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Clinical characteristics of and outcomes for patients with COVID-19 and comorbid lung diseases primarily hospitalized in a conventional pulmonology unit: a retrospective study - 12/11/20

Doi : 10.1016/j.resmer.2020.100801 
Marianne Riou, MD 1, 2, , Christophe Marcot, MD 1, Matthieu Canuet, MD 1, Benjamin Renaud-Picard, MD 1, Eva Chatron, MD 1, Michele Porzio, MD 1, Tristan Dégot, MD 1, Sandrine Hirschi, MD 1, Carine Metz-Favre, MD 1, Loïc Kassegne, MD 1, Carole Ederle, MD 1, 2, Naji Khayath, MD 1, 2, Aissam Labani, MD 3, Pierre Leyendecker, MD 3, Frédéric De Blay, MD PhD 1, 2, Romain Kessler, MD PhD 1, 4
1 Chest diseases department, Strasbourg University Hospital, France 
2 UR 3070 Federation of Translational Medicine, FHU Homicare, University of Strasbourg, France 
3 Department of Radiology B, Strasbourg University Hospital, France 
4 INSERM-UNISTRA, UMR 1260 “Regenerative NanoMedecine”, University of Strasbourg, France 

Corresponding Author: Department: Chest diseases department, Institute/University/Hospital: Strasbourg University Hospital, Street Name & Number: 1 place de l’hôpital, 67091 Strasbourg, FranceDepartment: Chest diseases department, Institute/University/Hospital: Strasbourg University HospitalStreet Name & Number: 1 place de l’hôpitalStrasbourg67091France

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Abstract

Background: Scant data are currently available about a potential link between comorbid chronic lung diseases and the risk and severity of the coronavirus disease 2019 (COVID-19) infection.

Methods: To describe the clinical characteristics of and outcomes for patients with COVID-19 infection, including patients with comorbid respiratory diseases, who have been primarily hospitalized in the pulmonology department of Strasbourg University Hospital, France. In this retrospective, single-center study, we included all confirmed cases of COVID-19 from March 3 to April 15, 2020. We then compared the symptoms, biological and radiological findings, and outcomes for patients with and without chronic lung disease.

Results: Of the 124 patients that were enrolled, the median age was 62 years, and 75 patients (60%) were male. Overall, 40% of patients (n = 50) had preexisting comorbid lung disease, including chronic obstructive pulmonary disease (COPD) (n = 15, 12%) and asthma (n = 19, 15%). Twenty-eight patients were transferred to the intensive care unit (ICU), and six patients died in our unit. Comorbid lung diseases were not predictive of ICU hospitalization, but a significantly higher total mortality was observed (17.6% vs. 5.5%, p < 0.05) in these patients.

Conclusions: Our results suggest the lack of an over-representation of CLD in COVID-19, representing 40% of patients in this cohort and even within a pulmonology department. CLD were not a risk factor for ICU management. However, a tendency to higher global mortality was observed in COVID-19 patients with CLD. Further studies are warranted to determine the risk of COVID-19 for patients with comorbid chronic lung diseases.

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Abbreviations : ACOS, COPD, COVID-19, CPAP, ICS, ICU, IQR, NIV, pO2, pCO2, RT-PCR, SARS-CoV-2

Keywords : asthma, COVID-19, COPD, coronavirus, SARS-CoV-2



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