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ABSTRACT: Introduction
Patients with pre-existing respiratory diseases in the setting of COVID-19 may have a greater risk of severe complications and even death.Methods
A retrospective, multicenter, cohort study with 5847 COVID-19 patients admitted to hospitals. Patients were separated in two groups, with/without previous lung disease. Evaluation of factors associated with survival and secondary composite end-point such as ICU admission and respiratory support, were explored.Results
1,271 patients (22%) had a previous lung disease, mostly COPD. All-cause mortality occurred in 376 patients with lung disease (29.5%) and in 819 patients without (17.9%) (p < 0.001). Kaplan-Meier curves showed that patients with lung diseases had a worse 30-day survival (HR = 1.78; 95%C.I. 1.58-2.01; p < 0.001) and COPD had almost 40% mortality. Multivariable Cox regression showed that prior lung disease remained a risk factor for mortality (HR, 1.21; 95%C.I. 1.02-1.44; p = 0.02). Variables independently associated with all-cause mortality risk in patients with lung diseases were oxygen saturation less than 92% on admission (HR, 4.35; 95% CI 3.08-6.15) and elevated D-dimer (HR, 1.84; 95% CI 1.27-2.67). Age younger than 60 years (HR 0.37; 95% CI 0.21-0.65) was associated with decreased risk of death.Conclusions
Previous lung disease is a risk factor for mortality in patients with COVID-19. Older age, male gender, home oxygen therapy, and respiratory failure on admission were associated with an increased mortality. Efforts must be done to identify respiratory patients to set measures to improve their clinical outcomes.
SUBMITTER: Signes-Costa J
PROVIDER: S-EPMC7744014 | biostudies-literature | 2021 Apr
REPOSITORIES: biostudies-literature
Signes-Costa Jaime J Núñez-Gil Iván J IJ Soriano Joan B JB Arroyo-Espliguero Ramón R Eid Charbel Maroun CM Romero Rodolfo R Uribarri Aitor A Fernández-Rozas Inmaculada I Aguado Marcos García MG Becerra-Muñoz Víctor Manuel VM Huang Jia J Pepe Martino M Cerrato Enrico E Raposeiras Sergio S Gonzalez Adelina A Franco-Leon Francisco F Wang Lin L Alfonso Emilio E Ugo Fabrizio F García-Prieto Juan Fortunato JF Feltes Gisela G Abumayyaleh Mohammad M Espejo-Paeres Carolina C Jativa Jorge J Masjuan Alvaro López AL Macaya Carlos C Carbonell Asíns Juan A JA Estrada Vicente V
Archivos de bronconeumologia 20201216
<h4>Introduction</h4>Patients with pre-existing respiratory diseases in the setting of COVID-19 may have a greater risk of severe complications and even death.<h4>Methods</h4>A retrospective, multicenter, cohort study with 5847 COVID-19 patients admitted to hospitals. Patients were separated in two groups, with/without previous lung disease. Evaluation of factors associated with survival and secondary composite end-point such as ICU admission and respiratory support, were explored.<h4>Results</h ...[more]