Long-term effects of COVID-19 on hospitalization, long term care admission, and mortality in chronic obstructive pulmonary disease (COPD) patients in the Omicron Era

INTRODUCTION There is limited information on the post-acute burden of COVID-19 in chronic obstructive pulmonary disease (COPD). The purpose of this study was to examine rates of admission to hospital or long-term care (LTC) and mortality in COPD patients following Omicron Era COVID-19 infection.METHODS We conducted a retrospective cohort study using health administrative data from Ontario Canada, from November 2021 to June 2022. Individuals with physician-diagnosed COPD who had received a COVID-19 PCR test (positive/negative) were included. Patients were followed from 12 wk post-PCR until they were admitted to hospital or LTC, died, or the study period ended. The effect of infection and vaccination status on admission to hospital and LTC was estimated using cause-specific hazard models. Risk of death was estimated using Cox proportional hazard models.RESULTS Among 99,524 participants, 29,294 had positive PCR tests, 7,311 (7.4%) were admitted to hospital or LTC and 4,731 (4.7%) died. The effect of Omicron infection on admission to hospital and LTC varied over time, with elevated rates observed for 91 days following the 12-week post-infection period (hazard ratios [HRs]: 51-days = 1.28 [CI 1.18–1.39]; 91-days = 1.09 [CI 1.01–1.17]). An Omicron era infection was not associated with an increased rate of death (HR = 1.01 [CI 0.95–1.08]). Having ≥2 vaccinations reduced the rate of admission to hospital or LTC.INTERPRETATION In COPD, the effects of Omicron infection extend beyond the acute 12-week period, with rates of hospital and LTC admission elevated for an additional 91 days. This implies that an Omicron era infection can have long-term implications for individuals with COPD.