Late Breaking Abstract - The effect of comorbidity on the course and outcomes of COPD in observation in the primary health care, including on the background of the COVID-19 pandemic: a comparative analysis

Abstract

Objective: to study structure and relationship of comorbidities with the severity of COPD in the primary care.

Materials and methods: 3-year clinical observations were conducted with analysis of the Charlson Comorbidity Index, the geriatric variant of cumulative disease assessment, the Bartel scale of daily life activity in 265 patients with COPD (189 were males, mean age – 64.6 ±13.1 years).

Results: A total of 1164 diseases were detected in 265 patients, the median per patient was 5.1 [4,2; 6,2]. One disease was registered in only 5.6% of patients. More than half of the patients (147, 55.5%) had more than 3 comorbidities. The most frequently diagnosed co-morbid conditions were arterial hypertension (71%), diabetes mellitus (32%), depression (19%). A j-shaped relationship with the COPD group was established.

Patients with COVID-19 were found to have a heavier COPD group (group D 44% after vs. 11% before), an increase in the number and change in the structure of comorbid pathology (median comorbidity 6.7 [5.4; 7.2], CHF, cognitive disorders).

During follow-up period 48 (18%) patients died with CCI > 4 points (odds ratio [OR], 4.92; 95% confidence interval [CI], 3.89-6.34; p<.001), with a median of concomitant diseases 6.7, with severe COVID-19, which can be determined as a prognostically unfavorable risk factor for death in COPD patients.

Conclusion: In COPD patients associated pathology, including COVID-19, forms a mutual burden syndrome, which leads to a heavier course, an increased risk of death, which is advisable to take into account when developing a treatment regimen.