https://orcid.org/0000-0001-6810-0436
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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.
Ethics and Consent Statements
The study was approved by both the Ethics Committee (Comité Ètic d’Investigació Clínica, Hospital San Pau, Barcelona) on 29 April 2020 and by the local committees of the participating centers. The study did not require informed consent.
List of RECOVID Principal Investigators
Clínica Asunción. Itxaso Sayago Reza.
Complejo Hospitalario Univ. de Albacete. Wanda Almonte Batista.
Complejo Hospitalario Univ. de Navarra. Laura Moreno Galarraga.
Hospital Clínic. Oriol Sibila Vidal.
Hospital Clínico San Carlos. Juan Luis Rodríguez Hermosa. Gianna Vargas Centanaro.
Hospital Clínico Univ. de Valladolid. Blanca de Vega Sánchez. Eduardo Solís García. Ester Rodríguez Florez. María José Chourio Estaba.
Hospital de Bellvitge. María Molina Molina. Jaume Bordas.
Hospital de Torrecárdenas. María Estela González Castro.
Hospital del Mar. Diana Badenes Bonet. Marisol Domínguez Álvarez.
Hospital Dos de Maig. Pérez-Rodas Eli-N (currently working at Hospital Municipal de Badalona, Barcelona). Alejandra Marín Arguedas.
Hospital Dr. José Molina Orosa. Berta Román Bernal.
Hospital General de Segovia. Graciliano Estrada Trigueros.
Hospital Gral. Univ. de Castellón. Selene Cuenca Peris. Margarita Martín Royo. Miguel Torres García.
Hospital Gral. Univ. de Ciudad Real. José Portillo Sánchez.
Hospital Gral. Univ. Santa Lucía. Francisca Lerenas Bernal. María Salome Ros Braquehais.
Hospital la Mancha Centro. José Alfonso García Guerra.
Hospital Lluis Alcanyís. María Dolores Martínez Pitarch. Iván Arroyo Fernández.
Hospital Ntra. Sra. de Sonsoles. Virginia Guevara Velázquez.
Hospital Plató. Pilar Martínez Olondris.
Hospital público de Monforte de Lemos. Marco Francisco Pereyra Barrionuevo.
Hospital Royo Villanova. Javier Lázaro Sierra. Paloma Clavería.
Hospital San Juan de Dios de Tenerife. Aurelio Luis Wangüemert Pérez. José Joel Ruiz Lacambra. Noelia Fernández Ramos. Sara Guanche Dorta.
Hospital Sant Jaume de Calella. Abigail Macias Paredes.
Hospital Santa Creu i Sant Pau. David de la Rosa Carrillo. Esther Palones Femenia. Inés Podzamczer Valls. Patricia Peñacoba Toribio.
Hospital de Jérez. Pilar Muñoz Zara.
Hospital Univ. 12 de octubre. Rocío García García.
Hospital Univ. A Coruña. María del Mar Marrube Fernández. Laura Villar Aguilar. Santiago de Jorge Domínguez Pazos. Tara Pereiro Brea. Angélica Consuegra-Vanegas
Hospital Univ. Central de Asturias. Ana Pando-Sandoval. Marta María García Clemente.
Hospital Univ. de Cabueñes. Amelia Alzueta Álvarez. Estela García Coya. Elizabeth de Freitas González.
Hospital Univ. de Galdakao-Usansolo. Pedro Pablo España Yandiola. Ane Uranga.
Hospital Univ. de Getafe. Beatriz Raboso Moreno. Carolina Panadero. Araceli Abad. Irene Cano (currently working at Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain).
Hospital Univ. Fundación Alcorcón. Iria Pérez Orbis.
Hospital Univ. Fundación Jiménez Díaz. German Peces-Barba, Carolina Gotera Rivera. Celia Ruiz Pérez.
Hospital Univ. i Politècnic La Fe. Rosario Menéndez Villanueva. Raúl Méndez. Ana Latorre, Paula González.
Hospital Univ. Infanta Sofía. Teresa Ramírez Prieto. Miguel Ángel Salvador Maya.
Hospital Univ. La Princesa. Claudia Valenzuela.
Hospital Univ. Marqués de Valdecilla. José M. Cifrián Martínez.
Hospital Univ. Ntra. Sra. Candelaria. Juan Marco Figueira Gonçalves. Adrián Baeza Ruiz. Andrea Expósito Marrero. Nikita Gurbani.
Hospital Univ. Puerta de Hierro. Rosa Malo de Molna Ruiz
Hospital Univ. Sagrat Cor. Marina Galdeano Lozano.
Hospital Univ. San Agustín. Manuel Villanueva Montes.
Hospital Univ. Son Espases. Nuria Toledo Pons. Luisa Ramón Clar.
Hospital Univ. Torrejón. Alba Esperanza Barrios.
Hospital Univ. Virgen del Rocío. Pilar Cejudo Ramos. Cecilia López Ramírez. Mirella Gaboli.
Hospital Univ. Virgen Macarena. Virginia Almadana Pacheco.
Hospital Univ. Arnau de Vilanova. Ferran Eduard Barbé Illa. Anna Clara.
Hospital Virgen de la Luz. Nuria Gutiérrez González.
Hospital Virgen de la Victoria. Eva Cabrera César.
Acknowledgments
Miriam Ovejero (SEPAR), Rafael Santana (data manager). SEPAR has contributed administrative personnel for logistical support, as well as a methodology and research platform. SEPAR’s integrated respiratory infection research program.
Author Contributions
All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.
Disclosure
Dr Pedro Pablo España reports personal fees from Glaxo, grants from Pfizer, outside the submitted work. Drs Nuria Toledo-Pons reports personal fees from GSK, Chiesi; non-financial support from FAES and Sanofi, outside the submitted work. The authors report no other conflicts of interest in this work.