PT  - JOURNAL ARTICLE
AU  - Erik Soeren Halvard Hansen
AU  - Amalie Lykkemark Moeller
AU  - Vibeke Backer
AU  - Mikkel Porsborg Andersen
AU  - Lars Kober
AU  - Kristian Kragholm
AU  - Christian Torp-Pedersen
TI  - Severe outcomes of COVID-19 among patients with COPD and asthma
AID  - 10.1183/23120541.00594-2020
DP  - 2020 Jan 01
TA  - ERJ Open Research
PG  - 00594-2020
4099  - http://openres.ersjournals.com/content/early/2020/10/22/23120541.00594-2020.short
4100  - http://openres.ersjournals.com/content/early/2020/10/22/23120541.00594-2020.full
AB  - Introduction Patients with obstructive lung diseases are possibly at risk of developing severe outcomes of COVID-19. Therefore, the aim with this study was to determine the risk of severe outcomes of COVID-19 among patients with asthma and COPD.Methods We performed a nationwide cohort study including patients with COVID-19 from February 1 to July 10, 2020. All patients with COVID-19 registered in the Danish registers were included. With ICD-codes and medication history, patients were divided into asthma, COPD or no asthma or COPD. Primary outcome was a combined outcome of severe COVID-19, intensive care or death.Results Among 5104 patients with COVID-19 (median age 54.8 years (25–75th% 40.5 to 72.3); women, 53.0%), 354 had asthma and 432 COPD. The standardised absolute risk of the combined endpoint was 21.2% (95% CI 18.8 to 23.6) in patients with COPD; 18.5% (95% CI 14.3 to 22.7) in patients with asthma and 17.2% (95% CI 16.1 to 18.3) in patients with no asthma or COPD. Patients with COPD had slightly increased risk of the combined endpoint compared with patients without asthma or COPD (Risk difference 4.0%; 95% CI 1.3 to 6.6; p=0.003). In age standardised analyses, there were no differences between the disease groups. Low blood eosinophil counts (<0.3×10^9 cells·liter−1) were associated with increased risk of severe outcomes among patients with COPD.Conclusion Patients with COPD have slightly increased risk of developing severe outcomes of COVID-19 compared with patients without obstructive lung diseases. However, in age standardised analysis, the risk difference disappears.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. Hansen has nothing to disclose.Conflict of interest: Dr. Moeller has nothing to disclose.Conflict of interest: Dr. Backer reports grants and personal fees from AstraZeneca, grants and personal fees from GSK, grants and personal fees from TEVA, grants and personal fees from Chiesi, grants and personal fees from Sanofi, grants and personal fees from MSD, grants and personal fees from Novartis, outside the submitted work.Conflict of interest: Dr. Andersen has nothing to disclose.Conflict of interest: Dr. Kober reports personal fees from Novo Nordisk, personal fees from Boehringer, personal fees from AstraZeneca, personal fees from Novartis, outside the submitted work.Conflict of interest: Dr. Kragholm reports personal fees from Novartis, outside the submitted work.Conflict of interest: Dr. Torp-Pedersen reports grants from Novo Nordisk, grants from Bayern, outside the submitted work.