COPD and smoking are associated with severe COVID-19 outcomes

Objectives:
An outbreak of Corona Virus Disease 2019 (COVID-19) has spread rapidly reaching over 3 million of confirmed cases worldwide. The association of respiratory diseases and smoking, both highly prevalent globally, with COVID-19 severity has not been elucidated. Therefore, this review article has been conducted.

Do underlying respiratory diseases and smoking increase severe outcomes in patients with COVID-19 infection?

Study design:
This review article included 22 studies with a total of 13,184 COVID-19 patients (55% males).

Results and conclusions:   
The investigators found patients with severe outcomes were older and a larger percentage was males (63% vs 51%) compared with the non-severe.

The investigators found respiratory diseases significantly increased severe COVID-19 outcomes with 321% [OR = 4.21, 95% CI = 2.9 to 6.0, I2 = 35%, p = 0.06].
A separate sensitivity analysis showed that patients with underlying COPD had higher odds of having severe-19 outcomes [OR = 5.8, 95% CI = 3.9 to 8.5].

The investigators found current smoking significantly increased severe COVID-19 outcomes with 98% [OR = 1.98, 95% CI = 1.16 to 3.39, I2 = 52%, p = 0.02].

The investigators found former smoking significantly increased severe COVID-19 outcomes with 246% [OR = 3.46, 95% CI = 2.46 to 4.85, I2 = 0%, p = 0.43].

The investigators concluded that underlying respiratory diseases, specifically COPD and smoking are associated with severe COVID-19 outcomes. These findings contribute to a better understanding of patient risk factors for severe COVID-19 which are valuable to support the development of preventive interventions and can help to improve the assessment and management of patient risk factors in clinical practice. Future studies should assess the association of severe COVID-19 outcomes with prevalence of other underlying respiratory diseases, other than COPD, as well as to explore the potential influence of their immune responses and undergoing pharmacological treatments. In addition, the association of severe COVID-19 with all level of smoking and the causal mechanisms should be the subject of future research.

Original title:
Underlying respiratory diseases, specifically COPD, and smoking are associated with severe COVID-19 outcomes: A systematic review and meta-analysis by Sanchez-Ramirez DC and Mackey D.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7391124/

Additional information of El Mondo:
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