Impact of the Presence of Chronic Respiratory Diseases on the Mortality of Hospitalized Patients with COVID-19 Pneumonia: A Single Center Experience

Objective: The influence of coexisting chronic respiratory diseases (CRDs) on the prognosis of patients with severe acute respiratory syndrome- coronavirus-2 (SARS-CoV-2) infection is debatable. This study aimed to investigate the consequences of CRDs on the mortality of coronavirus disease-2019 (COVID-19) pneumonia inpatients.
Material and Methods: Hospitalized patients with confirmed SARS-CoV-2 infection were included. The data were derived from electronic medical records retrospectively and patients with and without CRD past history were analyzed concerning in-hospital mortality.
Results: In 1.529 patients with COVID-19 pneumonia, 54 (58.1%) were male and the mean age was 61.18±15.03 years. A total of 245 individuals were diagnosed with CRD. The CRD group consisted of asthma (128 cases, 52.24%), chronic obstructive pulmonary disease [(COPD), 79 cases, 32.37%], lung cancer (15 cases, 6.14%), obstructive sleep apnea syndrome (12 cases, 4.91%), and interstitial lung disease [(ILD), 11 cases, 4.5%]. Mean age, female gender, respiratory rate, and supplemental oxygen requirement were significantly higher in the CRD group (p=0.001; p<0.01 for all). In-hospital mortality was 11.8% (29 cases) in the CRD group and 8.4% (108 cases) in the group without CRD. In univariate analysis, there was no significant difference in-hospital mortality between the two groups (p>0.05). Although CRD patients had a similar mortality ratio compared with non-CRD patients on multivariate logistic analysis [odds ratio (OR): 0.262, 95% confidence interval (CI): 0.071-0.968; p=0.045]; COPD and ILD subgroups exhibited 2.1 fold (OR: 2.1, 95% CI: 1.13-3.92; p=0.017) and 3.87 fold (OR: 3.87, 95% CI: 1.015-14.772; p=0.033) increased risk of in-hospital mortality respectively.
Conclusion: Even though patients with COVID-19 pneumonia and CRDs do not have a higher mortality rate, it is crucial to closely monitor these patients because of the elevated mortality risk associated with COPD and ILD.