Clinical characteristics of patients >65 years old with acute exacerbation of chronic obstructive pulmonary disease and COVID-19 infection
10.3760/cma.j.cn431274-20240104-00026
- VernacularTitle:>65岁慢性阻塞性肺疾病急性加重合并新型冠状病毒感染患者临床特征
- Author:
Yuanzhen JIAN
1
;
Caijun WU
;
Li LI
;
Jiahao DU
;
Aiguo ZHANG
;
Zhiyuan NIE
;
Qiaojie SUN
Author Information
1. 北京中医药大学第一临床医学院，北京 100700
- Keywords:
Pulmonary disease, chronic obstructive;
COVID-19;
Aged
- From:
Journal of Chinese Physician
2024;26(2):166-171
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical characteristics of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and corona virus disease 2019 (COVID-19) infection.Methods:Clinical data of AECOPD patients over 65 years old who were diagnosed in the Respiratory and Emergency Departments of the Dongzhimen Hospital, Beijing University of Chinese Medicine from September 2022 to September 2023 were collected. AECOPD patients were divided into a COVID-19 group ( n=29) and a non COVID-19 group ( n=31). The platelet count, white blood cell count, lymphocyte count, neutrophil count, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), C-reactive protein (CRP), procalcitonin (PCT), partial pressure of oxygen (PO 2), partial pressure of carbon dioxide (PCO 2), D-dimer (D-D), and interleukin-6 (IL-6) were compared between two groups of patients upon admission Confusion, Uremia, Respiratory, BP, Age 65 Years (CURB-65) was used to compare length of hospital stay, AECOPD grading, and mortality endpoint days. Results:There was no statistically significant difference in platelet count, white blood cell count, lymphocyte count, neutrophil count, NLR, and PLR between the COVID-19 group and the non COVID-19 group (all P>0.05). The proportion of males, CRP, PCO 2, D-D, IL-6, and CURB-65 scores in the COVID-19 group were higher than those in the non COVID-19 group, while PCT and PO 2 were lower than those in the non COVID-19 group, with statistically significant difference (all P<0.05). The proportion of AECOPD grade Ⅲ in the COVID-19 group was significantly higher than that in the non COVID-19 group, and the progression rate of the disease was higher in the COVID-19 group (37.9% vs 22.6%, P<0.05). COVID-19 was an independent influencing factor for the progression of AECOPD. Conclusions:Patients over 65 years old with AECOPD infected with COVID-19 have a more pronounced inflammatory response, and CRP, IL-6, and CURB-65 scores can be used as indicators to evaluate the degree of inflammation. AECOPD infected with COVID-19 are more prone to coagulation disorders, hypoxemia, more severe illness, and easier progression, suggesting that COVID-19 infection is an independent influencing factor for the progression of AECOPD.
