Objectives:To determine the high risk factors of death of patients with corona-virus disease2019(COVID-19)and chronic obstructive pulmonary disease(COPD),and to provide some medical evidence for the diagnosis and treatment of COVID-19 patients with COPD,we retrospectively study the clinical data of patients with COVID-19 with COPD,and to further analyze the clinical characteristics of the survivors and the dead with COVID-19 patients combining with COPD.Methods:In this study,262 hospitalized patients who were diagnosed with COVID-19 in the First Affiliated Hospital of Kunming Medical University from November 2022 to January 2023 were enrolled,and they were divided into two groups according to whether be combined with COPD or not.The main clinical data of patients were collected as follows:(1)General clinical data;(2)Vital signs within 24 hours after admission;(3)Laboratory findings;(4)Therapeutic drugs and clinical outcomes.The clinical data of the enrolled patients were analyzed retrospectively,and the baseline of COPD group and non-COPD group was controlled by propensity score matching to explore the clinical characteristics of COVID-19 patients with COPD.Then,according to the clinical outcome during hospitalization,the patients with COVID-19 and COPD were divided into death group and survival group.We further studied the difference of clinical characteristics between the death and the survivors of COVID-19 patients with COPD,and analyzed the related factors of death in patients with COVID-19 with COPD.SPSS 27.0 was used for statistical analysis and Graph Pad Prism 9.5.1 was used for plotting.Results:1.Totally 135 patients with COVID-19 and COPD were enrolled,the age was83.0(74.0,87.0)years old,and the BMI was 22.21±4.49 kg/m~2,including 121(89.6%)males.COVID-19 patients with COPD were older,and had a higher proportion of male patients and smoking rates.2.Compared with COVID-19 patients,there were higher values of Pa CO2,HCT,RDW-CV,IL-6,GGT,myoglobin,troponin I,PT,APTT and lower values of OI,platelet,plasma albumin and FIB in patients with COVID-19 and COPD.3.Compared with COVID-19 patients,there were increased in the fungal infection rate,SOFA score,the incidence of respiratory failure in COVID-19 patients with COPD,and they need more antibiotics and mechanical ventilation than patients without COPD.4.In COVID-19 patients and COPD,the lactic acid,neutrophil count,red blood cell distribution width,IL-6,PCT,hs-CRP,NLR,PLR,SII,AST,BUN,troponin I,myoglobin,D-dimer,FDP,INR,PT,APTT in the dead were higher than those in the survivors,while oxygenation index,lymphocyte count,total protein,albumin,lymphocyte count,T lymphocyte count,CD4+T lymphocyte count,CD8+T lymphocyte count in the dead were lower than those in the survivors.5.Both the high value of myoglobin and the prolonged prothrombin time are risk factors for death in patients with COPD,while reduced oxygenation index,albumin and CD8+T lymphocyte count were risk factors for death patients with COVID-19 and COPD.Conclusions:Compared with the patient with COVID-19 alone,patients with COVID-19 and COPD were older,had a higher male proportion and smoking rate,more severe degree of sickness and more demands for the uses of antibiotics and mechanical ventilation.For the first time,we found that RDW-CV and GGT in patients with COVID-19and COPD were higher than those without COPD,and RDW-CV and GGT increased more significantly in COVID-19 patients with COPD death.Compared with the patient with COVID-19 alone,PCO2,HCT,IL-6,MYO,c Tn I,PT and APTT were increased in patients with COVID-19 and COPD,while OI,PLT,ALB and FIB were decreased compared.There was no significant difference between the baseline data of COVID-19patients with COPD death and survivors.Compared with survivors of COVID-19 and COPD,lymphocyte count was significantly reduced in patients who died of COVID-19 and COPD,and systemic inflammatory response and blood coagulation abnormalities were more significant in COVID-19 patients with COPD death.Increased myoglobin,prolonged prothrombin time,and decreased oxygenation index,albumin,and CD8+T lymphocytes count were independent risk factors for death in patients with COVID-19 and COPD.And compared with single risk factor,the combined predictor was the most effective in predicting death in patients with COVID-19 and COPD. |