Effect of chronic obstructive pulmonary disease and smoking on the outcome of COVID-19

Abstract

OBJECTIVE: To investigate the association between chronic obstructive pulmonary disease (COPD) and smoking with outcome in patients with COVID-19.METHODS: A systematic literature search was performed using PubMed, EuropePMC, SCOPUS and the Cochrane Central Database. A composite of poor outcome, mortality, severe COVID-19, the need for treatment in an intensive care unit (ICU) and disease progression were the outcomes of interest.RESULTS: Data on 4603 patients were pooled from 21 studies. COPD was associated with an increased risk for composite poor outcome (OR 5.01, 95%CI 3.06–8.22; P < 0.001; I2 0%), mortality (OR 4.36, 95%CI 1.45–13.10; P = 0.009; I2 0%), severe COVID-19 (OR 4.62, 95%CI 2.49–8.56; P < 0.001; I2 0%), ICU care (OR 8.33, 95%CI 1.27–54.56; P = 0.03; I2 0%), and disease progression (OR 8.42, 95%CI 1.60–44.27; P = 0.01; I2 0%). Smoking was found to increase the risk of composite poor outcome (OR 1.52, 95%CI 1.16–2.00; P = 0.005; I2 12%), and subgroup analysis showed that smoking was significant for increased risk of severe COVID-19 (OR 1.65, 95%CI 1.17–2.34; P = 0.004; I2 11%). Current smokers were at higher risk of composite poor outcomes (OR 1.58, 95%CI 1.10–2.27; P = 0.01; I2 0%) than former/non-smokers.CONCLUSION: Our systematic review and meta-analysis revealed that COPD and smoking were associated with poor outcomes in patients with COVID-19.

Clinical frailty scale and mortality in COVID-19: A systematic review and dose-response meta-analysis

“…Analysis for heterogeneity was limited due to the fact that only two studies reported comorbidities that are associated with increased mortality in COVID-19 patients. These comorbidities are obesity (OR 1.55), hypertension (OR 2.21), diabetes (Risk Ratio [RR] 2.38), cardiovascular diseases (RR 2.25), and chronic obstructive pulmonary disease (OR 4.36) ( Huang et al., 2020 ; Pranata et al., 2020b , c ; Pranata, Lim, Huang, Raharjo & Lukito, 2020a ; Pranata, Huang, Lim, Wahjoepramono & July, 2020d ). Ideally, exploration of heterogeneity can be performed using meta-regression, however, it cannot be performed due to the lack of studies.…”

Coronavirus disease 2019 (COVID-19) markedly increased mortality in patients with hip fracture – A systematic review and meta-analysis

“…22 Nevertheless, there are several factors that commonly coexists in patients with hip fracture, namely advanced age, obesity, and various comorbidities which are associated with increased severity and mortality of COVID-19. 8e11, 14,15,29,30 Because of reduced functional reserves and weakened immune function, these individuals are more adversely affected by SARS-COV-2 infection. The poor prognosis can be attributed to a combination of these factors rather than purely attributed to a single factor.…”

“…In addition to the presence of more than three pre-existing comorbidities, smoking, which is associated with increased severity in COVID-19, was found to independently increase postoperative mortality rates in COVID-19 patients. 7,14 After surgery, thromboembolic events can occur in patients due to restricted mobility. In certain cases, postoperative pulmonary complications could be observed within a few days or weeks after surgery.…”

“…20 Even worse, the risk of poor outcomes is exacerbated by the patients' characteristics, including advanced age and the presence of comorbidities. 8e11, 14,25,28 Therefore, these patients may require priority for early surgery even more than usual, which can help reduce the length of hospitalization and decrease the risks of nosocomial infection, post-operative adverse events, and inhospital mortality.…”

Sports activities during any pandemic lockdown

“…Older individuals and those with underlying comorbidities, such as hypertension, diabetes, cardiovascular and cerebrovascular diseases, coagulopathy, kidney and liver problems, and chronic lung disease, are categorized as high-risk groups for contracting severe COVID-19 [25][26][27][28][29][30][31][32]. Under such a pandemic, they are forced into social isolation and quarantine at home, and most of these individuals are being physically inactive and mentally stressed (e.g., depression and anxiety) [33].…”