{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:17:14Z","timestamp":1760660234817,"version":"build-2065373602"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T00:00:00Z","timestamp":1755734400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The COVID-19 pandemic has severely impacted Italy, leading to millions of cases and high mortality rates. Pre-existing chronic respiratory diseases may influence patient outcomes, and understanding their role is essential for improving healthcare strategies during such crises. This study analysed data from the Italian hospital discharge records database to explore the association between chronic respiratory diseases and in-hospital mortality due to COVID-19. Patients hospitalized in 2020 were studied, with exposure to respiratory diseases assessed based on hospitalizations between 2010 and 2019. Cox regression models were used to adjust for demographic and clinical factors, including age, gender, and comorbidity. Patients with pre-existing chronic respiratory diseases (n\u2009=\u200928\u2009375, 13.9% of the total study population of 203\u2009820) had a 71% higher risk (hazard ratio: 1.71, confidence interval: 1.54\u20131.90, P\u2009&amp;lt;\u2009.001) of in-hospital mortality compared to those without such conditions. Age, gender, the number of previous hospitalizations, and the Charlson comorbidity index were identified as key factors in mortality. Kaplan\u2013Meier survival curves demonstrated significant differences in survival probabilities between exposed and unexposed groups across various age categories. Chronic respiratory diseases are associated with increased COVID-19 mortality, underscoring the need for targeted interventions in vulnerable populations to reduce the impact of future pandemics.<\/jats:p>","DOI":"10.1093\/eurpub\/ckaf149","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T11:42:16Z","timestamp":1755776536000},"page":"1058-1063","source":"Crossref","is-referenced-by-count":0,"title":["Assessing the impact of chronic respiratory diseases on COVID-19 in-hospital mortality in the Italian population: a comparative study"],"prefix":"10.1093","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6118-5906","authenticated-orcid":false,"given":"Silvia","family":"Fattori","sequence":"first","affiliation":[{"name":"Department of Statistical Sciences, La Sapienza University , Rome,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanna","family":"Jona Lasinio","sequence":"additional","affiliation":[{"name":"Department of Statistical Sciences, La Sapienza University , Rome,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Alf\u00f2","sequence":"additional","affiliation":[{"name":"Department of Statistical Sciences, La Sapienza University , Rome,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Graziano","family":"Onder","sequence":"additional","affiliation":[{"name":"Department of Geriatrics and Orthopaedic Sciences, Fondazione Policlinico Agostino Gemelli IRCSS , Rome,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giada","family":"Minelli","sequence":"additional","affiliation":[{"name":"Statistical Service, Istituto Superiore di Sanit\u00e0 , Rome,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,8,20]]},"reference":[{"author":"WHO","key":"2025101607013852600_ckaf149-B1"},{"key":"2025101607013852600_ckaf149-B2","doi-asserted-by":"crossref","first-page":"200054","DOI":"10.1183\/13993003.00547-2020","article-title":"Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis","volume":"55","author":"Guan","year":"2020","journal-title":"Eur Respir J"},{"key":"2025101607013852600_ckaf149-B3","doi-asserted-by":"crossref","first-page":"2801","DOI":"10.1007\/s11606-020-05991-z","article-title":"Charlson comorbidity index score and risk of severe outcome and death in Danish COVID-19 patients","volume":"35","author":"Christensen","year":"2020","journal-title":"J Gen Intern Med"},{"key":"2025101607013852600_ckaf149-B4","doi-asserted-by":"crossref","first-page":"6049","DOI":"10.18632\/aging.103000","article-title":"Does comorbidity increase the risk of patients with COVID-19: evidence from meta-analysis","volume":"12","author":"Wang","year":"2020","journal-title":"Aging (Albany NY)"},{"key":"2025101607013852600_ckaf149-B5","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1007\/s00392-020-01626-9","article-title":"Prevalence and impact of cardiovascular metabolic diseases on covid-19 in China","volume":"109","author":"Li","year":"2020","journal-title":"Clin Res Cardiol"},{"key":"2025101607013852600_ckaf149-B6","doi-asserted-by":"crossref","first-page":"e03647-20","DOI":"10.1128\/mBio.03647-20","article-title":"Comorbidities in SARS-CoV-2 patients: a systematic review and meta-analysis","volume":"12","author":"Ng","year":"2021","journal-title":"MBio"},{"key":"2025101607013852600_ckaf149-B7","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1007\/s00592-020-01636-z","article-title":"The triumvirate: why hypertension, obesity, and diabetes are risk factors for adverse effects in patients with covid-19","volume":"58","author":"Shah","year":"2021","journal-title":"Acta Diabetol"},{"key":"2025101607013852600_ckaf149-B8","doi-asserted-by":"crossref","first-page":"2645","DOI":"10.1016\/j.jaip.2021.02.041","article-title":"Chronic respiratory diseases and the outcomes of COVID-19: a nationwide retrospective cohort study of 39,420 cases","volume":"9","author":"Guan","year":"2021","journal-title":"J Allergy Clin Immunol Pract"},{"key":"2025101607013852600_ckaf149-B9","doi-asserted-by":"crossref","first-page":"106096","DOI":"10.1016\/j.rmed.2020.106096","article-title":"Underlying respiratory diseases, specifically COPD, and smoking are associated with severe covid-19 outcomes: a systematic review and meta-analysis","volume":"171","author":"Sanchez-Ramirez","year":"2020","journal-title":"Respir Med"},{"key":"2025101607013852600_ckaf149-B10","doi-asserted-by":"crossref","first-page":"2101209","DOI":"10.1183\/13993003.01209-2021","article-title":"Asthma and COVID-19 risk: a systematic review and meta-analysis","volume":"59","author":"Sunjaya","year":"2022","journal-title":"Eur Respir J"},{"key":"2025101607013852600_ckaf149-B11","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.arbres.2023.01.001","article-title":"Impact of covid-19 infection on patients with preexisting interstitial lung disease: a Spanish multicentre study","volume":"59","author":"Mart\u00ednez-Besteiro","year":"2023","journal-title":"Arch Bronconeumol"},{"key":"2025101607013852600_ckaf149-B12","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1016\/S2213-2600(21)00095-3","article-title":"Association between preexisting respiratory disease and its treatment, and severe covid-19: a population cohort study","volume":"9","author":"Aveyard","year":"2021","journal-title":"Lancet Respir Med"},{"author":"ISTAT\u2014Italian National Institute of Statistics","key":"2025101607013852600_ckaf149-B13"},{"key":"2025101607013852600_ckaf149-B14","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J Chronic Dis"},{"key":"2025101607013852600_ckaf149-B15","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1159\/000521288","article-title":"Charlson comorbidity index: a critical review of clinimetric properties","volume":"91","author":"Charlson","year":"2022","journal-title":"Psychother Psychosom"},{"author":"Epicentro\u2014Italian National Institute of Health","key":"2025101607013852600_ckaf149-B16"},{"key":"2025101607013852600_ckaf149-B17","doi-asserted-by":"publisher","first-page":"462","DOI":"10.1186\/s12890-023-02761-5","article-title":"Asthma and COPD as co-morbidities in patients hospitalised with covid-19 disease: a global systematic review and meta-analysis","volume":"23","author":"Finnerty","year":"2023","journal-title":"BMC Pulm Med"},{"key":"2025101607013852600_ckaf149-B18","doi-asserted-by":"publisher","first-page":"220098","DOI":"10.1183\/16000617.0098-2022","article-title":"Prognostic factors for mortality, intensive care unit and hospital admission due to SARS-CoV-2: a systematic review and meta-analysis of cohort studies in Europe","volume":"31","author":"Vardavas","year":"2022","journal-title":"Eur Respir Rev"},{"key":"2025101607013852600_ckaf149-B19","doi-asserted-by":"publisher","first-page":"2087","DOI":"10.3390\/jcm10102087","article-title":"Assessment of the association of COPD and asthma with In-Hospital mortality in patients with COVID-19. A systematic review, Meta-Analysis, and Meta-Regression analysis","volume":"10","author":"Reyes","year":"2021","journal-title":"J Clin Med"},{"key":"2025101607013852600_ckaf149-B20","first-page":"135","article-title":"La mortalit\u00e0 in Italia nell\u2019anno 2020","volume":"23","author":"Manno","year":"2023","journal-title":"Rapporti ISTISAN"}],"container-title":["European Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eurpub\/article-pdf\/35\/5\/1058\/64100069\/ckaf149.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurpub\/article-pdf\/35\/5\/1058\/64100069\/ckaf149.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T11:02:00Z","timestamp":1760612520000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurpub\/article\/35\/5\/1058\/8239049"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,20]]},"references-count":20,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,8,20]]},"published-print":{"date-parts":[[2025,10,1]]}},"URL":"https:\/\/doi.org\/10.1093\/eurpub\/ckaf149","relation":{},"ISSN":["1101-1262","1464-360X"],"issn-type":[{"type":"print","value":"1101-1262"},{"type":"electronic","value":"1464-360X"}],"subject":[],"published-other":{"date-parts":[[2025,10]]},"published":{"date-parts":[[2025,8,20]]}}}