COPD and the risk of poor outcomes in COVID-19: A systematic review and meta-analysis. (March 2021)

• Record Type: Journal Article
• Authors: Gerayeli, Firoozeh V.; Milne, Stephen; Cheung, Chung; Li, Xuan; Yang, Cheng Wei Tony; Tam, Anthony; Choi, Lauren H.; Bae, Annie; Sin, Don D.
• Is Part Of: EClinicalMedicine. Volume 33(2021)
• Publication Date: 2021-03
• Subjects: COVID-19 -- COPD -- Meta-analysis -- mortality; Medicine -- Research -- Periodicals; Medical policy -- Periodicals; Clinical Medicine; Health Policy; Public Health; Medical policy; Medicine -- Research; Periodical; Electronic journals; Periodicals; 613
• DOI: 10.1016/j.eclinm.2021.100789
• Languages: English
• ISSNs: 2589-5370

Abstract

Abstract: Background: Patients with chronic obstructive pulmonary disease (COPD) are highly susceptible from respiratory exacerbations from viral respiratory tract infections. However, it is unclear whether they are at increased risk of COVID-19 pneumonia or COVID-19-related mortality. We aimed to determine whether COPD is a risk factor for adverse COVID-19 outcomes including hospitalization, severe COVID-19, or death. Methods: Following the PRISMA guidelines, we performed a systematic review of COVID-19 clinical studies published between November 1 st, 2019 and January 28 th, 2021 (PROSPERO ID: CRD42020191491). We included studies that quantified the number of COPD patients, and reported at least one of the following outcomes stratified by COPD status: hospitalization; severe COVID-19; ICU admission; mechanical ventilation; acute respiratory distress syndrome; or mortality. We meta-analyzed the results of individual studies to determine the odds ratio (OR) of these outcomes in patients with COPD compared to those without COPD. Findings: Fifty-nine studies met the inclusion criteria, and underwent data extraction. Most studies were retrospective cohort studies/case series of hospitalized patients. Only four studies examined the effects of COPD on COVID-19 outcomes as their primary endpoint. In aggregate, COPD was associated with increased odds of hospitalization (OR 4.23, 95% confidence interval [CI] 3.65–4.90), ICU admission (OR 1.35, 95% CI 1.02–1.78), and mortality (OR 2.47, 95% CI 2.18–2.79). Interpretation: Having a clinical diagnosis of COPD significantly increases the odds of poor clinical outcomes in patients with COVID-19. COPD patients should thus be considered a high-risk group, and targeted for preventative measures and aggressive treatment for COVID-19 including vaccination.