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The following is a summary of “Determining the Impact of COVID-19 Infection on Patients Hospitalized With COPD Exacerbations: A Nationwide Analysis,” published in the October 2024 issue of Pulmonology by Arumairaj et al. 

The impact of COVID-19 on people with chronic obstructive pulmonary disease (COPD) is uncertain, with studies showing both positive and negative effects. 

Researchers conducted a retrospective National Inpatient Sample (NIS) study to assess COVID-19’s effect on COPD exacerbation severity. 

They identified adult patients hospitalized with COVID-19 infections and COPD exacerbations from the 2020 NIS database. Statistical analysis was conducted using STATA/MP 17.0 software. P-values were calculated using the Chi-square test for categorical variables and the t-test for continuous variables. Multivariate logistic regression analysis was also performed. 

They identified 339,873 adult patients hospitalized with COVID-19 and 205,350 with COPD exacerbations from the 2020 NIS database. Patients with COPD exacerbations were categorized by COVID-19 status, 194,517 had COPD without COVID-19, and 10,833 had both conditions. Caucasians were the largest ethnic group, followed by African Americans and the lowest income quartile, and Medicaid insurance was most prevalent in both groups. 

Hospitalization outcomes, length of stay, invasive ventilation, and mortality rates were compared. The unadjusted OR for COPD patients with COVID-19 was 1.00, while the adjusted OR was 0.78 (P<0.001), indicating significantly lower hospitalizations for COPD with COVID-19. Length of stay was 9.2 days for those with COVID-19 and 5.7 days for those without, a statistically significant difference (P<0.001). The unadjusted OR for invasive ventilation was 1.96, and the adjusted OR was 2.00 (P<0.001), indicating a twofold higher need for invasive ventilation in patients with COPD and COVID-19. The unadjusted mortality OR was 6.07, with an adjusted OR of 5.62 (P<0.001), showing that mortality rates for patients with COPD and COVID-19 were over 5 times higher than for those without. 

They concluded that patients with COPD exacerbation and COVID-19 infection had worse outcomes, including more extended hospital stays, increased need for ventilation, and higher mortality rates compared to those without COVID-19. 

Source: journal.chestnet.org/article/S0012-3692(24)02055-5/fulltext