摘要：

Aims & objectives: Individuals with COPD have increased risk of severe pneumonia and poor outcomes when they develop SARS-CoV-2 (Hoffmann 2020). We hypothesised that there would be a difference in survival between COPD phenotypes with SARS-CoV-2 infections requiring hospital admission.Methods: Observational retrospective analysis of individuals admitted to critical care was performed during the first peak of the SARS-CoV-2 pandemic. Individuals with COPD were identified and grouped into phenotypes; frequent exacerbators (≥2 severe exacerbations in the last 12 months), emphysema-predominant, chronic bronchitis (cough and sputum production) and eosinophilic-predominant (plasma eosinophil count ≥ 300 cells/L). Survival for all phenotypes was compared using Kaplan-Meier methodology.Results: 508 individuals were admitted to hospital with SARS-CoV-2 infection. 55 (11%) of these individuals had a diagnosis of COPD. Survival was significantly lower in all individuals with SARS-CoV-2 infection (34%) compared to individuals with SARS-CoV-2 infection and co-existing COPD (58%) (p=0.0003). There was no difference between baseline characteristics between COPD phenotypes. Median (IQR) FEV1 0.79 (0.62, 1.75) L, FVC 2.68 (1.83, 3.22) L. There was no significant difference in survival between all 4 phenotypes; median survival for frequent exacerbators, emphysema-predominant, chronic bronchitis and eosinophilia-predominant (113 vs 7 vs 39 vs 36 respectively), X2 (2) = 3.9, p=0.3.Conclusions: These data do not support the hypothesis that COPD phenotype would result in a difference in a difference in survival. Further study should investigate factors which predict survival of SARS-CoV-2 infection in individuals with co-existent COPD in a larger population.

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