Mortality and Severity of COVID-19 Patients with Chronic Obstructive Pulmonary Disease: A Meta-Analysis
Abstract
Background: COVID-19 has become a pandemic in all countries including Indonesia. The death rate from COVID-19 is concentrated in elderly patients and those with comorbidities. COPD is one of the comorbidities that can worsen and even cause death. COPD ranks in the top 3 leading causes of death in the world causing 2.3 million deaths in 2019. This study aims to analyze the effect of COPD comorbidities on mortality and severity of COVID-19 patients.
Subjects and Method: This study used a systematic review and meta-analysis by following the PRISMA flow chart. Search articles through journal databases, namely: Google scholar, PubMed, Science Direct and Link Springer. The articles search was done by considering the eligibility criteria defined in the PICO model. P= COVID-19 patient; I= COPD participant; C= without COPD; O= need for mechanical ventilation, ICU admission, and death. Inclusion criteria were cohort full paper articles, in English, multivariate analysis with adjusted Odds Ratio. Articles analyzed with RevMan 5.3.
Results: The 13 cohort study designs reviewed with a meta-analysis to estimate the risk of death showed that comorbid COPD increased the risk of death (aOR= 1.33; 95% CI= 1.08 to 1.64; p= 0.007). 9 cohort study designs were reviewed with a meta-analysis to estimate the risk of severity with indicators of mechanical ventilation need (aOR= 1.38; 95% CI= 1.05 to 1.82; p= 0.020). 7 cohort study designs were reviewed by meta-analysis to estimate the risk of severity with indicators of risk of ICU admission (aOR= 1.25; 95% CI= 1.04 to 1.50; p= 0.020).
Conclusion: COPD comorbidities increase the risk of need for mechanical ventilation, ICU admission and death among COVID-19 patients.
Keywords: COVID-19, COPD, death, severity
Correspondence:
References
Amin M (2016). Omeostasis sebagai mekanisme perlindungan terhadap kerusakan jaringan paru perspektif dan implikasi teori protease-antiprotease (Homeostasis as a protection mechanism for pulmonary tissue damage perspectives and implications of protease-antiprotease theory). Surabaya: Airlangga University Press. http://-repository.unair.ac.id/id/eprint/30411
Angelidi AM, Belanger MJ, Lorinsky MK, Karamanis D, Chamorro-Pareja N, Ognibene J, Palaiodimos l, et al. (2021). Vitamin D status is associated with in-hospital mortality and mechanical ventilation: A cohort of COVID-19 hospitalized patients. Mayo Clin Proc. 96(4): 875-886. doi: 10.1016/j.mayocp.2021.01.001
Asyrofy A, Arisdiani T, Aspian M (2021). Karakteristik dan kualitas hidup pasien Penyakit Paru Obstruksi Kronik (PPOK) (Characteristics and Quality of Life Patients with Chronic Obstruction Pulmonary Disease (COPD)). Nurscope. 7(1): 13-21.
Beltramo G, Cottenet J, Mariet A, Georges M, Piroth L, Tubbert-Bitter P, Bonniaud P, et al. (2021). Chronic respiratory diseases are predictors of severe outcome in COVID-19 hospitalised patients: a nationwide study. Eur Respir J. doi: 10.1183/13993003.04-474-2020).
Budiman A, Majid A, Syam I, Efendi S (2021). gambaran kualitas tidur dan fungsi kognitif pada pasien ppok di BBKPM Makassar (Description of sleep quality and cognitive function in COPD patients at BBKPM Makassar). Jurnal Kesehatan. 14(1): 29. doi: 10.24252/kesehatan.v14i1.14140.
Carbonell L, Urgeles S, Rodriguez A, Bodi M, Martin-Loeches I, SoleViolan J, Diaz E, et al. (2021). Mortality comparison between the first and second/third waves among 3,795 critical COVID-19 patients with pneumonia admitted to the ICU: A multicentre retrospective cohort study. Elsevier. doi: 10.1016/j.lanepe.2021.100243.
Cedano J, Corona EF, Gonzales-Lara M, Santana M, Younes I, Ayad S, Kos-sack A, et al. (2021). Characteristics and outcomes of patients with COVID-19 in an intensive care unit of a community hospital; retrospective cohort study. J Community Hosp Intern Med Perspect. 11(1): 27-31. doi: 10.1080/20009666.2020.1830-516.
Chen J, Bai H, Liu J, Chen G, Liao Q, Yang J, Wu P, et al. (2020). Distinct clinical characteristics and risk factors for mortality in female inpatients with coronavirus disease 2019 (COVID-19): A Sex-stratified, Large-scale Cohort Study in Wuhan, China. Clin Infect Dis. 3188-3195. doi: 10.1093/cid/ciaa920.
Choi JC, Jung S, Yoon UA, You S, Kim M, Baek MS, Jung J, et al. (2020) Inhaled Corticosteroids and COVID-19 Risk and Mortality: A Nationwide Cohort Study. (2020). J. Clin. Med. doi: 10.3390/jcm9113406.
Corradini E, Ventura P, Ageno W, Cogliate CB, Mmuiesan ML, Girelli D, Pirisi M, et al. (2021). Clinical factors associated with death in 3044 COVID?19 patients managed in internal medicine wards in Italy: results from the SIMI?COVID?19 study of the Italian Society of Internal Medicine (SIMI). Intern Emerg Med. doi: 10.1007/s11739-021-02742-8.
Doriane C, Shoppie G, Nathalie M, Anne-Noelle F, Marie T, Olivier B, Julien B, et al. (2020). Asthma and COPD are not risk factors for ICU stay and death in case of SARS-CoV-2 infec-tion. Elsevier. doi: 10.1016/j.jaip.20-20.09.044
Fauzia D (2017). peranan statin dalam memperbaiki fungsi paru pada penyakit paru obstruktif kronik (PPOK) (The role of statins in improving lung function in chronic obstructive pulmonary disease (COPD)). Jurnal Ilmu Kedokteran. 10(2): 71. doi: 10.26891/jik.v10i2.20-16.71-79.
Fried MW, Crawford JM, Mospan AR, Watkins SE, Munoz B, Zink RC, Elliott S, et al. (2021). Patient characteristics and outcomes of 11 721 patients with coronavirus disease 2019 (COVID-19) Hospitalized Across the United States. Clin Infect Dis. doi: 10.1093/cid/ciaa1268.
Kammar-Garcia A, Vidal-Mayo JDJ, Vra-Zertuche JM, Lazcano-Hernandez M, Vera-Lopez O, Segura-Badilla O, Aguilar-Alonso P, Navaro-Cruz AR (2021). Impact of comorbidities in Mexican SARS-CoV-2-positive patients: a retrospective analysis in a national cohort. Revista de Investigaci
Gerwen MV, Alsen M, Little C, Barlow J, Genden E, Naymagon L, Tremblay D (2020). Risk factors and outcomes of COVID?19 in New York City; a retros-pektif cohort study. J Med Virol. doi: 10.1002/jmv.26337.
Graziani D, Sariono JB, Rio-Bermudez CD, Morena D, Diaz T, Castillo M, Alonso M, et al. (2020). Characteristics and prognosis of COVID-19 in Patients with COPD. J. Clin. Med. 9(10): 3259. doi: 10.3390/jcm9103259.
Guan W, Liang W, Shi Y, Gan L, Wang HB, He J, Zhoung N (2021). Chronic respiratory diseases and the outcomes of COVID-19: A Nationwide Retrospective Cohort. Study of 39,420 Cases. J Allergy Clin Immunol Pract. doi: 10.1016/j.jaip.2-021.02.041.
Gude-Sampedro F, Fernandez-Merino C, Ferreiro L, Lado-Baleato O, Espasandin-Dominguez J, et al. (2020). 2019 (COVID-19): A sex-stratified, large-scale cohort study in Wuhan, China. 1-11. doi: 10.1093/ije/dyaa209.
Hern
Hobbs ALV, Turner N, Omer I, Walker MK, Beaulieu RM, Sheikh M, Spires SS, et al. (2020). Risk factors for mortality and progression to severe covid-19 disease in the Southeast United States (US): A report from the SEUS study group. Infect Control Hosp Epidemiol. doi: 10.1017/ice.2020.1435.
Hu W, Dong M, Xiong M, Zhao D, Zhao Y, Wang M, Tao W, et al. (2020). Clini-cal courses and outcomes of patients with chronic obstructive pulmonary disease during the covid-19 epidemic in Hubei, China. Int J Chron Obstruct Pulmon Dis. 15: 2237-2248. doi: 10.-2147/COPD.S265004.
Lee SC, Son KJ, Han CH, Park SC, Jung JY. (2021). Impact of COPD on COVID-19 prognosis: A nationwide population-based study in South Korea. Sci Rep. 11(1): 1-8. doi: 10.1038/s41598-021-83226-9.
Lohia P, Sreeram K, Nguyen P, Choudhary A, Kicher S, Yarandi H, Kapur S, Badr MS (2021). Preexisting respiratory diseases and clinical outcomes in COVID?19: a multihospital cohort study on predominantly African American population. Repis Res. 22-37. doi: 10.1186/s12931-021-01647-6.
Meza D, Khuder B, Bailey JI, Rosenberg SR, Kalhan R, Reyfman PA (2021). Mortality from COVID-19 in Patients with COPD: A US Study in the N3C Data Enclave. Int J Chron Obstruct Pulmon Dis. 16: 2323-2326. doi: 10.2147/COPD.S318000.
Oh KT, Song IA (2021). Impact of coro-navirus disease?2019 on chronic respiratory disease in South Korea: an NHIS COVID?19 database cohort study. BMC Pulm Med. 21(12). doi: 10.1186/s12890-020-01387-1.
Purroy F, Gloria A (2021). Influence of thromboembolic events in the prognosis of COVID-19 hospitalized patients. Results from a cross sectional study. PLoS One. 16(6): 1-11. doi: 10.1371/journal.pone.0252351.
Raad M, Gorgis S, Abshire C, Yost M, Dabbagh FM, Chehab O, Aurora L, et al. (2021). COVID?19 risk index (CRI): a simple and validated emer-gency department risk score that predicts mortality and the need for mechanical ventilation. J. Thromb. Thrombolysis. doi: 10.1007/s11239-021-02565-6.
Santorelli G, McCooe M, Sheldon TA, Wright J, Lawton T (2021). Ethnicity, pre-existing comorbidities, and outcomes of hospitalised patients with COVID-19. Wellcome Open Res. doi: 10.12688/wellcomeopenres.16580.2.
Sin DD (2020). COVID-19 in COPD: A growing concern. EClinicalMedicine. 26: 100546. doi: 10.1016/j.eclinm.2020.100546.
Timberlake DT, Narayanan D, Ogbogu PU, Raveendran R, Porter K, Scherzer R, Prince B, Greyson MH (2021). Severity of COVID-19 in hospitalized pati-ents with and without atopic disease. World Allergy Organ J. doi: doi.org/-10.1016/j.waojou.2021.100508.
WHO (2021). WHO Coronavirus (COVID-19) Dashboard. Retrieved from https://covid19.who.int/ at 9 September 2021.
WHO (2019). Newsroom: Chronic obstructive pulmonary disease (COPD). Retrieved from https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd). Pada 2 September 2021
Wu F, Zhou Y, Wang Z, Xie M, Shi Z, Tang Z, Li X, et al. (2020). Clinical characteristics of COVID-19 infection in chronic obstructive pulmonary disease: a multicenter, retrospective, observational study. J Thorac Dis. 12(5): 1811-1823. doi: 10.21037/jtd-20-1914.
