目的:这项回顾性队列研究旨在探讨慢性阻塞性肺疾病(COPD)与感染Omicron变异型COVID-19患者预后之间的关系。主要目标是确定患有COPD的COVID-19患者与没有COPD的患者相比是否有更高的死亡率。次要目标包括评估呼吸衰竭的风险,住院时间,重症监护病房(ICU)入院,COPD合并COVID-19患者的氧需求。
方法:该研究包括玛格丽特公主医院收治的2761例COVID-19患者,香港,2022年1月1日至6月30日。其中,7.4%(n=205)患有COPD。人口统计学和临床数据,包括疫苗接种状况和合并症,被收集。主要结果是30天死亡率,次要结局包括呼吸支持需求,住院时间,ICU入院。进行Logistic回归分析,调整潜在的混杂因素。
结果:校正混杂因素后,COPD并没有独立增加COVID-19死亡的风险。相反,年龄较大,男性,不完全疫苗接种,长期使用氧疗,特定的合并症被确定为30日死亡率的重要预测因子.COPD患者更可能需要氧气和无创通气,但与非COPD患者相比,其他次要结局无显著差异.
结论:COPD本身不是COVID-19死亡率的独立危险因素。年龄,性别,疫苗接种状况,合并症,长期氧疗是死亡率的重要预测因素.这些发现强调了在评估COPD对COVID-19预后的影响时考虑多种因素的重要性,特别是Omicron变体。
OBJECTIVE: This retrospective cohort study aimed to investigate the association between chronic obstructive pulmonary disease (COPD) and the prognosis of COVID-19 patients infected with the Omicron variant. The primary objective was to determine if COVID-19 patients with COPD had higher mortality rates compared to those without COPD. Secondary objectives included assessing the risk of respiratory failure, hospital stay length, intensive care unit (ICU) admission, and oxygen requirements in COPD patients with COVID-19.
METHODS: The study included 2761 COVID-19 patients admitted to the Princess Margaret Hospital, Hong Kong, between January 1 and June 30, 2022. Among them, 7.4% (n = 205) had COPD. Demographic and clinical data, including vaccination status and comorbidities, were collected. The primary outcome was 30-day mortality, and secondary outcomes included respiratory support requirement, hospital stay length, and ICU admission. Logistic regression analyses were conducted, adjusting for potential confounders.
RESULTS: COPD did not independently increase the risk of COVID-19 mortality after adjusting for confounders. Instead, older age, male sex, incomplete vaccination, long-term oxygen therapy use, and specific comorbidities were identified as significant predictors of 30-day mortality. COPD patients were more likely to require oxygen and noninvasive ventilation, but there were no significant differences in other secondary outcomes compared to non-COPD patients.
CONCLUSIONS: COPD itself was not an independent risk factor for COVID-19 mortality. Age, sex, vaccination status, comorbidities, and long-term oxygen therapy use were important predictors of mortality. These findings underscore the importance of considering multiple factors when assessing the impact of COPD on COVID-19 prognosis, particularly with the Omicron variant.