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Is COPD a risk factor for COVID-19?

Wednesday, October 21, 2020 - Oxygen
Man on Oxygen Therapy

As of September 30, 2020, the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for the coronavirus disease 2019 (COVID-19) pandemic, has infected over 30 million people around the world and caused more than 1 million deaths. Given the devastating impact that COVID-19 can have on the lung, it is natural to fear for patients with underlying COPD. Currently, there is limited data and information about the impact of underlying medical conditions and whether they increase the risk for severe illness from COVID-19. However, based on multiple research studies that have been published to date, it is possible to anticipate that patients with impaired or compromised lung conditions, particularly COPD and asthma are at particular risk for COVID-19 with worse outcomes.

COPD & COVID

It is important to note that while having COPD may not increase the risk of developing an infection with the new coronavirus, the lung damage caused by COPD may increase the chance of developing more severe COVID-19 symptoms. COPD can cause the airways in the lungs to become chronically inflamed. This can obstruct the airways, lead to poor airflow, and even destroy the portion of the lungs involved in gas exchange.

A recent meta-analysis epidemiological study, used to systematically assess multiple COVID-19 research studies, found COPD to be one of the most prevalent underlying diseases present in patients hospitalized for COVID-19. Similarly, a recent CDC surveillance data published in the Morbidity and Mortality Weekly Report (MMWR) indicated that the most common underlying health conditions were:

  • cardiovascular disease (32%)
  • diabetes (30%)
  • chronic lung disease (18%).

According to another meta-analysis epidemiological study, people with COPD are five times more likely to develop COVID-19 as a result of contracting SARS-CoV-2. This analysis also determined that patients with COPD are more likely to have profound oxygenation issues and are more likely to be admitted to an intensive care unit, and to need mechanical ventilation. The same research determined that people with COPD are more likely to succumb to COVID-19.

COPD risk of infection

Patients with a history of COPD should be encouraged to adopt more restrictive measures for minimizing potential exposure to SARS-CoV-2 and contact with suspected or confirmed cases of COVID-19. Clinicians taking care of patients with chronic lung disease should carefully monitor all COPD patients with suspected infection. Additionally, clinicians are key to help educate those patients about COVID-19 including the practice of hand washing with soap and water, avoiding touching eyes/nose/mouth, covering coughs or sneezes with tissue paper, and cleaning and disinfecting frequently touched objects and surfaces. 

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References

  • Emami A, Javanmardi F, Pirbonyeh N, Akbari A. Prevalence of Underlying Diseases in Hospitalized Patients with COVID-19: a Systematic Review and Meta-Analysis. Arch Acad Emerg Med. 2020;8(1):e35. Published 2020 Mar 24.
  • Stokes EK, Zambrano LD, Anderson KN, et al. Coronavirus Disease 2019 Case Surveillance — United States, January 22–May 30, 2020. MMWR Morb Mortal Wkly Rep 2020;69:759–765. DOI: http://dx.doi.org/10.15585/mmwr.mm6924e2
  • Lippi, G., & Henry, B. M. (2020). Chronic obstructive pulmonary disease is associated with severe coronavirus disease 2019 (COVID-19). Respiratory Medicine, 167, 105941. doi:10.1016/j.rmed.2020.105941
  • Sanchez-Ramirez, D. C., & Mackey, D. (2020). Underlying respiratory diseases, specifically COPD, and smoking are associated with severe COVID-19 outcomes: A systematic review and meta-analysis. Respiratory Medicine, 171, 106096. doi:10.1016/j.rmed.2020.106096
  • Attaway, A. A., Zein, J., & Hatipoğlu, U. S. (2020). SARS-CoV-2 infection in the COPD population is associated with increased healthcare utilization: An analysis of Cleveland clinic's COVID-19 registry. EClinicalMedicine, 100515. doi:10.1016/j.eclinm.2020.100515

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