Can COVID-19 Cause COPD Illustration

Can COVID-19 Cause COPD? (2024)

by | Updated: Apr 18, 2024

The global effects of COVID-19 have raised numerous concerns about its long-term impact on respiratory health.

Among these concerns is the potential link between COVID-19 and chronic obstructive pulmonary disease (COPD), a progressive lung disease characterized by increasing breathlessness.

Given the respiratory nature of the coronavirus and the vulnerabilities of those with pre-existing lung conditions, understanding this connection is of paramount importance.

Can COVID-19 Cause COPD?

COVID-19 primarily affects the respiratory system, leading to acute symptoms like cough and difficulty breathing. While it can cause severe respiratory distress and lung damage, there is no conclusive evidence that COVID-19 directly causes chronic obstructive pulmonary disease (COPD).

However, individuals with pre-existing COPD may experience exacerbated symptoms if infected with the virus.

Can COVID Cause COPD Vector Illustration

What is the Link Between COPD and COVID-19?

The link between COPD and COVID-19 revolves around the increased vulnerability of COPD patients to severe manifestations of the coronavirus and the role of ACE2 receptors in both conditions:

  • Increased Vulnerability: COPD patients have compromised lung function, making them more susceptible to respiratory infections, including COVID-19. The inflammation and damage already present in the lungs of COPD patients can exacerbate the effects of the virus, leading to more severe symptoms and complications.
  • ACE2 Receptors: The SARS-CoV-2 virus, responsible for COVID-19, uses ACE2 receptors to enter human cells. These receptors are predominantly found in the lungs. Research has indicated that levels of ACE2 are altered in patients with COPD. Specifically, increased levels of ACE2 have been observed in the lungs of COPD patients, potentially providing more entry points for the virus. This raises concerns about whether COPD patients have a higher susceptibility to severe COVID-19 due to the increased presence of the virus’s entry point.
  • Severity of COVID-19 in COPD Patients: Studies have shown that COPD patients have a significantly increased risk of developing severe COVID-19. The odds ratio suggests a nearly six-fold increased risk for severe disease manifestations in COPD patients compared to those without COPD.

Summary: The link between COPD and COVID-19 is characterized by the heightened risk COPD patients face when contracting the virus and the shared involvement of ACE2 receptors in the pathology of both conditions.

How to Know if it’s COPD or COVID-19?

Distinguishing between COPD exacerbations and COVID-19 can be challenging since both conditions affect the respiratory system and can present with overlapping symptoms.

Here’s how to differentiate between the two:

History and Onset

  • COPD: Patients with a history of COPD may experience periodic exacerbations triggered by factors like infections, air pollution, or allergens. These exacerbations are consistent with their known disease pattern.
  • COVID-19: The onset might be sudden and may be accompanied by symptoms not typical for a COPD exacerbation. Exposure history to a confirmed COVID-19 case can also be a clue.

Associated Symptoms

  • COPD: Exacerbations primarily involve respiratory symptoms like increased shortness of breath, wheezing, increased sputum production, and change in sputum color.
  • COVID-19: Apart from respiratory symptoms, COVID-19 can present with fever, loss of taste or smell, muscle aches, fatigue, gastrointestinal symptoms, and in some cases, skin rashes.

Response to Treatment

  • COPD: Patients usually have a known management plan for exacerbations, which might include increased bronchodilator use or corticosteroids. They typically respond to these interventions.
  • COVID-19: Symptoms might not respond to the usual COPD treatments and may progressively worsen, especially in the second week of illness.

Diagnostic Tests

  • COPD: Spirometry and other pulmonary function tests can help assess the severity of COPD and its exacerbations.
  • COVID-19: A PCR test using a nasal or throat swab is the standard diagnostic tool for confirming COVID-19. Chest X-rays or CT scans might show lung abnormalities consistent with viral pneumonia.

Blood Tests

  • COPD: Elevated white blood cell count might indicate a bacterial infection triggering the exacerbation.
  • COVID-19: Some patients show lymphopenia (reduced lymphocyte count) and elevated markers of inflammation.

Note: If someone with COPD experiences symptoms that are unusual for their typical exacerbations or has been exposed to a confirmed case of COVID-19, they should seek medical advice. Testing for COVID-19 is essential to rule out the infection and ensure appropriate care.

How Does COVID-19 Affect the Respiratory Tract?

COVID-19, caused by the SARS-CoV-2 virus, primarily targets the respiratory system. Upon entering the body, the virus binds to ACE2 receptors present in the lungs, particularly in the alveoli.

This binding can lead to inflammation and damage to lung tissue, manifesting as symptoms like cough, shortness of breath, and in severe cases, pneumonia. The inflammation can cause the alveoli to fill with fluid or pus, making breathing difficult.

Over time, this can compromise the lungs’ ability to oxygenate blood efficiently.

In severe cases, patients may require ventilatory support due to acute respiratory distress syndrome (ARDS) resulting from extensive lung damage.

What is the Role of ACE2 in COPD and COVID-19?

ACE2, or angiotensin-converting enzyme 2, plays a crucial role in both COPD and COVID-19, albeit in different ways:

  • Role in COPD: Chronic obstructive pulmonary disease (COPD) is characterized by chronic inflammation and lung tissue damage. Research has indicated that levels of ACE2 are altered in patients with COPD. The enzyme is involved in the renin-angiotensin system, which regulates blood pressure and fluid balance. In the context of lung health, ACE2 has protective effects against lung injury and inflammation. However, in COPD patients, the imbalance or dysregulation of this system might contribute to disease progression and exacerbations.
  • Role in COVID-19: The SARS-CoV-2 virus, responsible for COVID-19, uses ACE2 as its primary receptor to enter human cells. The spike protein of the virus binds to ACE2 receptors, predominantly found in the lungs, especially in the alveolar cells. This binding facilitates the virus’s entry into the cells, leading to infection. Interestingly, it has been observed that levels of ACE2 are increased in the lungs of COPD patients. This raises concerns about whether COPD patients have a higher susceptibility to severe COVID-19 due to the increased presence of the virus’s entry point.

Summary: While ACE2 has protective roles in the lungs, its presence also provides a gateway for the SARS-CoV-2 virus, linking the enzyme to both COPD and COVID-19.

What is the Severity of COVID-19 in COPD Patients?

The severity of COVID-19 in COPD patients is of particular concern due to the pre-existing vulnerabilities of their respiratory system.

The pooled data from several studies revealed that COPD patients have a significantly increased risk of developing severe COVID-19.

Specifically, the odds ratio (OR) was found to be 5.69, indicating that COPD patients have a nearly six-fold increased risk of experiencing severe manifestations of the disease.

This underscores the importance of extra precautions for COPD patients during the pandemic, as their pre-existing respiratory condition makes them more susceptible to exacerbated symptoms if infected with the virus.

FAQs About COPD and COVID-19

Is There a Connection Between COVID and COPD?

Yes, there is a connection between COVID-19 and COPD. COPD patients have compromised lung function, making them more susceptible to respiratory infections, including COVID-19.

Studies have shown that COPD patients face a heightened risk of developing severe manifestations of the virus.

Additionally, both conditions involve the ACE2 receptors in the lungs, which the SARS-CoV-2 virus uses to enter human cells.

What Does COVID Do to the Lungs?

COVID-19 primarily targets the respiratory system. The SARS-CoV-2 virus binds to ACE2 receptors in the lungs, leading to inflammation and damage to lung tissue. This can result in symptoms like cough, shortness of breath, and in severe cases, pneumonia.

The inflammation can cause the alveoli (tiny air sacs in the lungs) to fill with fluid or pus, compromising the lungs’ ability to oxygenate blood.

In extreme cases, this can lead to acute respiratory distress syndrome (ARDS).

Do People with COPD Need Specific COVID-19 Treatment?

People with COPD who contract COVID-19 may require specialized treatment due to their pre-existing lung condition.

While the primary treatment for COVID-19 remains consistent for all patients, those with COPD might need additional respiratory support, closer monitoring, and adjustments to their COPD medications.

It’s crucial for COPD patients to continue their regular medications and treatments and consult their healthcare provider if they suspect a COVID-19 infection.

Is COPD a Risk Factor for COVID-19?

Yes, COPD is considered a risk factor for severe COVID-19. Patients with COPD have a compromised respiratory system, making them more vulnerable to the effects of the virus.

Research, including meta-analyses, has shown that COPD patients have a significantly increased risk of experiencing severe symptoms and complications from COVID-19 compared to those without COPD.

Can COVID Cause Obstructive Airway Disease?

While COVID-19 primarily affects the respiratory system and can lead to acute respiratory symptoms, there is no conclusive evidence that it directly causes obstructive airway diseases.

However, the virus can exacerbate symptoms in individuals with pre-existing obstructive airway conditions.

Can COVID-19 Be Misdiagnosed as COPD?

COVID-19 and COPD can present with overlapping respiratory symptoms, making initial diagnosis challenging. However, COVID-19 may also present with additional symptoms like fever, loss of taste or smell, and muscle aches.

Proper diagnostic tests, such as PCR tests for COVID-19 and spirometry for COPD, are essential to differentiate between the two.

It’s crucial to consider the patient’s medical history, exposure to confirmed COVID-19 cases, and the presence of non-respiratory symptoms.

Can COVID Make COPD Worse?

Yes, contracting COVID-19 can exacerbate the symptoms of COPD. The inflammation and lung damage caused by the virus can further compromise the respiratory function of COPD patients, leading to more severe symptoms and complications.

Note: It’s essential for COPD patients to take extra precautions to avoid exposure to the virus.

Can COVID Cause Emphysema?

Emphysema is a long-term, progressive disease of the lungs and is a subtype of COPD. While COVID-19 can cause acute lung damage and has been associated with long-term lung complications in some patients, there is no direct evidence to suggest that the virus can cause emphysema.

However, individuals with emphysema are at a higher risk of severe COVID-19 symptoms due to their pre-existing lung condition.

Can COVID-19 Cause Permanent Lung Damage?

Yes, in severe cases, COVID-19 can lead to permanent lung damage. Some patients, especially those who have experienced acute respiratory distress syndrome (ARDS) or required prolonged mechanical ventilation, may have long-term lung complications.

This can manifest as fibrosis (scarring) of the lung tissue, reducing lung function and capacity.

Regular follow-ups and pulmonary rehabilitation can help in managing and improving lung function post-recovery.

Final Thoughts

While COVID-19 has undeniably demonstrated its capacity to inflict severe respiratory distress, there is no conclusive evidence to suggest that it directly causes COPD.

However, the virus can exacerbate symptoms in individuals with pre-existing COPD, emphasizing the need for heightened precautions for this demographic.

As research continues, a clearer picture of the long-term respiratory implications of COVID-19 will emerge, but for now, vigilance and preventive measures remain the best defense for those with and without COPD.

John Landry, BS, RRT

Written by:

John Landry, BS, RRT

John Landry is a registered respiratory therapist from Memphis, TN, and has a bachelor's degree in kinesiology. He enjoys using evidence-based research to help others breathe easier and live a healthier life.

References

  • Singh D, Mathioudakis AG, Higham A. Chronic obstructive pulmonary disease and COVID-19: interrelationships. Curr Opin Pulm Med. 2022 Mar 1
  • Lippi G, Henry BM. Chronic obstructive pulmonary disease is associated with severe coronavirus disease 2019 (COVID-19). Respir Med. 2020 Jun
  • Diamond M, Peniston HL, Sanghavi DK, et al. Acute Respiratory Distress Syndrome. [Updated 2023 Apr 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.
  • Jeong JS, Kim JS, You YS, Yeom SW, Lee YC. COPD is a risk factor for COVID-19, but does not confer increased severity of the disease. Respir Med. 2021 Nov-Dec
  • “Coronavirus Disease 2019 (COVID-19).” Centers for Disease Control and Prevention, 11 Feb. 2020.
  • “Managing Your Medical Condition.” University of Maryland Medical System.

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