Due to the prevalence of COVID-19, to no one’s surprise arose the concern regarding the odds of surviving coronavirus with COPD. Does this dangerous virus affect COPD? How dangerous is COVID-19 for those with COPD? What are COPD and COVID-19 survival rates?
You can expect all these questions. Bearing in mind the root of the said health condition and the deadly virus, these are concerning and essential to regard to those with COPD. Thankfully, researchers have done (and still doing) their work. And we have the results of studies conducted to know the COVID-19 and COPD survival rate. Read more to find out the chances of surviving COVID-19 with COPD.
COVID-19 And COPD: How Dangerous Is This Combo?
I am certain there is no need to explain much about COVID-19. The year 2020 has taught even little kids the severity of the deadly virus the world is still suffering from. As of April 2021, with more than 147 million new cases and considerable mortality crippling the world, COVID-19 remains to be a threat to humanity. But for people with specific health conditions, is the virus considered more threatening? In this case, is COVID-19 more dangerous to people with this medical condition?
As per the studies, there is a direct connection between the two. Come to think of it. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 with lungs as the primary target. In COPD (Chronic Obstructive Pulmonary Disease), the target remains the same. COPD is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Both cases lead to respiratory failure and complications. Naturally, anyone would think that those with COPD are at a higher risk of getting infected by COVID-19.
However, surprisingly, according to researches (though limited) conducted regarding the odds of surviving COVID-19 with COPD, people with COPD are not at a higher risk of getting COVID-19. How is that possible? With the severity of COVID-19 ranging from mild upper respiratory tract illness and asymptomatic infections to severe pneumonia with respiratory failure and even death, how is that possible?
Also, those with COPD have increased expression of angiotensin-converting enzyme 2 (ACE-2) receptor in their small airways. After considering these factors along with the already poor underlying lung reserve, how are people with COPD not at higher risk?
How Does COVID-19 Affect COPD?
After it is inhaled, the COVID-19 virus invades lung tissues and causes inflammation and breathing issues. Most COVID-19 cases are mild and can be treated at home. But some cases may lead to pneumonia—if the infection worsens. In some rare cases, acute respiratory distress syndrome (ARDS) can also develop. Meaning, the patient requires ventilation for oxygen. All of these facts sound threatening to COPD.
Anyone will die without sufficient oxygen. So, those with COPD are supposed to be vulnerable with an increased risk of acquiring COVID-19. But according to a 2020 report of 140 people with COVID-19, the mere factor of having an existing lung disease (COPD) does not make people any more likely to acquire COVID-19. In fact, in China, only 2%(1)of patients with COVID-19 admitted to hospitals had underlying COPD.
But this is not to say COVID-19 does not affect COPD at all. What I explained till now is only about getting infected. In a nutshell, just because someone has COPD does not make them more vulnerable to COVID-19. But once they do contract, things may get ugly.
Surviving COVID-19 With COPD
If a person with COPD contracts Coronavirus, they are more likely to experience breathlessness, leading to the requirement of oxygen and then, hospitalization. However, the result of a detailed evaluation of 22 studies from 8 countries shows something different.
In patients hospitalized with COVID-19, prior diabetes (23%) and hypertension (42%) diagnoses were far significantly more prevalent than COPD (5%). Then again, the severity of the outcome of infection does not lessen by the fact of less prevalence of hospitalization.
Unfortunately, those with chronic diseases and viruses have a worse clinical outcome with higher rates of mortality. Together with poor outcomes, certain treatments relevant to patients with COPD such as non-invasive ventilation (NIV) and nebulized bronchodilators carry a higher risk of viral spread via aerosols. This can lead to further complications.
In one study of about 4610 Covid patients in Korea, 96.9% and 3.1% were categorized into non-COPD and COPD groups respectively. Compared to the non-COPD group, the COPD group had greater proportions of older people and male patients. Patients with COPD received intensive critical care (7.1% VS 3.7) and mechanical ventilation (5.% VS 2.4%).
Furthermore, deaths that occurred due to this cannot be ignored. While the overall case fatality rate (CFR) was 2.3% with confirmed cases of COVID-19, in people with chronic respiratory disease, the CFR was 6.3% (2). So, it is safe to conclude that though those with COPD are not at a higher risk of acquiring COVID-19, they are at a higher risk of developing a more severe COVID-19 infection than others.
What’s more concerning is that patients with COPD and smokers have an increased risk for severe disease and even COVID-19 severity. So, if you are smoking with COPD (that itself is bad) and COVID-19, you are calling for death.
COPD and COVID-19 Vaccine
It is completely safe for those with lung diseases, including COPD, to take the COVID-19 vaccine. High-risk people come on the prioritized vaccination list. The COVID-19 vaccines are tested on people with long-term conditions as well. Besides, all approved vaccines must meet the safety requirements. So, if you have COPD, you can get the vaccine.
Precautions For Those With COPD
The lower prevalence of COVID-19 in patients with COPD simply reflects the greater safety measures taken by COPD(3) patients to avoid COVID-19 exposure. As the existing lung damage makes it more difficult for the lungs to fight off an infection as deadly as Corona, a person with Chronic Pulmonary disease should take appropriate precaution steps to avoid complications.
- Do not stop taking your treatments and medications, unless advised otherwise by the physician.
- Stay at home except for essential medical care.
- Wear a mask and maintain social distancing, if necessary to leave home.
- Wash hands regularly.
- Keep at least a 30-day supply of any prescription medication.
- Store non-perishable food to cut down trips to grocery stores.
- Avoid sick people.
- Eat a healthy diet and stay hydrated.
- Exercise to stay physically fit.
- Keep in touch with your healthcare provider for emergencies.
If you or anyone you know with COPD (4) develop any symptoms of COVID-19, do not hesitate to contact your healthcare provider to advise what to do. For severe symptoms, seek medical attention immediately.
Due to the existing lung damage, anyone with chronic disease should be wary of COVID-19. They have to take extra precautions to prevent themselves from contracting COVID-19. Not because they are at a higher risk of contracting, but rather the poor outcome of contraction could be severe for them. So, follow the standard safety measures to protect yourself and others with or without COPD.
- .BMJ Journals. (2020). Caring for patients with COPD and COVID-19: a viewpoint to spark discussion. (online). Available at https://thorax.bmj.com/content/75/12/1035.citation-tools.
- National Health Commission of the People’s Republic of China. (2020). Characteristics of and important lessons from the Coronavirus Disease 2019 (COVID-19) outbreak in China. (Online). Available at https://jamanetwork.com/journals/jama/fullarticle/276213
- National Centre for Biotechnology Information. (2013). Optimizing safety of COPD treatments: role of the nurse practitioner. (Online). Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3583441/
- National Centre for Biotechnology Information. (2020).Characteristics and prognosis of Covid-19 in patients with COPD. (Online). Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7600734/