{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:23:47Z","timestamp":1789053827853,"version":"build-2803163510"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:00:00Z","timestamp":1752537600000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Respiratory J"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pre\u2010Omicron studies identified chronic obstructive pulmonary disease (COPD) as a significant risk factor for adverse COVID\u201019 outcomes. Given Omicron's altered pathogenicity and widespread population\u2010level immunity, the association between COPD and COVID\u201019 outcomes warrants reassessment in light of the variant's distinct clinical profile. We evaluated whether COPD remained a risk factor for poor clinical outcomes among hospitalized patients with SARS\u2010CoV\u20102 infection during Omicron predominance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a two\u2010center retrospective cohort study of 1176 adults hospitalized with confirmed Omicron infection between January 2022 and December 2023 in Northern China. Patients were stratified by pre\u2010existing COPD status. To address confounding by treatment selection, inverse probability weighting (IPW) was applied based on the likelihood of receiving inhaled corticosteroids. Multivariable logistic regression models, adjusted for comorbidities, disease severity (as measured by the PSI), inflammatory markers (CRP, D\u2010dimer, NLR, LDH), and treatment regimens, were used to evaluate the associations between COPD and in\u2010hospital outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 1176 patients (337 COPD; 839 non\u2010COPD), COPD patients had significantly lower PSI scores and lower levels of systemic inflammation despite a higher prevalence of respiratory comorbidities. In unadjusted models, COPD was associated with reduced odds of mortality (OR 0.52), respiratory failure (OR 0.24), and ventilatory support. However, after IPW adjustment, these associations were no longer statistically significant (mortality: adjusted OR 0.90, 95% CI 0.22\u20133.74, <jats:italic>p<\/jats:italic>\u2009=\u20090.887).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>COPD was not independently associated with increased risk of mortality, respiratory failure, or ventilatory support in hospitalized Omicron\u2010infected patients after rigorous adjustment for confounding. These findings suggest a shifting risk profile for COPD during Omicron predominance, likely influenced by variant tropism, treatment effects, and altered inflammatory responses. Future prospective studies are warranted to validate these findings and explore the mechanisms underlying this observed shift.<\/jats:p><\/jats:sec>","DOI":"10.1111\/crj.70104","type":"journal-article","created":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T04:26:42Z","timestamp":1752640002000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association of COPD With Clinical Outcomes After Hospital Admission in SARS\u2010CoV\u20102 Patients During the Omicron Variant Period: A Retrospective Cohort Study"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9747-8697","authenticated-orcid":false,"given":"Rui","family":"Tang","sequence":"first","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine Hebei Medical University, Tangshan Gongren Hospital  Tangshan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5984-1603","authenticated-orcid":false,"given":"Lijuan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine China\u2010Japan Friendship Hospital, National Clinical Research Center of Respiratory Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuwei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine Tangshan Gongren Hospital  Tangshan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fen","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine Tangshan Gongren Hospital  Tangshan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renwei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine Tangshan Gongren Hospital  Tangshan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine Tangshan Gongren Hospital  Tangshan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine Tangshan Gongren Hospital  Tangshan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanying","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine Tangshan Gongren Hospital  Tangshan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yadong","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine The Second Hospital of Hebei Medical University  Shijiazhuang China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,15]]},"reference":[{"issue":"10","key":"e_1_2_12_2_1","first-page":"e1357","article-title":"The Political Determinants of COVID\u201019: Challenges for Equitable Vaccine Access","volume":"9","author":"Figueroa J. 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