4.6 Article

Prognosis Predictive Markers in Patients with Chronic Obstructive Pulmonary Disease and COVID-19

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DIAGNOSTICS
卷 13, 期 15, 页码 -

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MDPI
DOI: 10.3390/diagnostics13152597

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COPD; COVID-19; SARS-CoV-2 infection; biomarkers; predictive model; mortality; intensive care unit; mechanical ventilation

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Some studies show that chronic respiratory illnesses in COVID-19 patients lead to higher hospitalization and death rates, while others suggest the opposite. This research aims to establish a predictive model for patients with both chronic obstructive pulmonary disease (COPD) and COVID-19 to determine their outcomes. The study analyzed a cohort of 165 patients with both diseases and identified several indicators, such as severity of COVID-19, renal failure, diabetes, smoking status, oxygen therapy requirement, high LDH and CRP levels, and low eosinophil and lymphocyte counts, as predictors of poor prognosis. Factors associated with poor prognosis in patients with both COPD and COVID-19 were similar to those in patients with only COVID-19.
Some studies have reported that chronic respiratory illnesses in patients with COVID-19 result in an increase in hospitalization and death rates, while other studies reported to the contrary. The present research aims to determine if a predictive model (developed by combing different clinical, imaging, or blood markers) could be established for patients with both chronic obstructive pulmonary disease (COPD) and COVID-19, in order to be able to foresee the outcomes of these patients. A prospective observational cohort of 165 patients with both diseases was analyzed in terms of clinical characteristics, blood tests, and chest computed tomography results. The beta-coefficients from the logistic regression were used to create a score based on the significant identified markers for poor outcomes (transfers to an intensive care unit (ICU) for mechanical ventilation, or death). The severity of COVID-19, renal failure, diabetes, smoking status (current or previous), the requirement for oxygen therapy upon admission, high lactate dehydrogenase (LDH) and C-reactive protein level (CRP readings), and low eosinophil and lymphocyte counts were all identified as being indicators of a poor prognosis. Higher mortality was linked to the occurrence of renal failure, the number of affected lobes, the need for oxygen therapy upon hospital admission, high LDH, and low lymphocyte levels. Patients had an 86.4% chance of dying if their mortality scores were -2.80 or lower, based on the predictive model. The factors that were linked to a poor prognosis in patients who had both COPD and COVID-19 were the same as those that were linked to a poor prognosis in patients who had only COVID-19.

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