Chronic Obstructive Pulmonary Disease in Post-COVID-19 Patients

Aim. To evaluate the course of chronic obstructive pulmonary disease (COPD) in patients who had SARS-CoV-2 infection of various severity.

Design. Three-centre cross-sectional study under the STROBE standard (STrengthening the Reporting of OBservational studies in Epidemiology).

 Materials and methods. We conducted a complete medical examination of 46 patients with COPD who had COVID-19 during the past year: without viral damage to pulmonary tissue (CT 0, n = 18), with viral damage to pulmonary tissue of max. 50 % (CT 1–2, n = 24) and with viral damage to pulmonary tissue of at least 50 % (CT 3–4, n = 4).

Examinations included analysis of clinical information, laboratory and functional tests, as well as assessment of physical and emotional condition of patients using questionnaires and scales.

Results. After the novel coronavirus infection (NCI), 69.6 % of patients developed COPD complications, 26.1 % of patients presented with COPD symptoms for the first time, which required medical assistance. Disease exacerbation was observed approximately 24 weeks after COVID-19. Post-COVID-19 patients required intensification of baseline therapy. COPD patients who had NCI with viral pulmonary involvement had elevated D-dimer levels; CT 3–4 group also had significant impairment of diffusive capacity of lungs. Patients with pulmonary involvement, corresponding to CT 3–4, had statistically higher (p < 0.001) risk of reduction in the quality of life and aggravated anxiety and depression.

Conclusion. In post-COVID-19 period, patients with COPD are at high risk of disease exacerbation requiring review of outpatient COPD baseline therapy in post-COVID-19-patients. COPD patients who had mild SARS-CoV-2 require long-term monitoring of their coagulation profile and diffusive capacity of lungs and are recommended long-term psychological support.

1. Kudryavtseva E.Z. Features of exacerbations of chronic obstructive pulmonary disease in patients with different phenotypes of the disease: Dissertation for candidate of medical sciences. M.; 2022: 55–96. (in Russian). URL: https://critub.ru/wp-content/uploads/Na-sajt-Dis-KUDRYAVTSEVA-E.Z..pdf (дата обращения — 21.01.2024).

2. Leung J.M., Yang C.X., Tam A., Shaipanich T. et al. ACE-2 expression in the small airway epithelia of smokers and COPD patients: implications for COVID-19. Eur. Respir. J. 2020;55(5):2000688. DOI: 10.1183/13993003.00688-2020

3. Alqahtani J.S., Oyelade T., Aldhahir A.M., Alghamdi S.M. et al. Prevalence, severity and mortality associated with COPD and smoking in patients with COVID-19: a rapid systematic review and meta-analysis. PLoS One. 2020;15(5):e0233147. DOI: 10.1371/journal.pone.0233147

4. Pardhan S., Wood S., Vaughan M., Trott M. The risk of COVID-19 related hospitalsation, intensive care unit admission and mortality in people with underlying asthma or COPD: a systematic review and meta-analysis. Front. Med. (Lausanne). 2021;8:668808. DOI: 10.3389/fmed.2021.668808

5. Rajabi H., Mortazavi D., Konyalilar N., Aksoy G.T. et al. Forthcoming complications in recovered COVID-19 patients with COPD and asthma; possible therapeutic opportunities. Cell Commun. Signal. 2022;20(1):173. DOI: 10.1186/s12964-022-00982-5

6. Wilson S.H., Cooke N.T., Edwards R.H., Spiro S.G. Predicted normal values for maximal respiratory pressures in caucasian adults and children. Thorax. 1984;39(7):535–8. DOI: 10.1136/thx.39.7.535

7. Zigmond A.S., Snaith R.P. The Hospital Anxiety and Depression Scale. Acta Psychiatr. Scand. 1983;67(6):361–70. DOI: 10.1111/j.16000447.1983.tb09716.x