Outcomes of Patients with COPD Hospitalized for Coronavirus Disease 2019

Puebla Neira, Daniel A; Watts, Abigail; Seashore, Justin; Duarte, Alexander; Nishi, Shawn P; Polychronopoulou, Efstathia; Kuo, Yong-Fang; Baillargeon, Jacques; Sharma, Gulshan

Rationale: There is controversy concerning the association of chronic obstructive pulmonary disease (COPD) as an independent risk factor for mortality in patients hospitalized with Coronavirus Disease 2019 (COVID-19). We hypothesize that patients with COPD hospitalized for COVID-19 have increased mortality risk. Objective: To assess whether COPD increased the risk of mortality among patients hospitalized for COVID-19. Methods: Retrospective cohort analysis of patients with COVID-19 between February 10, 2020 and November 10, 2020 and hospitalized within 14 days of diagnosis. Electronic health records from US facilities (Optum COVID-19 data) were used. Results: In our cohort of 31,526 patients, 3,030 (9.6%) died during hospitalization. Mortality in patients with COPD was higher than that of patients without COPD, 14.02% and 8.8%, respectively. Univariate [Odds Ratio (OR) 1.68; 95% Confidence Interval (CI) 1.54 -1.84] and multivariate (OR 1.33; 95% CI 1.18 - 1.50) analysis showed that patients with COPD had greater odds of death due to COVID-19 than patients without COPD. We found significant interactions between COPD and sex and COPD and age. Specifically, the increased mortality risk associated with COPD was observed among female (OR 1.62; 95% CI 1.36 - 1.95) but not male patients (OR 1.14; 95% CI 0.97 - 1.34); and in patients aged 40 to 64 (OR 1.42; 95% CI 1.07 - 1.90) and 65 to 79 (OR 1.48; 95% CI 1.23 - 1.78) years. Conclusions: COPD is an independent risk factor for death in adults aged 40 to 79 years hospitalized with COVID-19 infection.