Long-term clinical outcomes of COVID-19 in patients with chronic obstructive pulmonary disease: results of a three-year follow-up

Aim. To evaluate the three-year dynamics in the frequency and severity of chronic obstructive pulmonary disease (COPD) exacerbations depending on the presence or absence of a prior SARS-CoV-2 infection (COVID-19). Materials and methods. The study was controlled prospective (2021–2024). The patients (n = 232) with verified chronic obstructive pulmonary disease (COPD) were examined. Patients divided into two groups: Group 1 (n = 172) – patients with COPD who had COVID-19; Group 2 (n=60) - patients with COPD without a COVID-19 history. The control points were initial examination (K0), examination after 1 year (K1), 2 years (K2) and 3 years (K3). Information collected on the presence, severity and number of exacerbations over the previous year (NEY), the time interval between exacerbations (tmonth), and cases of hospitalization for COPD exacerbation. Results. At point K1 NEY differed significantly between the groups (p = 0.037). In Group 1, the number of individuals with frequent exacerbations was significantly higher than in Group 2 (p = 0.008). In Group 1 at point K1, the risk of identifying the COPD phenotype with frequent exacerbations was 4.71 times higher than in Group 2, and the risk of developing exacerbations leading to hospitalization was 7.33 times higher. Correlation did not found between the severity of COVID-19 and the studied indicators. At point K2 in Group 1, episodes of COPD exacerbations observed less frequently. Indicator tmonth remained significantly shorter in Group 1. The level NEY did not reach the pre-COVID baseline at point K3. Indicator tmonth remained consistently shorter in Group 1 than in Group 2 (p = 0.014). Conclusion. In COPD patients, regardless of the initial severity of COVID-19, SARS-CoV-2 infection is associated with a sustained increase in exacerbation frequency and shortened intervals between exacerbations over a three-year period – primarily driven by an increased prevalence of the "frequent exacerbator" phenotype.