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

AIMS: 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. METHODS: A comprehensive systematic literature search was carried out to find studies published from December 2019 to 22nd March 2020 from 5 Database. The language 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. RESULTS: Overall 11 case-series, published either in Chinese or English language with a total of 2002 cases were included in the study. The pooled OR of COPD and the development of severe Covid-19 was 4.38 (Fixed effect model, 95% CI: 2.34-8.20), while the OR of ongoing smoking was 1.98 (Fixed effect model, 95% CI: 1.29-3.05). There was no publication bias as examined by the funnel plot and Egger's test (p=NS). The heterogeneity of included studies was moderate for both COPD and ongoing smoking history on the severity of Covid-19. CONCLUSIONS: COPD and ongoing smoking history attribute to the worse progression and outcome of Covid-19. This article is protected by copyright. All rights reserved.