| Peer-Reviewed

COPD and COVID-19 Pneumonia: A Retrospective Single Center Analysis of Respiratory Status and Outcome

Received: 20 May 2022     Accepted: 16 June 2022     Published: 20 July 2022
Views:       Downloads:
Abstract

Acute respiratory syndrome caused by SARS-CoV-2 is associated with severe mortality in the general population. COPD patients are at risk for severe pneumonia and poor prognosis associated with COVID-19 infection. This may be due to insufficient lung reserve or the expression of the ACE-2 receptor in the small airways. We wanted to find out if COPD patients had more severe COVID-19 pneumonia and worse clinical outcomes. We did a retrospective analysis of 101 patients with COVID-19 admitted to the Pulmonology Department of Monaldi Hospital (Naples) from November 2020 to May 2021. The calculated criteria were obtained only by patients with positive real-time reverse-transcriptase-polymerase chain reaction (RT-PCR). The study included computed tomography (CT) scans with specific COVID-19 results. We used fractional inhaled oxygen (PaO2/FiO2) to assess respiratory status and Chung score on chest TC to assess the severity of COVID-19 pneumonia. We investigated comorbidities, need of ventilation (NIV/CPAP), hospitalization and patients’ outcome. We used descriptive statistics, Chi square test and independent sample test to analyze our population. Out of 101 patients, 10,89% of them had COPD in anamnesis or had enphysema on chest TC. In the patients without COPD the mean P/F ratio was 167,9 (SD: 93.854). Their mean Chung score was 12,178 (SD: 3,505). They had an average of 20.111 (SD: 11.037) hospitalization days. 40% of them needed non-invasive ventilation (including CPAP) and 28,9% of them died. In patients with COPD the mean P/F ratio was 124,273 (SD: 61,254). Their mean Chung score was 11,727 (SD: 4,149). They had a mean hospitalization days of 22,273 (SD: 11,714). 63,636% of them needed non-invasive ventilation (including CPAP) and 72,727% of them died. In COPD patients we observed a higher prevalence of obesity, a higher number of deaths and a higher LDH value. In particular in obese patients that needed noninvasive ventilation we found a longer hospitalization and a higher LDH value. Although the two groups studied had the same severity of respiratory status and pneumonia, we found a worse outcome in patients with COPD.

Published in International Journal of Biomedical Science and Engineering (Volume 10, Issue 3)
DOI 10.11648/j.ijbse.20221003.11
Page(s) 61-68
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

COVID-19, COPD, Obesity, Lactate Dehydrogenase

References
[1] WHO. (s.d.). WHO. Situation Report -22 2020. Tratto da WHO: https://www.who.int/docs/default-source/
[2] WHO. (s.d.). Tratto da https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd)
[3] Su S, W. G. (2016). Epidemiology, Genetic Recombination, and Pathogenesis of Coronaviruses. Trends Microbiol., 24 (6): 490–502. doi: https://doi.org/10.1016/j.tim.2016.03.003.
[4] Zhu N, Z. D. (2020). A Novel Coronavirus from Patients with Pneumonia in China. 382 (8): 727–33. doi: https://doi.org/10.1056/NEJMoa2001017.
[5] WHO. (2022, May 18). Coronavirus disease (COVID-2019) Situation Report 2022-Weekly epidemiological update. Tratto da WHO: http://www.who.int
[6] Anka AU, T. M. (2021, April). Coronavirus disease 2019 (COVID-19): An overview of the immunopathology, serological diagnosis and management. Scand J Immunol., 93 (4): e12998. doi: doi: 10.1111/sji.12998.
[7] P. Mehta, D. M. (2020). Speciality Collaboration, COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet 395, 1033–1034. doi: https://doi.org/10.1016/S0140-6736(20)30628-0.
[8] C. Zhang, Z. W. (2020). Cytokine release syndrome in severe COVID-19: interleukin-6 receptor antagonist tocilizumab may be the key to reduce mortality. Int. J. Antimicrob. Agents 55, 105954. doi: https://doi.org/10.1016/j.ijantimicag.2020.105954.
[9] F. J. Warner, A. S. (2004). Angiotensin-converting enzyme-2: a molecular and cellular perspective. Cell. Mol. Life Sci. 61, 2704–2713. doi: https://doi.org/10.1007/s00018-004-4240-7.
[10] Cevik M, B. C. (2020;). COVID-19 pandemic-a focused review for clinicians. Clin Microbiol Infect, 26: 842-7. doi: doi: 10.1016/j.cmi.2020.04.023 pmid: 32344166.
[11] Mahmud-Al-Rafat, M. M.-R. (2020). A combinational approach to restore cytokine balance and to inhibit virus growth may promote patient recovery in severe COVID-19 cases. Cytokine 136, 155228. doi: https://doi.org/10.1016/j.cyto.2020.155228.
[12] Darif D, H. I. (2021). The pro-inflammatory cytokines in COVID-19 pathogenesis: What goes wrong? Microb Pathog., 153: 104799. doi: doi: 10.1016/j.micpath.2021.104799.
[13] Sia SF, Y. L. (2020). Pathogenesis and transmission of SARS-CoV-2 in golden hamsters. Nature, 583: 834-8. doi: doi: 10.1038/s41586-020-2342-5.
[14] Monteil V, K. H. (2020). Inhibition of SARS-CoV-2 infections in engineered human tissues using clinical-grade soluble human ACE2. Cell, 181: 905-913.e7. doi: doi: 10.1016/j.cell.2020.04.004.
[15] Herold T., e. a. (2020). Elevated levels of IL-6 and CRP predict the need for mechanical ventilation in COVID-19. J Allergy Clin Immunol, 2020., 146 (1): p. 128–136 e4. doi: https://doi.org/10.1016/j.jaci.2020.05.008.
[16] Poggiali E., e. a. (2020). Lactate dehydrogenase and C-reactive protein as predictors of respiratory failure in COVID-19 patients. Clin Chim Acta, 509: p. 135–138. doi: https://doi.org/10.1016/j.cca.2020.06.012.
[17] Huang I., e. a. (2020). C-reactive protein, procalcitonin, D-dimer, and ferritin in severe coronavirus disease-2019: a meta-analysis. Ther Adv Respir Dis, 14: p. 1753466620937175. doi: https://doi.org/10.1177/1753466620937175.
[18] Henry B. M., e. a. (2020). Lactate dehydrogenase levels predict coronavirus disease 2019 (COVID-19) severityand mortality: A pooled analysis. Am J Emerg Med, 38 (9): p. 1722–1726. doi: https://doi.org/10.1016/ j.ajem.2020.05.073.
[19] Cianci R., e. a. (2021). Correlation between lactate dehydrogenase and therapeutic strategy in COVID-19 pneumonia. European Respiratory Journal 2021, 58: PA1091. doi: 10.1183/13993003.congress-2021.PA1091.
[20] GOLD. (s.d.). https://goldcopd.org. Tratto da https://goldcopd.org/2022-gold-reports-2/
[21] 2020, W. C.-2. (2020). https://www.who.int/. Tratto da WHO.
[22] De Ramón Fernández A, R. F.-J. (2020). Support System for Early Diagnosis of Chronic Obstructive Pulmonary Disease Based on the Service-Oriented Architecture Paradigm and Business Process Management Strategy: Development and Usability Survey Among Patients and Health Care Providers. J Med Internet Res., 22 (3): e17161. doi: 10.2196/17161.
[23] Miravitlles M, S. J.-R.-T. (2009). Prevalence of COPD in Spain: impact of undiagnosed COPD on quality of life and daily life activities. Thorax., 64 (10): 863–8. doi: 10.1136/thx.2009.115725.
[24] Seemungal TA, D. G. (1998). Effect of exacerbation on quality of life in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med., 157 (5 Pt 1): 1418–22.
[25] White AJ, G. S. (2003). Chronic obstructive pulmonary disease. 6: The aetiology of exacerbations of chronic obstructive pulmonary disease. Thorax., 58 (1): 73–80. doi: 10.1136/thorax.58.1.73.
[26] Leung JM, Y. C. (2020). ACE-2 Expression in the small airway epithelia of smokers and COPD patients: implications for COVID-19. Eur Respir J 2020, 55: 2000688.
[27] Gershon AS, T. D. (2018). Health services burden of undiagnosed and overdiagnosed COPD. Chest 2018, 153: 1336–1346.
[28] Yang J, Z. Y. (2020, May). Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis, 94: 91-95. doi: 10.1016/j.ijid.2020.03.017.
[29] Cecconi M, P. D. (2020). Early predictors of clinical deterioration in a cohort of 239 patients hospitalized for COVID-19 infection in Lombardy, Italy. 2020;. J Clin Med, 9: 1548.
[30] Inciardi RM, A. M. (2020). Characteristics and outcomes of patients hospitalized for COVID-19 and cardiac disease in Northern Italy. 2020;. Eur Heart J, 41: 1821–1829.
[31] Alqahtani JS, O. T. (2020). Prevalence, severity and mortality associated with COPD and smoking in patients with COVID-19: a rapid systematic review and meta-analysis. PLoS One, 15: e0233147.
[32] Li W, M. M. (2003). Angiotensin-converting enzyme 2 is a functional receptor for the SARS coronavirus.. Nature, 426: 450–454.
[33] Hoffmann M, K.-W. H. (2020). SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell 2020;, 181: 271–280.
[34] Leung JM, N. M. (2020). COVID-19 and COPD. Eur Respir J., 56 (2): 2002108. doi: 10.1183/13993003.02108-2020.
[35] Cai G, B. Y. (2020). Tobacco smoking increases the lung gene expression of ACE2, the receptor of SARS-CoV-2. Am J Respir Crit Care Med, 201: 1557–1559.
[36] Russo P, B. S. (2020). COVID-19 and smoking: is nicotine the hidden link? Eur Respir J, 55: 2001116.
[37] Hurst JR, S. N. (2020). Understanding the impact of chronic obstructive pulmonary disease exacerbations on patient health and quality of life. European journal of internal medicine, 73: 1–6. doi: 10.1016/j.ejim.2019.12.014.
[38] Yang J, Z. Y. (2020). Prevalence of comorbidities in the novel Wuhan coronavirus (COVID-19) infection: a systematic review and meta-analysis. International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases.
[39] Koo HJ, L. S. (2018). Radiographic and CT Features of Viral Pneumonia. RadioGraphics, 38 (3): 719–739.
[40] Chung M, B. A. (2020). CT imaging features of 2019 novel coronavirus (2019-nCoV). Radiology, 295 (1): 202–7.
[41] Kuno T, T. M. (2020). Cardiovascular comorbidities, cardiac injury and prognosis of COVID-19 in New York City. Am Heart J, 226: 24–25.
[42] Palaiodimos L, K. D. (2020). Severe obesity, increasing age and male sex are independently associated with worse in-hospital outcomes, and higher in-hospital mortality, in a cohort of patients with COVID-19 Bronx, New York. Metab Clin Exp, 108: 154262.
[43] Vestbo J, H. S. (2013). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med, 187: 347–65.
[44] Poulain M, D. M. (2008). Metabolic and inflammatory profile in obese patients with chronic obstructive pulmonary disease. Chron Respir Dis., 5: 35–41.
[45] Sawadogo W, T. M. (2022). Overweight and obesity as risk factors for COVID-19-associated hospitalisations and death: systematic review and meta-analysis. BMJ Nutrition, Prevention & Health, e000375. doi: 10.1136/bmjnph-2021-000375.
[46] Orozco-Levi, M. (2003). 11 Structure and function of the respiratory muscles in patients with COPD: impairment or adaptation? European Respiratory Journal, 46 suppl) 41s-51s.
[47] Spruit, M. A., Pennings, H. J., Does, J. D., Möller, G. M., Janssen, P. P., & altri. , e. (2008). Serum LDH and exercise capacity in COPD. Thorax,; London Vol. 63, Fasc. 5,): 472.
Cite This Article
  • APA Style

    Cianci Roberta, Masi Umberto, Buonincontro Miriam, Squillante Francesco, Bocchino Vincenzo. (2022). COPD and COVID-19 Pneumonia: A Retrospective Single Center Analysis of Respiratory Status and Outcome. International Journal of Biomedical Science and Engineering, 10(3), 61-68. https://doi.org/10.11648/j.ijbse.20221003.11

    Copy | Download

    ACS Style

    Cianci Roberta; Masi Umberto; Buonincontro Miriam; Squillante Francesco; Bocchino Vincenzo. COPD and COVID-19 Pneumonia: A Retrospective Single Center Analysis of Respiratory Status and Outcome. Int. J. Biomed. Sci. Eng. 2022, 10(3), 61-68. doi: 10.11648/j.ijbse.20221003.11

    Copy | Download

    AMA Style

    Cianci Roberta, Masi Umberto, Buonincontro Miriam, Squillante Francesco, Bocchino Vincenzo. COPD and COVID-19 Pneumonia: A Retrospective Single Center Analysis of Respiratory Status and Outcome. Int J Biomed Sci Eng. 2022;10(3):61-68. doi: 10.11648/j.ijbse.20221003.11

    Copy | Download

  • @article{10.11648/j.ijbse.20221003.11,
      author = {Cianci Roberta and Masi Umberto and Buonincontro Miriam and Squillante Francesco and Bocchino Vincenzo},
      title = {COPD and COVID-19 Pneumonia: A Retrospective Single Center Analysis of Respiratory Status and Outcome},
      journal = {International Journal of Biomedical Science and Engineering},
      volume = {10},
      number = {3},
      pages = {61-68},
      doi = {10.11648/j.ijbse.20221003.11},
      url = {https://doi.org/10.11648/j.ijbse.20221003.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijbse.20221003.11},
      abstract = {Acute respiratory syndrome caused by SARS-CoV-2 is associated with severe mortality in the general population. COPD patients are at risk for severe pneumonia and poor prognosis associated with COVID-19 infection. This may be due to insufficient lung reserve or the expression of the ACE-2 receptor in the small airways. We wanted to find out if COPD patients had more severe COVID-19 pneumonia and worse clinical outcomes. We did a retrospective analysis of 101 patients with COVID-19 admitted to the Pulmonology Department of Monaldi Hospital (Naples) from November 2020 to May 2021. The calculated criteria were obtained only by patients with positive real-time reverse-transcriptase-polymerase chain reaction (RT-PCR). The study included computed tomography (CT) scans with specific COVID-19 results. We used fractional inhaled oxygen (PaO2/FiO2) to assess respiratory status and Chung score on chest TC to assess the severity of COVID-19 pneumonia. We investigated comorbidities, need of ventilation (NIV/CPAP), hospitalization and patients’ outcome. We used descriptive statistics, Chi square test and independent sample test to analyze our population. Out of 101 patients, 10,89% of them had COPD in anamnesis or had enphysema on chest TC. In the patients without COPD the mean P/F ratio was 167,9 (SD: 93.854). Their mean Chung score was 12,178 (SD: 3,505). They had an average of 20.111 (SD: 11.037) hospitalization days. 40% of them needed non-invasive ventilation (including CPAP) and 28,9% of them died. In patients with COPD the mean P/F ratio was 124,273 (SD: 61,254). Their mean Chung score was 11,727 (SD: 4,149). They had a mean hospitalization days of 22,273 (SD: 11,714). 63,636% of them needed non-invasive ventilation (including CPAP) and 72,727% of them died. In COPD patients we observed a higher prevalence of obesity, a higher number of deaths and a higher LDH value. In particular in obese patients that needed noninvasive ventilation we found a longer hospitalization and a higher LDH value. Although the two groups studied had the same severity of respiratory status and pneumonia, we found a worse outcome in patients with COPD.},
     year = {2022}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - COPD and COVID-19 Pneumonia: A Retrospective Single Center Analysis of Respiratory Status and Outcome
    AU  - Cianci Roberta
    AU  - Masi Umberto
    AU  - Buonincontro Miriam
    AU  - Squillante Francesco
    AU  - Bocchino Vincenzo
    Y1  - 2022/07/20
    PY  - 2022
    N1  - https://doi.org/10.11648/j.ijbse.20221003.11
    DO  - 10.11648/j.ijbse.20221003.11
    T2  - International Journal of Biomedical Science and Engineering
    JF  - International Journal of Biomedical Science and Engineering
    JO  - International Journal of Biomedical Science and Engineering
    SP  - 61
    EP  - 68
    PB  - Science Publishing Group
    SN  - 2376-7235
    UR  - https://doi.org/10.11648/j.ijbse.20221003.11
    AB  - Acute respiratory syndrome caused by SARS-CoV-2 is associated with severe mortality in the general population. COPD patients are at risk for severe pneumonia and poor prognosis associated with COVID-19 infection. This may be due to insufficient lung reserve or the expression of the ACE-2 receptor in the small airways. We wanted to find out if COPD patients had more severe COVID-19 pneumonia and worse clinical outcomes. We did a retrospective analysis of 101 patients with COVID-19 admitted to the Pulmonology Department of Monaldi Hospital (Naples) from November 2020 to May 2021. The calculated criteria were obtained only by patients with positive real-time reverse-transcriptase-polymerase chain reaction (RT-PCR). The study included computed tomography (CT) scans with specific COVID-19 results. We used fractional inhaled oxygen (PaO2/FiO2) to assess respiratory status and Chung score on chest TC to assess the severity of COVID-19 pneumonia. We investigated comorbidities, need of ventilation (NIV/CPAP), hospitalization and patients’ outcome. We used descriptive statistics, Chi square test and independent sample test to analyze our population. Out of 101 patients, 10,89% of them had COPD in anamnesis or had enphysema on chest TC. In the patients without COPD the mean P/F ratio was 167,9 (SD: 93.854). Their mean Chung score was 12,178 (SD: 3,505). They had an average of 20.111 (SD: 11.037) hospitalization days. 40% of them needed non-invasive ventilation (including CPAP) and 28,9% of them died. In patients with COPD the mean P/F ratio was 124,273 (SD: 61,254). Their mean Chung score was 11,727 (SD: 4,149). They had a mean hospitalization days of 22,273 (SD: 11,714). 63,636% of them needed non-invasive ventilation (including CPAP) and 72,727% of them died. In COPD patients we observed a higher prevalence of obesity, a higher number of deaths and a higher LDH value. In particular in obese patients that needed noninvasive ventilation we found a longer hospitalization and a higher LDH value. Although the two groups studied had the same severity of respiratory status and pneumonia, we found a worse outcome in patients with COPD.
    VL  - 10
    IS  - 3
    ER  - 

    Copy | Download

Author Information
  • Department of Pulmonology and Oncology, Respiratory Intensive Care Unit, Monaldi Hospital, Napoli, Italy

  • Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli" Monaldi Hospital, Napoli, Italy

  • Department of Pulmonology and Oncology, Respiratory Intensive Care Unit, Monaldi Hospital, Napoli, Italy

  • Department of Pulmonology and Oncology, Respiratory Intensive Care Unit, Monaldi Hospital, Napoli, Italy

  • Department of Pulmonology and Oncology, Respiratory Intensive Care Unit, Monaldi Hospital, Napoli, Italy

  • Sections