Research Summary

Long-Term Mortality Risk After COVID-19 Recovery Increased in Patients With COPD

Miranda Manier, BA

Key Highlights

  • Mortality was 4.8% in patients with chronic obstructive pulmonary disease (COPD) who recovered from COVID-19 versus 2.7% in matched controls.
  • Overall risk of death was significantly higher in the COVID-19 cohort (aHR=1.81, 95% CI=1.35–2.45).
  • Severe COVID-19 was strongly associated with increased mortality (aHR=5.05, 95% CI=3.65–6.97), particularly within the first 30 days post-recovery (aHR=20.25, 95% CI=7.79–52.64).
  • Non-severe COVID-19 was not linked to increased long-term mortality compared with controls.

Patients with chronic obstructive pulmonary disease (COPD) who recovered from COVID-19 experienced higher long-term mortality compared with matched controls. In this nationwide Korean cohort, mortality was nearly twofold higher in the COVID-19 group, with the most pronounced effect among those who had severe disease.

COPD is a known risk factor for severe COVID-19 outcomes, but the long-term risk of death after recovery in this population has been less clearly defined. This study was designed to address this gap by comparing mortality risk between patients with COPD who recovered from COVID-19 and matched controls who did not contract COVID-19, while also assessing the impact of COVID-19 severity.

This retrospective cohort study used data from the Korean National Health Insurance database. Investigators identified 2499 patients with COPD who recovered from COVID-19 between October 2020 and December 2021 and matched them 1:1 with 2499 controls. The study population was followed until death or September 30, 2022, with a median follow-up of 319 days. Mortality risk was assessed overall and by COVID-19 severity.

During follow-up, 4.8% of patients with COPD who recovered from COVID-19 died compared with 2.7% of controls. Overall, the adjusted hazard ratio for death was 1.81 (95% CI=1.35–2.45). The excess risk was concentrated among patients with severe COVID-19 (aHR=5.05, 95% CI=3.65–6.97), particularly within the first 180 days of recovery. The highest mortality risk occurred during the initial 30 days post-recovery (aHR=20.25, 95% CI=7.79–52.64). In contrast, non-severe COVID-19 was not associated with increased long-term mortality (aHR=0.85, 95% CI=0.57–1.28).

Limitations include potential selection bias from using claims-linked health screening data, inability to assess certain confounders such as lung function or home oxygen therapy, and restriction to a single Asian country, which may limit generalizability.

“Individuals with COPD recovering from COVID-19 showed an increased risk of long-term mortality, particularly within the first 180 days post-recovery, especially those who experienced severe COVID-19,” Lee et al concluded.

Reference:
Lee H, Kim SH, Jeong CY, et al. COVID-19 and risk of long-term mortality in COPD: a nationwide population-based cohort study. BMJ Open Respir Res. 2025;12(1):e002694. doi:10.1136/bmjresp-2024-002694