 6 and 12 months, where re-admission and mortality were recorded.

Results: A total of 2047 patients were included (5.6% had a COPD diagnosis). At discharge, patients with COPD had greater dyspnea and a greater need for prescription home oxygen. After adjusting for age, sex and Charlson comorbidity index, patients with COPD had a greater risk of hospital re-admission due to respiratory causes (HR 2.57 [1.35-4.89], p = 0.004), with no significant differences in survival.

Conclusion: Patients with COPD who overcome a serious SARS-CoV2 infection show a worse clinical situation at discharge and a greater risk of re-admission for respiratory causes.

Keywords: COPD; COVID-19; RECOVID; SARS-CoV2; SEPAR; Spanish COVID-19 registry; chronic obstructive pulmonary disease; coronavirus disease 2019; respiratory failure; severe acute respiratory syndrome coronavirus 2.

Publication types

  • Observational Study
  • Multicenter Study

MeSH terms

  • COVID-19* / complications
  • COVID-19* / therapy
  • Dyspnea / complications
  • Hospitalization
  • Humans
  • Oxygen
  • Pulmonary Disease, Chronic Obstructive* / diagnosis
  • Pulmonary Disease, Chronic Obstructive* / epidemiology
  • Pulmonary Disease, Chronic Obstructive* / therapy
  • RNA, Viral / therapeutic use
  • Respiratory Insufficiency* / complications
  • Respiratory Insufficiency* / diagnosis
  • Respiratory Insufficiency* / therapy
  • Retrospective Studies
  • SARS-CoV-2

Substances

  • RNA, Viral
  • Oxygen

Grants and funding

A non-conditional grant from Gebro Pharma Laboratories, which did not participate in the design, data collection, statistical analysis or writing of the article. Sociedad Española de Neumología y Cirugía Torácica (SEPAR): 1078/2020 and 1290/2022. Raúl Méndez is the recipient of a Juan Rodés grant, supported by the Instituto de Salud Carlos III (ISCIII [JR21/00051]).