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Prevalence, Severity and Mortality associated with COPD and Smoking in patients with COVID-19: A Rapid Systematic Review and Meta-Analysis.
PLoS One. 2020; 15(5):e0233147.Plos

Abstract

BACKGROUND

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.

METHODS

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).

RESULTS

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%.

CONCLUSION

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.

Authors+Show Affiliations

UCL Respiratory, University College London, London, United Kingdom. Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia.UCL Institute for Liver and Digestive Health, London, United Kingdom.UCL Respiratory, University College London, London, United Kingdom. Respiratory Care Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia.National Heart and Lung Institute, Imperial College London, London, United Kingdom. Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia.UCL Institute for Risk and Disaster, London, United Kingdom.Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia.UCL Respiratory, University College London, London, United Kingdom.UCL Respiratory, University College London, London, United Kingdom. Royal Free London NHS Foundation Trust, London, United Kingdom.UCL Respiratory, University College London, London, United Kingdom.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

32392262

Citation

Alqahtani, Jaber S., et al. "Prevalence, Severity and Mortality Associated With COPD and Smoking in Patients With COVID-19: a Rapid Systematic Review and Meta-Analysis." PloS One, vol. 15, no. 5, 2020, pp. e0233147.
Alqahtani JS, Oyelade T, Aldhahir AM, et al. Prevalence, Severity and Mortality associated with COPD and Smoking in patients with COVID-19: A Rapid Systematic Review and Meta-Analysis. PLoS One. 2020;15(5):e0233147.
Alqahtani, J. S., Oyelade, T., Aldhahir, A. M., Alghamdi, S. M., Almehmadi, M., Alqahtani, A. S., Quaderi, S., Mandal, S., & Hurst, J. R. (2020). Prevalence, Severity and Mortality associated with COPD and Smoking in patients with COVID-19: A Rapid Systematic Review and Meta-Analysis. PloS One, 15(5), e0233147. https://doi.org/10.1371/journal.pone.0233147
Alqahtani JS, et al. Prevalence, Severity and Mortality Associated With COPD and Smoking in Patients With COVID-19: a Rapid Systematic Review and Meta-Analysis. PLoS One. 2020;15(5):e0233147. PubMed PMID: 32392262.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence, Severity and Mortality associated with COPD and Smoking in patients with COVID-19: A Rapid Systematic Review and Meta-Analysis. AU - Alqahtani,Jaber S, AU - Oyelade,Tope, AU - Aldhahir,Abdulelah M, AU - Alghamdi,Saeed M, AU - Almehmadi,Mater, AU - Alqahtani,Abdullah S, AU - Quaderi,Shumonta, AU - Mandal,Swapna, AU - Hurst,John R, Y1 - 2020/05/11/ PY - 2020/03/31/received PY - 2020/04/29/accepted PY - 2020/5/12/entrez PY - 2020/5/12/pubmed PY - 2020/5/15/medline SP - e0233147 EP - e0233147 JF - PloS one JO - PLoS One VL - 15 IS - 5 N2 - BACKGROUND: 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. METHODS: 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). RESULTS: 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%. CONCLUSION: 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. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/32392262/Prevalence_Severity_and_Mortality_associated_with_COPD_and_Smoking_in_patients_with_COVID_19:_A_Rapid_Systematic_Review_and_Meta_Analysis_ DB - PRIME DP - Unbound Medicine ER -