1.Clinical profile and outcomes of COVID-19 positive patients with Chronic Obstructive Pulmonary Disease (COPD) in a tertiary government COVID-19 referral center
Mary Bianca Doreen F. Ditching ; Joel M. Santiague
Acta Medica Philippina 2024;58(Early Access 2024):1-7
Introduction:
It is anticipated that Chronic Obstructive Pulmonary Disease (COPD) has greater risk in acquiring
COVID-19 infection and poorer outcome. However, current worldwide data are conflicting.
Objectives:
This study primarily aims to compare the outcomes of COVID-19 patients with COPD and those without COPD in terms of length of hospital stay (LOS), recovery or mortality, treatment received, and predictors of mortality.
Methods:
This is a retrospective cohort chart review of 1,017 admitted adult COVID-19 patients from July to
December 2020. Age, gender, smoking status, current control and medications for COPD, COVID-19 severity, symptoms, treatment, and outcomes of the two study groups were compared.
Results:
Prevalence rate of COPD was 3.8%. COVID-19 patients with COPD were older (median age of 69 vs 54,
p<0.001), male (87% vs 50%, p<0.001), hypertensive (72% vs 48%, p=0.004), and with tuberculosis (31% vs 11%,
p=0.002). COVID-19 patients with COPD more commonly needed oxygen therapy, High Flow Nasal Cannula,
Mechanical Ventilation, Tocilizumab, Convalescent Plasma Therapy and Dexamethasone, and had longer LOS.
Significant risk factors for mortality are malignancy, investigational therapies, smoking, and older age. There was no difference in survival rates between the two groups.
Conclusion
COPD increases the risk for severe COVID-19 and lengthens LOS.
COVID-19
;
Pulmonary Disease, Chronic Obstructive
;
Mortality
2.Clinical profile and outcomes of all admitted COVID-19 positive patients with primary lung cancer in a Tertiary Government COVID-19 Referral Center: A retrospective cohort study
Ria Katrina B. Cortez ; Joel M. Santiaguel ; Mary Bianca Doreen F. Ditching
Acta Medica Philippina 2024;58(Early Access 2024):1-12
Background:
COVID-19 infection poses a continuing challenge especially to those already with prior lung disease. To analyze such patients’ profile is essential in today’s health care management.
Objective:
The study aimed to compare the outcomes of COVID-19 confirmed patients with and without primary lung cancer in terms of hospital stay, recovery, and mortality.
Methods:
The study employed a retrospective cohort design. Chart review of all adult COVID-19 patients in Philippine General Hospital from January 2021 to June 2021 was done. A matched cohort study was conducted between COVID-19 patients with and without primary lung cancer.
Results:
Among the 953 COVID-19 patients, there were 14 patients with primary lung cancer. In terms of length of hospital stay, patients with primary lung cancer had shorter days from 1.32 to 15.1 days compared to 2.28 to 18.36 days in patients without primary lung cancer (p-value 0.271). Furthermore, they had 64% recovery rate compared to 78% in those without primary lung cancer (p-value 0.118). In terms of overall mortality rate, primary lung cancer patients had 36% rate as compared to 22% in the non-lung cancer group (p-value 0.119). Diabetes mellitus, mild to severe COVID, Remdesivir, and antibiotic use were associated with longer hospital stay while oxygen support via nasal cannula and invasive ventilation led to shorter hospital stay. Age above 50 years, chronic liver disease, other malignancy, shortness of breath, oxygen support via face mask, high flow nasal cannula, invasive ventilation, antibiotic use, hemoperfusion and nebulization showed a decrease chance of recovery while on contrary, Remdesivir showed an increase chance of recovery. An increase mortality rate was seen among age above 50 years, chronic liver disease, other malignancy, shortness of breath, oxygen support via facemask, high flow nasal cannula, invasive ventilation, antibiotics, hemoperfusion, and nebulization, in contrast to a decrease in Remdesivir therapy.
Conclusions
Among all admitted COVID-19 patients, primary lung cancer patients were associated with shorter hospital stay (8.21+6.89days), lower rate of recovery (64%), and higher mortality rate (36%) as compared to those without primary lung cancer. However, based on the computed p-values for each outcome, these differences are not statistically significant.
COVID-19
;
lung cancer
;
lung neoplasm