Prevalence, Severity and Mortality associated with COPD and Smoking in patients with COVID-19: A Rapid Systematic Review and Meta-Analysis
Coronavirus disease 2019 (COVID-19) is an evolving infectious disease that dramatically spread all over the world in the early part of 2020. No studies have yet summarized the potential severity and mortality risks caused by COVID-19 in patients with chronic obstructive pulmonary disease (COPD), and...
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| Veröffentlicht in: | PloS one 2020-05, Vol.15 (5), p.e0233147 |
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| creator | Alqahtani, Jaber S Oyelade, Tope Aldhahir, Abdulelah M Alghamdi, Saeed M Almehmadi, Mater Alqahtani, Abdullah S Quaderi, Shumonta Mandal, Swapna Hurst, John R |
| description | Coronavirus disease 2019 (COVID-19) is an evolving infectious disease that dramatically spread all over the world in the early part of 2020. No studies have yet summarized the potential severity and mortality risks caused by COVID-19 in patients with chronic obstructive pulmonary disease (COPD), and we update information in smokers.
We systematically searched electronic databases from inception to March 24, 2020. Data were extracted by two independent authors in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study quality was assessed using a modified version of the Newcastle-Ottawa Scale. We synthesized a narrative from eligible studies and conducted a meta-analysis using a random-effects model to calculate pooled prevalence rates and 95% confidence intervals (95%CI).
In total, 123 abstracts were screened and 61 full-text manuscripts were reviewed. A total of 15 studies met the inclusion criteria, which included a total of 2473 confirmed COVID-19 patients. All studies were included in the meta-analysis. The crude case fatality rate of COVID-19 was 7.4%. The pooled prevalence rates of COPD patients and smokers in COVID-19 cases were 2% (95% CI, 1%-3%) and 9% (95% CI, 4%-14%) respectively. COPD patients were at a higher risk of more severe disease (risk of severity = 63%, (22/35) compared to patients without COPD 33.4% (409/1224) [calculated RR, 1.88 (95% CI, 1.4-2.4)]. This was associated with higher mortality (60%). Our results showed that 22% (31/139) of current smokers and 46% (13/28) of ex-smokers had severe complications. The calculated RR showed that current smokers were 1.45 times more likely [95% CI: 1.03-2.04] to have severe complications compared to former and never smokers. Current smokers also had a higher mortality rate of 38.5%.
Although COPD prevalence in COVID-19 cases was low in current reports, COVID-19 infection was associated with substantial severity and mortality rates in COPD. Compared to former and never smokers, current smokers were at greater risk of severe complications and higher mortality rate. Effective preventive measures are required to reduce COVID-19 risk in COPD patients and current smokers. |
| doi_str_mv | 10.1371/journal.pone.0233147 |
| format | Article |
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We systematically searched electronic databases from inception to March 24, 2020. Data were extracted by two independent authors in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study quality was assessed using a modified version of the Newcastle-Ottawa Scale. We synthesized a narrative from eligible studies and conducted a meta-analysis using a random-effects model to calculate pooled prevalence rates and 95% confidence intervals (95%CI).
In total, 123 abstracts were screened and 61 full-text manuscripts were reviewed. A total of 15 studies met the inclusion criteria, which included a total of 2473 confirmed COVID-19 patients. All studies were included in the meta-analysis. The crude case fatality rate of COVID-19 was 7.4%. The pooled prevalence rates of COPD patients and smokers in COVID-19 cases were 2% (95% CI, 1%-3%) and 9% (95% CI, 4%-14%) respectively. COPD patients were at a higher risk of more severe disease (risk of severity = 63%, (22/35) compared to patients without COPD 33.4% (409/1224) [calculated RR, 1.88 (95% CI, 1.4-2.4)]. This was associated with higher mortality (60%). Our results showed that 22% (31/139) of current smokers and 46% (13/28) of ex-smokers had severe complications. The calculated RR showed that current smokers were 1.45 times more likely [95% CI: 1.03-2.04] to have severe complications compared to former and never smokers. Current smokers also had a higher mortality rate of 38.5%.
Although COPD prevalence in COVID-19 cases was low in current reports, COVID-19 infection was associated with substantial severity and mortality rates in COPD. Compared to former and never smokers, current smokers were at greater risk of severe complications and higher mortality rate. Effective preventive measures are required to reduce COVID-19 risk in COPD patients and current smokers.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0233147</identifier><identifier>PMID: 32392262</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Betacoronavirus ; Bias ; Biology and Life Sciences ; Chronic obstructive lung disease ; Chronic obstructive pulmonary disease ; Communicable diseases ; Complications ; Complications and side effects ; Confidence intervals ; Coronavirus Infections - complications ; Coronavirus Infections - epidemiology ; Coronavirus Infections - mortality ; Coronavirus Infections - physiopathology ; Coronaviruses ; COVID-19 ; Disease ; Disease transmission ; Diseases ; Editorials ; Exports ; Health aspects ; Health risks ; Health sciences ; Humans ; Infectious diseases ; Lung diseases ; Medical research ; Medicine and Health Sciences ; Meta-analysis ; Middle East respiratory syndrome ; Mortality ; Narratives ; Obstructive lung disease ; Pandemics ; Patient outcomes ; Physical Sciences ; Pneumonia, Viral - complications ; Pneumonia, Viral - epidemiology ; Pneumonia, Viral - mortality ; Pneumonia, Viral - physiopathology ; Prevalence ; Prevalence studies (Epidemiology) ; Pulmonary Disease, Chronic Obstructive - complications ; Quality assessment ; Research and Analysis Methods ; Respiratory diseases ; Risk ; Risk factors ; SARS-CoV-2 ; Severe acute respiratory syndrome coronavirus 2 ; Severity of Illness Index ; Smokers ; Smoking ; Social Sciences ; Software ; Studies ; Survival Rate ; Systematic review ; Viral diseases</subject><ispartof>PloS one, 2020-05, Vol.15 (5), p.e0233147</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Alqahtani et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Alqahtani et al 2020 Alqahtani et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-8a5029b66da00d7ad94203383297473349b733cde6af6a7281cc3e8441c6c6b83</citedby><cites>FETCH-LOGICAL-c692t-8a5029b66da00d7ad94203383297473349b733cde6af6a7281cc3e8441c6c6b83</cites><orcidid>0000-0003-1795-5092</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213702/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213702/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32392262$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Alqahtani, Jaber S</creatorcontrib><creatorcontrib>Oyelade, Tope</creatorcontrib><creatorcontrib>Aldhahir, Abdulelah M</creatorcontrib><creatorcontrib>Alghamdi, Saeed M</creatorcontrib><creatorcontrib>Almehmadi, Mater</creatorcontrib><creatorcontrib>Alqahtani, Abdullah S</creatorcontrib><creatorcontrib>Quaderi, Shumonta</creatorcontrib><creatorcontrib>Mandal, Swapna</creatorcontrib><creatorcontrib>Hurst, John R</creatorcontrib><title>Prevalence, Severity and Mortality associated with COPD and Smoking in patients with COVID-19: A Rapid Systematic Review and Meta-Analysis</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Coronavirus disease 2019 (COVID-19) is an evolving infectious disease that dramatically spread all over the world in the early part of 2020. No studies have yet summarized the potential severity and mortality risks caused by COVID-19 in patients with chronic obstructive pulmonary disease (COPD), and we update information in smokers.
We systematically searched electronic databases from inception to March 24, 2020. Data were extracted by two independent authors in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study quality was assessed using a modified version of the Newcastle-Ottawa Scale. We synthesized a narrative from eligible studies and conducted a meta-analysis using a random-effects model to calculate pooled prevalence rates and 95% confidence intervals (95%CI).
In total, 123 abstracts were screened and 61 full-text manuscripts were reviewed. A total of 15 studies met the inclusion criteria, which included a total of 2473 confirmed COVID-19 patients. All studies were included in the meta-analysis. The crude case fatality rate of COVID-19 was 7.4%. The pooled prevalence rates of COPD patients and smokers in COVID-19 cases were 2% (95% CI, 1%-3%) and 9% (95% CI, 4%-14%) respectively. COPD patients were at a higher risk of more severe disease (risk of severity = 63%, (22/35) compared to patients without COPD 33.4% (409/1224) [calculated RR, 1.88 (95% CI, 1.4-2.4)]. This was associated with higher mortality (60%). Our results showed that 22% (31/139) of current smokers and 46% (13/28) of ex-smokers had severe complications. The calculated RR showed that current smokers were 1.45 times more likely [95% CI: 1.03-2.04] to have severe complications compared to former and never smokers. Current smokers also had a higher mortality rate of 38.5%.
Although COPD prevalence in COVID-19 cases was low in current reports, COVID-19 infection was associated with substantial severity and mortality rates in COPD. Compared to former and never smokers, current smokers were at greater risk of severe complications and higher mortality rate. Effective preventive measures are required to reduce COVID-19 risk in COPD patients and current smokers.</description><subject>Betacoronavirus</subject><subject>Bias</subject><subject>Biology and Life Sciences</subject><subject>Chronic obstructive lung disease</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Communicable diseases</subject><subject>Complications</subject><subject>Complications and side effects</subject><subject>Confidence intervals</subject><subject>Coronavirus Infections - complications</subject><subject>Coronavirus Infections - epidemiology</subject><subject>Coronavirus Infections - mortality</subject><subject>Coronavirus Infections - physiopathology</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>Disease</subject><subject>Disease transmission</subject><subject>Diseases</subject><subject>Editorials</subject><subject>Exports</subject><subject>Health aspects</subject><subject>Health risks</subject><subject>Health sciences</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Lung diseases</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Meta-analysis</subject><subject>Middle East respiratory syndrome</subject><subject>Mortality</subject><subject>Narratives</subject><subject>Obstructive lung disease</subject><subject>Pandemics</subject><subject>Patient outcomes</subject><subject>Physical Sciences</subject><subject>Pneumonia, Viral - complications</subject><subject>Pneumonia, Viral - epidemiology</subject><subject>Pneumonia, Viral - mortality</subject><subject>Pneumonia, Viral - physiopathology</subject><subject>Prevalence</subject><subject>Prevalence studies (Epidemiology)</subject><subject>Pulmonary Disease, Chronic Obstructive - complications</subject><subject>Quality assessment</subject><subject>Research and Analysis Methods</subject><subject>Respiratory diseases</subject><subject>Risk</subject><subject>Risk factors</subject><subject>SARS-CoV-2</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Severity of Illness Index</subject><subject>Smokers</subject><subject>Smoking</subject><subject>Social Sciences</subject><subject>Software</subject><subject>Studies</subject><subject>Survival Rate</subject><subject>Systematic review</subject><subject>Viral diseases</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk9uO0zAQhiMEYpfCGyCIhIRAIsWnOgkXSFWXQ6VFXbWwt9bEmbZekrjEbpe-Ak-Ne1q1aC9QpBycb_7xzO-JoueUdClP6fsbu2wbqLoL22CXMM6pSB9E5zTnLJGM8IdH72fRE-duCOnxTMrH0RlnPGdMsvPoz1WLK6iw0fgunuAKW-PXMTRl_M22Hqrtl3NWG_BYxrfGz-PB6Opii0xq-9M0s9g08QK8wca7A3E9vEho_iHux2NYmICuncc6QDoe48rg7S4Hekj6oYq1M-5p9GgKlcNn-2cn-vH50_fB1-Ry9GU46F8mWubMJxn0CMsLKUsgpEyhzEWokGec5alIORd5Ee66RAlTCSnLqNYcMyGolloWGe9EL3e6i8o6tW-jU0wQSmTe4yIQwx1RWrhRi9bU0K6VBaO2C7adKWhDKRUqJFAAE0WZAxGF0BlNp1kvbK-QQuiyCFof99mWRY2lDk1qoToRPf3TmLma2ZVKWbA5-NqJ3uwFWvtric6r2jiNVQUN2uVu31lwOpjbiV79g95f3Z6aBd-VaaY25NUbUdWXjPeYJDQNVPceKlwl1kaHMzc1Yf0k4O1JQGA8_vYzWDqnhpPx_7Oj61P29RE7R6j83Nlq6Y1t3CkodqBurXMtTu-aTInajMyhG2ozMmo_MiHsxbFBd0GHGeF_AcGtD7E</recordid><startdate>20200511</startdate><enddate>20200511</enddate><creator>Alqahtani, Jaber S</creator><creator>Oyelade, Tope</creator><creator>Aldhahir, Abdulelah M</creator><creator>Alghamdi, Saeed M</creator><creator>Almehmadi, Mater</creator><creator>Alqahtani, Abdullah S</creator><creator>Quaderi, Shumonta</creator><creator>Mandal, Swapna</creator><creator>Hurst, John R</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>COVID</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-1795-5092</orcidid></search><sort><creationdate>20200511</creationdate><title>Prevalence, Severity and Mortality associated with COPD and Smoking in patients with COVID-19: A Rapid Systematic Review and Meta-Analysis</title><author>Alqahtani, Jaber S ; Oyelade, Tope ; Aldhahir, Abdulelah M ; Alghamdi, Saeed M ; Almehmadi, Mater ; Alqahtani, Abdullah S ; Quaderi, Shumonta ; Mandal, Swapna ; Hurst, John R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-8a5029b66da00d7ad94203383297473349b733cde6af6a7281cc3e8441c6c6b83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Betacoronavirus</topic><topic>Bias</topic><topic>Biology and Life Sciences</topic><topic>Chronic obstructive lung disease</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Communicable diseases</topic><topic>Complications</topic><topic>Complications and side effects</topic><topic>Confidence intervals</topic><topic>Coronavirus Infections - 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physiopathology</topic><topic>Prevalence</topic><topic>Prevalence studies (Epidemiology)</topic><topic>Pulmonary Disease, Chronic Obstructive - complications</topic><topic>Quality assessment</topic><topic>Research and Analysis Methods</topic><topic>Respiratory diseases</topic><topic>Risk</topic><topic>Risk factors</topic><topic>SARS-CoV-2</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>Severity of Illness Index</topic><topic>Smokers</topic><topic>Smoking</topic><topic>Social Sciences</topic><topic>Software</topic><topic>Studies</topic><topic>Survival Rate</topic><topic>Systematic review</topic><topic>Viral diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Alqahtani, Jaber S</creatorcontrib><creatorcontrib>Oyelade, Tope</creatorcontrib><creatorcontrib>Aldhahir, Abdulelah M</creatorcontrib><creatorcontrib>Alghamdi, Saeed M</creatorcontrib><creatorcontrib>Almehmadi, Mater</creatorcontrib><creatorcontrib>Alqahtani, Abdullah S</creatorcontrib><creatorcontrib>Quaderi, Shumonta</creatorcontrib><creatorcontrib>Mandal, Swapna</creatorcontrib><creatorcontrib>Hurst, John R</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>Coronavirus Research Database</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Alqahtani, Jaber S</au><au>Oyelade, Tope</au><au>Aldhahir, Abdulelah M</au><au>Alghamdi, Saeed M</au><au>Almehmadi, Mater</au><au>Alqahtani, Abdullah S</au><au>Quaderi, Shumonta</au><au>Mandal, Swapna</au><au>Hurst, John R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence, Severity and Mortality associated with COPD and Smoking in patients with COVID-19: A Rapid Systematic Review and Meta-Analysis</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2020-05-11</date><risdate>2020</risdate><volume>15</volume><issue>5</issue><spage>e0233147</spage><pages>e0233147-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Coronavirus disease 2019 (COVID-19) is an evolving infectious disease that dramatically spread all over the world in the early part of 2020. No studies have yet summarized the potential severity and mortality risks caused by COVID-19 in patients with chronic obstructive pulmonary disease (COPD), and we update information in smokers.
We systematically searched electronic databases from inception to March 24, 2020. Data were extracted by two independent authors in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study quality was assessed using a modified version of the Newcastle-Ottawa Scale. We synthesized a narrative from eligible studies and conducted a meta-analysis using a random-effects model to calculate pooled prevalence rates and 95% confidence intervals (95%CI).
In total, 123 abstracts were screened and 61 full-text manuscripts were reviewed. A total of 15 studies met the inclusion criteria, which included a total of 2473 confirmed COVID-19 patients. All studies were included in the meta-analysis. The crude case fatality rate of COVID-19 was 7.4%. The pooled prevalence rates of COPD patients and smokers in COVID-19 cases were 2% (95% CI, 1%-3%) and 9% (95% CI, 4%-14%) respectively. COPD patients were at a higher risk of more severe disease (risk of severity = 63%, (22/35) compared to patients without COPD 33.4% (409/1224) [calculated RR, 1.88 (95% CI, 1.4-2.4)]. This was associated with higher mortality (60%). Our results showed that 22% (31/139) of current smokers and 46% (13/28) of ex-smokers had severe complications. The calculated RR showed that current smokers were 1.45 times more likely [95% CI: 1.03-2.04] to have severe complications compared to former and never smokers. Current smokers also had a higher mortality rate of 38.5%.
Although COPD prevalence in COVID-19 cases was low in current reports, COVID-19 infection was associated with substantial severity and mortality rates in COPD. Compared to former and never smokers, current smokers were at greater risk of severe complications and higher mortality rate. Effective preventive measures are required to reduce COVID-19 risk in COPD patients and current smokers.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>32392262</pmid><doi>10.1371/journal.pone.0233147</doi><tpages>e0233147</tpages><orcidid>https://orcid.org/0000-0003-1795-5092</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2020-05, Vol.15 (5), p.e0233147 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2401069534 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Betacoronavirus Bias Biology and Life Sciences Chronic obstructive lung disease Chronic obstructive pulmonary disease Communicable diseases Complications Complications and side effects Confidence intervals Coronavirus Infections - complications Coronavirus Infections - epidemiology Coronavirus Infections - mortality Coronavirus Infections - physiopathology Coronaviruses COVID-19 Disease Disease transmission Diseases Editorials Exports Health aspects Health risks Health sciences Humans Infectious diseases Lung diseases Medical research Medicine and Health Sciences Meta-analysis Middle East respiratory syndrome Mortality Narratives Obstructive lung disease Pandemics Patient outcomes Physical Sciences Pneumonia, Viral - complications Pneumonia, Viral - epidemiology Pneumonia, Viral - mortality Pneumonia, Viral - physiopathology Prevalence Prevalence studies (Epidemiology) Pulmonary Disease, Chronic Obstructive - complications Quality assessment Research and Analysis Methods Respiratory diseases Risk Risk factors SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 Severity of Illness Index Smokers Smoking Social Sciences Software Studies Survival Rate Systematic review Viral diseases |
| title | Prevalence, Severity and Mortality associated with COPD and Smoking in patients with COVID-19: A Rapid Systematic Review and Meta-Analysis |
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