Pre-existing COPD is associated with an increased risk of mortality and severity in COVID-19: a rapid systematic review and meta-analysis.

Bangladesh Betar (Radio), Ministry of Information, Dhaka, Bangladesh. Institute for Physical Activity and Nutrition, Deakin University, Burwood, Australia. School of Health, Federation University Australia, Berwick, Australia. Australian Institute of Primary Care and Ageing, La Trobe University, Melbourne, Australia. Infectious Diseases Division, International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh. School of Public Health, Guangxi Medical University, Nanning, China. Department of Public Health, University of South Asia, Dhaka, Bangladesh. School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.

Expert review of respiratory medicine. 2021;(5):705-716
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Abstract

Objectives: The objective of this systematic review and meta-analysis was to investigate COVID-19 mortality and severity among patients with pre-existing COPD.Methods: We performed systematic searches in Ovid Medline, Embase via Ovid, PubMed, and Scopus from 15 December 2019 to 7 July 2020. Studies which reported the association and presented data on risk estimate (Hazard Ratio [HR]) with 95% confidence intervals (95%CIs) were extracted. A random-effects model was used to obtain the pooled estimates, and a pooled Risk Ratio (RR) was calculated. Study quality was assessed using a modified version of the Newcastle-Ottawa Scale.Results: Our meta-analysis showed an increased likelihood of mortality in COVID-19 patients with pre-existing COPD (RR 3.18, 95% CI 2.11-4.80, HR 1.90, 95%CI 1.11-3.26). Furthermore, the pooled estimate for the association between pre-existing COPD and severity due to COVID-19 was also significant (RR 3.63, 95%CI 2.48-5.31). Males had an increased risk of mortality (RR 1.20, 95%CI 1.12-1.29) compared to females.Conclusion: We found that patients with pre-existing COPD had more than 3 times higher risk of mortality and severe COVID-19. There is a need to identify patients with pre-existing COPD during the pandemic so that early interventions can be aimed at this group of patients.

Methodological quality

Publication Type : Meta-Analysis

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