Are people with COPD immunocompromised?

What is COPD?

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Chronic obstructive pulmonary disease, commonly referred to as COPD, is a term for a group of progressive lung diseases, including emphysema and chronic bronchitis. These conditions affect the airways and can make it difficult for a person to breathe.

Emphysema slowly destroys the lungs’ alveoli, or air sacs. These air sacs, in their vast number, are essential to the process of breathing.

Eventually, the damage can cause the air sacs to rupture, leading to the formation of one large air pocket instead of multiple tiny ones. This reduces the lung surface area and makes it difficult for inhaled oxygen from the lungs to get into the bloodstream. Breathing also becomes increasingly difficult.

Conversely, bronchitis causes inflammation and narrowing of the bronchial tubes. These tubes carry air from the windpipe to the lungs. These changes can cause mucus to build up. A person with bronchitis can develop long-term breathing difficulties if bronchial tubes become too inflamed or accumulated mucus is difficult to clear.

Smoking is a major risk factor for developing COPD. Other causes of COPD can include exposure to:

• air pollution
• dust
• toxic gases

COPD has no cure, but treatments can help relieve symptoms, slow the progression of the disease, and improve a person’s quality of life.

The link between COPD and COVID-19

People living with COPD should continually monitor their breathing and lung health. Having COPD increases a person’s susceptibility to certain infections, such as COVID-19.

Although COPD is not a risk factor for COVID-19, existing lung damage makes it more likely for people to experience severe COVID-19 complications. Having COPD is a major risk factor for hospitalization, intensive care unit admission, and death from COVID-19.

If someone with COPD contracts COVID-19, they have a higher risk of developing serious disease. Other risk factors for severe illness include advanced age, diabetes, high blood pressure, cancer, and many other health conditions.

Acute respiratory distress syndrome (ARDS)

ARDS is a complication of COVID-19 that can occur while a person is in the hospital.

In ARDS, fluid accumulates in the alveoli, or air sacs of the lungs. This prevents the lungs from filling with air. As a result, sufficient oxygen cannot move into the bloodstream and to other parts of the body. The organs and tissues can become starved of oxygen, leading to organ failure.

ARDS is a life threatening condition. People with ARDS require supportive therapy while the lungs are given the time to heal. Examples of therapy might include ventilator support, fluid management, and medication. These measures should help the person breathe easier.

Due to the seriousness of potential complications, anyone living with COPD should make every effort to avoid contracting SARS-CoV-2, the virus that causes COVID-19.

Symptoms of COVID-19 and COPD

Symptoms of COVID-19 typically manifest 2–14 days following exposure to the virus. They can include:

• fever
• chills
• fatigue
• dry cough
• loss of taste or smell
• stuffy or runny nose
• sore throat
• muscle and joint pain
• vomiting or nausea
• diarrhea

Most people will recover without hospital treatment. However, in people with COPD, the likelihood of requiring intensive care in a hospital or dying from the infection increases by 4 times. These individuals are more likely to have poor lung function and develop pneumonia, ARDS, and blood clots in the lungs and heart.

Due to the similarities between some COPD and COVID-19 symptoms, doctors may have trouble differentiating between the two. Also, people should note that COVID-19 can trigger COPD exacerbations or worsen symptoms.

Doctors find that over 60% of people with COVID-19 have cough and breathlessness, which are also features of COPD. However, the following additional symptoms might indicate COVID-19 infection:

• fever
• digestive symptoms
• muscle aches and pains
• loss of taste or smell

If someone with COPD has symptoms of worsening cough or breathlessness, doctors should consider testing them for SARS-CoV-2.

Around the 7-day mark, people with COPD and SARS-CoV-2 infection can experience rapid deterioration of lung function leading to respiratory failure. This makes it important for diagnosis to be quick so that treatment can commence.

In a small number of individuals with COPD, and particularly in older adults, the first sign of COVID-19 can be delirium — a state of mental confusion and emotional disruption.

Vaccination in people with COPD

As COVID-19 can cause severe complications in people with COPD, those living with the condition should receive a COVID-19 vaccine as soon as they can. The American Lung Association recommends that individuals with COPD get vaccinated.

Likewise, the Centers for Disease Control and Prevention (CDC) recommend that anyone with a compromised immune system — such as those living with an autoimmune disease, those who have had an organ transplant, or those currently on chemotherapy — receive a COVID-19 vaccination.

These individuals are not only at an increased risk of a severe form of COVID-19 illness but also prone to a weaker immune response to vaccination than people who are not immunocompromised.

The vaccines are safe and provide protection against COVID-19. They reduce the risk of a person developing the illness and experiencing its potential consequences. The recommendations for moderately or severely immunocompromised individuals might include a course of four doses of mRNA COVID-19 vaccines.

Preventive measures to take

In people with COPD, COVID-19 or any other respiratory infection can become serious. Therefore, people should protect themselves by taking the following measures:

• washing hands frequently
• using hand sanitizer
• wearing a face mask
• avoiding crowds, particularly during the cold and flu season
• asking people only to visit when they are healthy
• brushing teeth twice a day and seeing the dentist every six months to prevent oral infections
• getting vaccinated against flu, pneumonia, and COVID-19
• encouraging family members and close friends to get vaccinated

How to stay healthy

Although people may find that living with COPD is challenging, there are ways to stay healthy.

One of the most important things is to protect the lungs as much as possible by:

• quitting smoking
• avoiding secondhand smoke
• minimizing exposure to dust, fumes, and pollution

People should also consider eating a healthy diet. Nutritious foods are important for overall health, and certain foods can affect breathing. Choosing the right mix of nutrients can help an individual breathe more easily. Therefore, if possible, people should seek a registered dietitian’s advice about foods to include or avoid.

Regular exercise is also part of a healthy lifestyle. Although it may feel unsafe to exercise with COPD, certain exercise routines can have benefits, such as improving the body’s use of oxygen, improving sleep, and boosting energy levels.

Summary

People with COPD are at an increased risk of developing severe illness if they contract SARS-CoV-2, the virus that causes COVID-19.

Therefore, those with COPD must take necessary precautions to avoid infection. Evidence suggests that the vaccines are safe and effective for people with COPD, so these individuals should receive the COVID-19 vaccine as soon as possible.