Most people who become infected with the new SARS-CoV-2 coronavirus do not become severely ill. However, patients with chronic respiratory and pulmonary diseases are particularly confused. The German Society for Pneumology and Respiratory Medicine (DGP) has issued a recent statement on which of these patients have a higher risk of severe disease progression.
In the majority of patients affected by COVID-19, the course of the disease is mild to moderate and symptoms are present for an average of 11.5 days after infection. According to the Robert Koch Institute, eight to ten percent of COVID-19 patients are hospitalized in Germany. “This figure probably still overestimates the proportion of severe cases, since especially at the beginning of the pandemic not only the severity of the disease, but partly also the necessary isolation was the reason for admission,” says Professor Torsten Bauer, MD, Deputy DGP President. “This is reflected in the relatively low proportion of intensive care treatments of only eight percent of these hospitalized cases.” The current estimated probability of dying from COVID-19 is less than one percent (based on the estimated total of all infected persons), according to currently available data. However, mortality rates vary considerably depending on the age group. Thus, older patients are more frequently affected than younger ones.
Many patients with chronic respiratory and pulmonary diseases, such as asthma or COPD, are concerned about the current pandemic and fear they are more at risk from SARS-CoV-2 than healthy individuals. “Patients want the best possible protection against infection,” said Professor Marek Lommatzsch, MD, senior physician at the Department of Pneumology at the University of Rostock and speaker of the German Lung Conference. “But physicians, who have a duty to provide appropriate and meaningful protective measures to their patients, are also confused.” Therefore, risk assessment is of particular importance for patient groups with pre-existing respiratory and pulmonary diseases.
COPD patients at higher risk
In the paper, “Risk Assessment in Patients with Chronic Respiratory and Pulmonary Diseases in the Context of the SARS-CoV-2 Pandemic,” DGP experts assess the risk of certain patient groups (for example, those with asthma, COPD, lung cancer, or sleep apnea) to suffer a severe COVID-19 illness and explain which patient groups need special protection. For example, well-treated patients with asthma are not at increased risk for severe COVID-19 courses. The situation is different for people with COPD: “From the data available so far, there are indications that patients with COPD have a higher risk of severe COVID-19 courses. In the presence of cardiovascular comorbidity, patients with COPD can be assumed to have a significantly increased risk,” explains Lommatzsch.
Experts advise all patients with chronic respiratory and pulmonary diseases to strictly follow the recommendations of the Robert Koch Institute. In particular, the distance requirements, hygiene rules and vaccination recommendations should be observed. The complete recommendations of the DGP can be found on the website of the professional society. They are regularly updated based on the daily new findings on COVID-19: https://pneumologie.de/aktuelles-service/covid-19/
Source: German Society for Pneumology and Respiratory Medicine (DGP)
InFo PNEUMOLOGY & ALLERGOLOGY 2020; 2(2): 4 (published 6/18/20, ahead of print).
