The impact of COPD and smoking history on the severity of COVID‐19: A systemic review and meta‐analysis

Comorbidities are associated with the severity of coronavirus disease 2019 (COVID‐19). This meta‐analysis aimed to explore the risk of severe COVID‐19 in patients with pre‐existing chronic obstructive pulmonary disease (COPD) and ongoing smoking history. A comprehensive systematic literature search...

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Published inJournal of medical virology Vol. 92; no. 10; pp. 1915 - 1921
Main Authors Zhao, Qianwen, Meng, Meng, Kumar, Rahul, Wu, Yinlian, Huang, Jiaofeng, Lian, Ningfang, Deng, Yunlei, Lin, Su
Format Journal Article
LanguageEnglish
Published United States Wiley Subscription Services, Inc 01.10.2020
John Wiley and Sons Inc
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Abstract Comorbidities are associated with the severity of coronavirus disease 2019 (COVID‐19). This meta‐analysis aimed to explore the risk of severe COVID‐19 in patients with pre‐existing chronic obstructive pulmonary disease (COPD) and ongoing smoking history. A comprehensive systematic literature search was carried out to find studies published from December 2019 to 22 March 2020 from five databases. The languages of literature included English and Chinese. The point prevalence of severe COVID‐19 in patients with pre‐existing COPD and those with ongoing smoking was evaluated with this meta‐analysis. Overall 11 case series, published either in Chinese or English language with a total of 2002 cases, were included in this study. The pooled OR of COPD and the development of severe COVID‐19 was 4.38 (fixed‐effects model; 95% CI: 2.34‐8.20), while the OR of ongoing smoking was 1.98 (fixed‐effects model; 95% CI: 1.29‐3.05). There was no publication bias as examined by the funnel plot and Egger's test (P = not significant). The heterogeneity of included studies was moderate for both COPD and ongoing smoking history on the severity of COVID‐19. COPD and ongoing smoking history attribute to the worse progression and outcome of COVID‐19.
AbstractList Comorbidities are associated with the severity of coronavirus disease 2019 (COVID‐19). This meta‐analysis aimed to explore the risk of severe COVID‐19 in patients with pre‐existing chronic obstructive pulmonary disease (COPD) and ongoing smoking history. A comprehensive systematic literature search was carried out to find studies published from December 2019 to 22 March 2020 from five databases. The languages of literature included English and Chinese. The point prevalence of severe COVID‐19 in patients with pre‐existing COPD and those with ongoing smoking was evaluated with this meta‐analysis. Overall 11 case series, published either in Chinese or English language with a total of 2002 cases, were included in this study. The pooled OR of COPD and the development of severe COVID‐19 was 4.38 (fixed‐effects model; 95% CI: 2.34‐8.20), while the OR of ongoing smoking was 1.98 (fixed‐effects model; 95% CI: 1.29‐3.05). There was no publication bias as examined by the funnel plot and Egger's test (P = not significant). The heterogeneity of included studies was moderate for both COPD and ongoing smoking history on the severity of COVID‐19. COPD and ongoing smoking history attribute to the worse progression and outcome of COVID‐19.
Comorbidities are associated with the severity of coronavirus disease 2019 (COVID-19). This meta-analysis aimed to explore the risk of severe COVID-19 in patients with pre-existing chronic obstructive pulmonary disease (COPD) and ongoing smoking history. A comprehensive systematic literature search was carried out to find studies published from December 2019 to 22 March 2020 from five databases. The languages of literature included English and Chinese. The point prevalence of severe COVID-19 in patients with pre-existing COPD and those with ongoing smoking was evaluated with this meta-analysis. Overall 11 case series, published either in Chinese or English language with a total of 2002 cases, were included in this study. The pooled OR of COPD and the development of severe COVID-19 was 4.38 (fixed-effects model; 95% CI: 2.34-8.20), while the OR of ongoing smoking was 1.98 (fixed-effects model; 95% CI: 1.29-3.05). There was no publication bias as examined by the funnel plot and Egger's test (P = not significant). The heterogeneity of included studies was moderate for both COPD and ongoing smoking history on the severity of COVID-19. COPD and ongoing smoking history attribute to the worse progression and outcome of COVID-19.Comorbidities are associated with the severity of coronavirus disease 2019 (COVID-19). This meta-analysis aimed to explore the risk of severe COVID-19 in patients with pre-existing chronic obstructive pulmonary disease (COPD) and ongoing smoking history. A comprehensive systematic literature search was carried out to find studies published from December 2019 to 22 March 2020 from five databases. The languages of literature included English and Chinese. The point prevalence of severe COVID-19 in patients with pre-existing COPD and those with ongoing smoking was evaluated with this meta-analysis. Overall 11 case series, published either in Chinese or English language with a total of 2002 cases, were included in this study. The pooled OR of COPD and the development of severe COVID-19 was 4.38 (fixed-effects model; 95% CI: 2.34-8.20), while the OR of ongoing smoking was 1.98 (fixed-effects model; 95% CI: 1.29-3.05). There was no publication bias as examined by the funnel plot and Egger's test (P = not significant). The heterogeneity of included studies was moderate for both COPD and ongoing smoking history on the severity of COVID-19. COPD and ongoing smoking history attribute to the worse progression and outcome of COVID-19.
Author Meng, Meng
Kumar, Rahul
Huang, Jiaofeng
Lian, Ningfang
Wu, Yinlian
Deng, Yunlei
Lin, Su
Zhao, Qianwen
AuthorAffiliation 3 Department of Gastroenterology and Hepatology Changi General Hospital Singapore
4 Liver Research Center The First Affiliated Hospitals of Fujian Medical University Fujian China
5 Department of Respiratory The First Affiliated Hospitals of Fujian Medical University Fujian China
1 Department of Gastroenterology and Hepatology, West China Hospital Sichuan University Chengdu China
2 Digestion Center, Beijing Hospital of Traditional Chinese Medicine Capital Medical University Beijing China
6 Department of Nephrology The Third People's Hospital of Chengdu Chengdu China
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Issue 10
Keywords COVID-2019
smoking
COPD
Language English
License 2020 Wiley Periodicals LLC.
This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.
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Notes Qianwen Zhao, Meng Meng, and Rahul Kumar contributed equally to this study and are co‐first authors.
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References_xml – year: 2020
  article-title: Clinical course and outcomes of critically ill patients with SARS‐CoV‐2 pneumonia in Wuhan, China: a single‐centered, retrospective, observational study
  publication-title: Lancet Respir Med
– volume: 9
  year: 2020
  article-title: From SARS to COVID‐19: a previously unknown SARS‐related coronavirus (SARS‐CoV‐2) of pandemic potential infecting humans—call for a one health approach
  publication-title: One Health (Amsterdam, Netherlands)
– year: 2020
  article-title: Clinical characteristics of coronavirus disease 2019 in China
  publication-title: N Engl J Med
– year: 2020
  article-title: Diagnostic utility of clinical laboratory data determinations for patients with the severe COVID‐19
  publication-title: J Med Virol
– year: 2020
  article-title: Imaging and clinical features of patients with 2019 novel coronavirus SAR‐CoV‐2: a systematic review and meta‐analysis
  publication-title: J Med Virol
– volume: 1
  year: 2020
  article-title: Coronavirus disease 2019: what we know?
  publication-title: J Med Virol
– volume: 323
  start-page: 1061
  issue: 11
  year: 2020
  article-title: Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus‐infected pneumonia in Wuhan, China
  publication-title: JAMA
– volume: 163
  start-page: 1304
  issue: 6
  year: 2001
  end-page: 1309
  article-title: Cellular and structural bases of chronic obstructive pulmonary disease
  publication-title: Am J Respir Crit Care Med
– volume: 395
  start-page: 497
  issue: 10223
  year: 2020
  end-page: 506
  article-title: Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China
  publication-title: Lancet
– year: 2020
  article-title: Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease
  publication-title: Chin Med J
– volume: 395
  start-page: 1054
  issue: 10229
  year: 2020
  end-page: 1062
  article-title: Clinical course and risk factors for mortality of adult inpatients with COVID‐19 in Wuhan, China: a retrospective cohort study
  publication-title: Lancet
– volume: 22
  start-page: 634
  issue: 4
  year: 2017
  end-page: 650
  article-title: The role of acute and chronic respiratory colonization and infections in the pathogenesis of COPD
  publication-title: Respirology (Carlton, Vic)
– volume: 14
  start-page: 357
  issue: 6
  year: 2000
  end-page: 361
  article-title: Cigarette smoking among the elderly: disease consequences and the benefits of cessation
  publication-title: Am J Health Promot
– volume: 92
  start-page: 552
  issue: 6
  year: 2020
  end-page: 555
  article-title: The neuroinvasive potential of SARS‐CoV2 may play a role in the respiratory failure of COVID‐19 patients
  publication-title: J Med Viro
– volume: 63
  start-page: 364
  issue: 3
  year: 2020
  end-page: 374
  article-title: Clinical and biochemical indexes from 2019‐nCoV infected patients linked to viral loads and lung injury
  publication-title: Sci China Life Sci
– year: 2020
  article-title: Clinical characteristics of 140 patients infected with SARS‐CoV‐2 in Wuhan, China
  publication-title: Allergy
– year: 2020
  article-title: Active smoking is not associated with severity of coronavirus disease 2019 (COVID‐19)
  publication-title: Eur J Intern Med
– year: 2020
  article-title: Retrospective study on the epidemiological characteristics of 139 patients with novel coronavirus pneumonia on the effects of severity
  publication-title: Chongqing Med.
– year: 2020
  article-title: Clinical features of 69 cases with coronavirus disease 2019 in Wuhan, China
  publication-title: Clin Infect Dis
– reference: 32369203 - J Med Virol. 2020 Nov;92(11):2304-2305
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Snippet Comorbidities are associated with the severity of coronavirus disease 2019 (COVID‐19). This meta‐analysis aimed to explore the risk of severe COVID‐19 in...
Comorbidities are associated with the severity of coronavirus disease 2019 (COVID-19). This meta-analysis aimed to explore the risk of severe COVID-19 in...
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SubjectTerms Chronic obstructive pulmonary disease
Comorbidity
COPD
Coronaviruses
COVID-19
COVID-19 - complications
COVID-19 - physiopathology
COVID‐2019
Disease Progression
English language
Heterogeneity
Humans
Lung diseases
Meta-analysis
Obstructive lung disease
Pulmonary Disease, Chronic Obstructive - complications
Smoking
Smoking - adverse effects
Viral diseases
Virology
Title The impact of COPD and smoking history on the severity of COVID‐19: A systemic review and meta‐analysis
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