Viral hospitalised AECOPD are associated with longer hospitalisation compared to non-viral exacerbations. Whilst comorbid COPD was shown to increase mortality among early reported cohorts of hospitalised SARS-Cov2 infection, the prognosis of SARS-CoV2 infection has since improved with vaccination, viral mutations and effective pharmacotherapies. The relative impact of SARS-CoV2 versus other respiratory viruses in hospitalised AECOPD in the current era has not been reported. 

Potential AECOPD admissions between Jan 2022 ? Aug 2022 were identified using discharge codes. During this period, circulating strains of SARS-Cov2 in the local population were generally Omicron derived. Manual case record inspection was performed to confirm accurate identification of AECOPDs with positive viral testing. Clinical characteristics and outcomes were compared between AECOPD due to SARS-CoV-2 and the other viruses. 

200 viral AECOPDs - 126 SARS-CoV-2 and 74 other viruses were identified. Of the SARS-CoV2 group. 13.6% were unvaccinated, 17.6% partially and 68.8% fully vaccinated. The SARS-CoV-2 group were older (78 vs 68, p<0.0001) with more comorbidities (1[1-2] vs 1[0-2], p=0.005) and lower candidacy for full resuscitation (25.4% vs 55.2%, p<0.001). Mortality tended to be higher among SARS-CoV2 admission (9.5% v 2.6%, p=0.062) but rates of ICU admission (10.3% v 13.2%, p=0.54), length of hospitalisation (5[3-9] vs 5[3-8.5], p=0.9) and readmission within 30 days (25% vs 33.8%, p=0.2) were similar. 

In a highly vaccinated population, those hospitalised with SARS-CoV2 appear older with more comorbidities than those admitted with other respiratory viruses, and in our cohort, inpatient mortality may be higher.