Epidemiologic studies suggest that COPD is associated with an increased risk of poor outcome in patients with COVID-19, although they failed to demonstrate COPD as a risk factor for acquiring COVID-19. However, most data have come from a limited global population. The aim of this study is to determine whether COPD influences the occurrence and clinical severity of COVID-19. This large-scale cohort covers individuals who underwent SARS-CoV-2 testing in South Korea from January 1, 2020 to May 1, 2020 supported by the Korean Centers for Disease Control and the National health insurance service (NHIS). For each patient who underwent SARS-CoV-2 testing, we combined medical data on COVID-19-related outcomes during the hospitalization with claim-based data from January 1, 2015 to May 1, 2020, including personal data (age, sex, region of residence, and socioeconomic status) and health care records of inpatients and outpatients throughout the past 5 years (including health care visits, prescriptions, diagnoses, and procedures), retrospectively. Among all patients tested, the positivity rate of SARS-CoV-2 testing in patients with COPD was 7.3% (350/4800), compared with 4.8% (230/4800) in those without COPD (aOR, 1.54; 95% CI, 1.3-1.83) The rate of severe disease in patients with COPD was 28.9% (101/350) among patients who tested positive for SARS-CoV-2, compared with 25.1% (88/350) in those without COPD (aOR, 1.23; 95% CI, 0.85-1.76). In particular, among patients confirmed to have COVID-19, the rate of mortality in patients with COPD was 17.7% (62/350), compared with 13.7% (48/350) in those without COPD (aOR, 1.39; 95% CI, 0.87-2.23) In this nationwide cohort study based on the Korean national health insurance claims-based database, COPD is associated with increased risk for COVID-19 and having COPD does not seem to confer substantial risk for severe COVID-19 and mortality.