Patients with chronic obstructive pulmonary disease (COPD) do not face greater odds of COVID-19 hospitalization or related death/hospice referral vs patients without COPD, according to study findings published in Respiratory Medicine.
Investigators aimed to compare the likelihood of COVID-19-related hospitalization among patients with and without COPD. Death/hospice referral following COVID-19 was the secondary endpoint.
This retrospective cohort study included 19,558 patients who were members the Kaiser Permanente Northern California (KPNC) health system. All patients were at least 40 years of age and had tested positive for SARS-CoV-2 infection at least 1 year after becoming KPNC members. The investigators reviewed health system and claims data using sequentially adjusted logistic regression models to assess COVID-19-related hospitalization risk stratified by disease severity.
Investigators found 697 (3.6%) of the 19,558 patients with COVID-19 had COPD. Patients with COPD vs patients without COPD, respectively, had more median baseline emergency (2 vs 1), inpatient (2 vs 1) and outpatient (8 vs 4) encounters. Patients with COPD vs those without also had a higher Elixhauser Comorbidity Index (5 vs 0, respectively) and were older (median age, 69 vs 53 years, respectively). Fewer patients with COPD and COVID-19 had ever smoked (34.7%) compared with patients with COVID-19 who did not have COPD (71.9%). Demographically, the COPD vs non-COPD groups, respectively, were 44% vs 25% White, 25% vs 47% Hispanic, 7% vs 13% Asian, 12% vs 7% Black, and 56% vs 52% female.
Unadjusted analyses showed increased odds of hospitalization among patients with COPD (odds ratio [OR], 3.93; 95% CI, 3.40-4.60). However, when fully adjusted for other risks, analyses showed no differences in odds of hospitalization (OR, 1.14; 95% CI, 0.93-1.40) or death/hospice referral (OR, 0.96; 95% CI, 0.72-1.27) between patients with and without COPD. Moreover, primary and secondary outcomes did not differ by COPD severity.
Notably, patients with COPD needing supplemental oxygen had a higher risk for hospitalization for COVID-19 than patients without COPD (OR, 1.84; 95% CI, 1.02-3.33).
Except for hospitalization among patients using supplemental oxygen, no differences in odds of hospitalization or death/hospice referral were observed in the COVID-19 patient sample depending on whether they had COPD.
Study limitations include the use of administrative codes that potentially lacked sensitivity to identify patients with COPD; exclusion of uninsured patients; the potential under-diagnosis of COPD due to unavailability of pulmonary function testing data; potential underreporting of outpatient deaths; and limited data for measuring COPD severity.
“Except for hospitalization among patients using supplemental oxygen, no differences in odds of hospitalization or death/hospice referral were observed in the COVID-19 patient sample depending on whether they had COPD,” the investigators concluded. These findings may benefit clinicians communicating potential risks associated with COVID-19 to patients with COPD, said study authors.
Disclosure: This research was supported by Boehringer Ingelheim Inc. Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.