Chronic respiratory diseases are predictors of severe outcome in COVID-19 hospitalised patients: a nationwide study

Abstract

BackgroundInfluenza epidemics were initially considered to be a suitable model for the COVID-19 epidemic, but there is a lack of data concerning patients with chronic respiratory diseases (CRD), who were supposed to be at risk of severe forms of COVID-19.MethodsThis nationwide retrospective cohort study describes patients with prior lung disease hospitalised for COVID-19 (March-April 2020) or influenza (2018–2019 influenza outbreak). We compare the resulting pulmonary complications, need for intensive care and in-hospital mortality depending on respiratory history and virus.ResultsIn the 89 530 COVID-19 cases, 16.03% had at least one CRD, which was significantly less frequently than in the 45 819 seasonal influenza patients. Patients suffering from chronic respiratory failure, chronic obstructive pulmonary disease, asthma, cystic fibrosis and pulmonary hypertension were underrepresented, contrary to those with lung cancer, sleep apnea, emphysema, and interstitial pulmonary diseases (ILD). COVID-19 patients with CRD developed significantly more ventilator-associated pneumonia and pulmonary embolism than influenza patients. They needed intensive care significantly more often and had a higher mortality rate (except for asthma) when compared to patients with COVID-19 but without CRD, or patients with influenza.ConclusionPatients with prior respiratory diseases were globally less likely to be hospitalised for COVID-19 than for influenza but were at higher risk of developing severe COVID-19 and had a higher mortality rate compared to influenza patients and patients without a history of respiratory illness.Our data suggest that these patients should have priority access to SARS-CoV2 vaccination.

COVID-19 Vaccinations: A Comprehensive Review of Their Safety and Efficacy in Special Populations

“…A systematic review and meta-analysis analyzing over 690,000 patients with chronic lung conditions with COVID-19 infection showed that chronic lung conditions significantly increase the odds of poor clinical outcomes in patients with COVID-19: increased odds of hospitalization (odd ratio 4.23, 95% CI, 3.65-4.90), ICU admission (odd ratio 1.35, 95% CI 1.02-1.78), and mortality (odd ratio 2.47, 95% CI 2.18-2.79) [99]. Patients with chronic respiratory diseases (CRD) such as chronic obstructive pulmonary disease, bronchiectasis, cystic fibrosis, and interstitial lung disease have higher risks for severe COVID-19 hospital admissions and mortality risk [100]. The risk of COVID-19 patients developing ventilator-associated pneumonia and pulmonary embolism is higher than patients with influenza.…”

Prognostic Role of Metabolic Syndrome in COVID-19 Patients: A Systematic Review Meta-Analysis

“…To further appraise the impact of potential baseline confounders, a meta-regression analysis using age, gender, HT, DM, chronic pulmonary disease and hyperlipidaemia as moderator variables was performed. These variables were selected since previous analyses have identified those comorbidities as independent predictors of mortality in COVID-19 patients [2,3,10,11]. All meta-analyses were conducted using Comprehensive Meta-Analysis software, version 3 (Biostat, Englewood, NJ, USA).…”

Clinical course and risk factors for severe COVID-19 among Italian patients with cystic fibrosis: a study within the Italian Cystic Fibrosis Society

“…Patients with respiratory diseases are considered at high risk of developing severe COVID-19 [ 1 ], and this is true also for CF patients for whom higher incidence and hospitalization rates were documented as compared to the age-matched general population [ 2 ].…”