After reviewing data from 15,586 patients ages 35 and older, researchers at the Cleveland Clinic Health System find adults with chronic obstructive pulmonary disease (COPD) are not more likely to test positive for the novel coronavirus (COVID-19) when compared to adults without COPD. However, COPD patients with COVID-19 are more likely to require hospitalization and emergency care, including breathing assistance. In-hospital survival rates for COVID-19 were the same for patients with and without COPD. The Cleveland Clinic review was funded by the National Heart, Lung, and Blood Institute and appears in The Lancet’s EClinicalMedicine.
Cleveland Clinic researchers were curious about how COPD, which impacts 16 million Americans, influences the severity and progression of COVID-19. They collected 22,000 records from patients who had COVID-19 symptoms and sought testing at Cleveland Clinic locations in Ohio and Florida between March 8-May 13, 2020. Within the Cleveland Clinic’s COVID-19 registry, the researchers created a COPD subdivision. They controlled for variables, such as age, asthma, and smoking history, to compare COPD patients with non-COPD patient peers.
Out of the sample, 12.4% of COPD patients (164/1,319) tested positive for COVID-19. Approximately 16.6% of patients without COPD (2,363/14,267) tested positive for COVID-19. About half of COPD patients with COVID-19 (79/164) required hospitalization, compared to one-fourth of hospitalized COVID-19 patients without COPD (626/2,363).
Out of the hospitalized COPD patients with COVID-19, about half (36/79) were admitted to the intensive care unit. One-third of non-COPD patients with COVID-19 (214/626) required intensive care. In-hospital mortality rates, or an increased risk of death due to COVID-19 severity, were the same for both groups after the researchers controlled for age, race, BMI, and preexisting health conditions.
Based on this data, the researchers recommend targeting public health outreach, such as through the Veterans Administration, to help COPD patients support health outcomes through coordinated care and awareness about preexisting conditions. In this analysis, COPD patients were more likely to have diabetes, high blood pressure, and cancer. African Americans with COPD were more likely to be hospitalized or require urgent care. The authors note future studies are needed to follow the long-term impact COVID-19 may have on COPD patients.
Strengths of the analysis include generating data to analyze how COPD influences COVID-19 severity and healthcare use. Areas for expansion include collecting data from patients living outside of Ohio and Florida. This will diversify registries and integrate patients from states experiencing higher COVID-19 rates during the pandemic.