COVID-19 and COPD: Important knowledge gaps in subclinical pulmonary disease in the Canadian population
The rapid outbreak of coronavirus disease 2019 (COVID-19) has resulted in a public health emergency of unprecedented international concern. To adequately guide clinical and public health responses to current and future outbreaks, the World Health Organization has established identifying groups of individuals at high risk of severe infection as an urgent research priority. Chronic Obstructive Pulmonary Disease (COPD) is a prevalent underlying co-morbidity and a leading risk factor for complications of COVID-19, but little is known on specific pulmonary risk factors for COVID‑19 severity. We propose to mobilize an existing resource, the CanCOLD longitudinal cohort, to address this knowledge gap. CanCOLD is a population-based cohort of 1561 individuals aged > 40 years categorized as healthy, “at-risk” (ex- & current smokers) and COPD recruited in 9 of Canada’s largest cities, where COVID‑19 transmission is the greatest. We will leverage this established cohort to assess the prevalence of COVID‑19 and its presentation (asymptomatic and symptomatic) in COPD, at-risk and healthy controls via serological antibody test. We will also exploit pre- and post-outbreak data and biosamples collected by CanCOLD to characterize prevalence and hazard of COVID‑19 hospitalization (with/without ICU) and death according to four pre-morbid pulmonary risk factors: pre-existing pulmonary disease (COPD, asthma, chronic bronchitis), severity of airflow obstruction, lung structure abnormalities, and use of respiratory medication. We will identify and characterize the immunologic profile of CanCOLD participants and its relationship with COVID‑19 susceptibility and severity. Finally, we will investigate the impacts of social isolation and confinement on mental health amongst Canadians with chronic airway disease. Ultimately, this study will provide an integrated perspective on COVID‑19 susceptibility that can guide recommendations for clinical practice and public health strategies.