KRONİK OBSTRÜKTİF AKCİĞER HASTALIĞI COVID-19 ENFEKSİYONUNUN ŞİDDETİNİ ETKİLİYOR MU?

Year 2020, Volume: 22 Issue: 3, 440 - 444, 31.12.2020

Aydın Kant Şenol Çomoğlu Sinan Öztürk Ercan Aydın Gürdal Yılmaz

https://doi.org/10.24938/kutfd.810344

Cited By: 3

Abstract

Amaç: Kronik obstrüktif akciğer hastalığı (KOAH) olan hastalar koronavirüs hastalığı-2019 (COVID-19) mortalitesi açısından yüksek riske sahiptir. Bu risk, eşlik eden diğer hastalıkların varlığı ile daha da artmaktadır. Çalışmamızda KOAH’lı hastalarda COVID-19’un şiddetinin belirlenmesi amaçlanmıştır.

Gereç ve Yöntemler: Çalışma 01 Nisan 2020-01 Ekim 2020 tarihleri arasında çalışmaya giren iki merkezde retrospektif vaka-kontrol çalışması olarak yapıldı. Vaka grubuna öncesinde KOAH tanısı olan COVID-19 rtRT-PCR pozitif hastalar alındı. Kontrol grubuna ise vaka grubuna alınan hastalardan bir sonra başvuran COVID-19 rtRT-PCR pozitif olan ve öncesinde KOAH tanısı olmayan hastalar alındı.

Bulgular: Çalışmaya 222’si KOAH’lı toplam 444 hasta alındı. Hastaların yaş ortalaması her iki grupta benzerdi. KOAH’lı hastalarda erkek cinsiyet oranı yüksekti (p=0,009). KOAH’lı hastaların Charlson comorbidite indeksi skoru daha yüksek olup, bu hasta grubunda hipertansiyon ve koroner arter hastalığı eşlik eden komorbid hastalıklardandı (p<0,05). KOAH’lı hastaların semptom başlangıcından hastaneye başvuruları arasında geçen süre daha kısaydı (p<0,001). Hastaneye başvuru anında kontrol grubundaki hastalarda ateş, myalji ve halsizlik şikayetleri daha fazla iken, KOAH’lı hastalarda nefes darlığı şikâyeti daha fazlaydı. KOAH’lı hastaların yoğun bakım ihtiyacı kontrol grubuna göre 1,88 kat daha fazlaydı (p=0,026). Prognoz açısından iki grup arasında fark yoktu.

Sonuç: COVID-19 geçiren KOAH’lı hasta grubunda yoğun bakım ihtiyacı daha sık gözlenmekte olup, bu hastaların kliniği daha ciddi seyredebilmektedir. COVID-19 tanısı konan KOAH’lı hastaların daha fazla yoğun bakım ihtiyacı gösterebileceği ve erken verilen destek tedavisinin prognoza katkı sağlayabileceği akılda tutulmalıdır.

Keywords

COVID-19, KOAH, Hastalık şiddeti

Supporting Institution

Yok

Project Number

-

Thanks

yok

Does Chronic Obstructive Pulmonary Disease Affect the Severity of COVID-19 Infection?

Abstract

Objective: Coronavirus disease-2019 (COVID-19) has a high risk of mortality in patients with chronic obstructive pulmonary disease (COPD). This risk increases with the presence of other comorbid diseases. In our study, it was aimed to determine the severity of COVID-19 in patients with COPD.

Material and Methods: The study was performed as a retrospective case-control study in two centers that participated in the study between April 01, 2020 and October 01, 2020. COVID-19 rtRT-PCR positive patients with prior COPD diagnosis were included in the case group. Patients with positive COVID-19 rtRT-PCR and who did not have a COPD history were included in the control group.

Results: A total of 444 patients with 222 COPD were included in the study. The mean age of the patients was similar in both groups. Male gender ratio was high in patients with COPD (p=0,009). Patients with COPD had higher Charlson Comorbidity Index scores, and in this group, hypertension and coronary artery disease were among the accompanying comorbid diseases (p<0,05). The elapsed time between the onset of symptoms and admission to the hospital was shorter in patients with COPD (p<0.001). Fever, myalgia and fatigue were more common in patients in the control group at the time of admission to the hospital, while shortness of breath was more common in patients with COPD. Intensive care need of patients with COPD was 1.88 times higher than the control group (p=0,026). There was no difference between the two groups in terms of prognosis. 

Conclusion: In the patient group with COPD, presence of COVID-19 disease increases the need for intensive care and the clinical course of these patients may be more severe. It should be kept in mind that COPD patients diagnosed with COVID-19 may need more intensive care and early supportive treatment may contribute to the prognosis.

Keywords

COVID-19, COPD, disease severity

Project Number

-

References

• 1. Zhang L, Liu Y. Potential interventions for novel coronavirus in China: A systematic review. J Med Virol. 2020;92(5):479-90. Doi:10.1002/jmv.25707.
• 2. World Health Organization (WHO). Q&A on smoking and COVID‐19. Accessed date: 30 June 2020:www.who.int/publications/i/item/WHO-2019-nCoV-Sci_Brief-Smoking-2020.2.
• 3. Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;8(5):475-81.
• 4. Lange P, Celli B, Agustí A, Boje Jensen G, Divo M, Faner R et al. Lung-function trajectories leading to chronic obstructive pulmonary disease. N Engl J Med. 2015;373(2):111-22.
• 5. Global Strategy for Prevention, Diagnosis and Management of COPD Accessed date: 03 December 2020: https://goldcopd.org/wp‐content/uploads/2019/12/GOLD‐2020‐FINAL‐ver1.2
• 6. Wedzicha JA. Role of viruses in exacerbations of chronic obstructive pulmonary disease. Proc Am Thorac Soc. 2004;1(2):115‐20.
• 7. Frickmann H, Jungblut S, Hirche TO, Gross U, Kuhns M, Zautner AE. The influence of virus infections on the course of COPD. Eur J Microbiol Immunol (Bp). 2012;2(3):176‐85.
• 8. Kefala AM, Fortescue R, Alimani GS, Kanavidis P, McDonnell MJ, Magiorkinis E et al. Prevalence and clinical implications of respiratory viruses in stable chronic obstructive pulmonary disease (COPD) and exacerbations: a systematic review and meta‐analysis protocol. BMJ Open. 2020;10(4):e035640. Doi:10.1136/bmjopen-2019-035640.
• 9. Lippi G, Henry BM. Chronic obstructive pulmonary disease is associated with severe coronavirus disease 2019 (COVID‐19). Respir Med. 2020;167:105941.
• 10. Leung JM, Yang CX, Tam A, Shaipanich T, Hackett TL, Singhera GK et al. ACE‐2 expression in the small airway epithelia of smokers and COPD patients: implications for COVID‐19. Eur Respir J. 2020;55(5):2000688.
• 11. Wilkinson TM, Hurst JR, Perera WR, Wilks M, Donaldson GC, Wedzicha JA. Effect of interactions between lower airway bacterial and rhinoviral infection in exacerbations of COPD. Chest. 2006;129(2):317‐24. Doi:10.1378/chest.129.2.317.