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Review
. 2021 May 13;10(10):2087.
doi: 10.3390/jcm10102087.

Assessment of the Association of COPD and Asthma with In-Hospital Mortality in Patients with COVID-19. A Systematic Review, Meta-Analysis, and Meta-Regression Analysis

Felix M Reyes  1   2 , Manuel Hache-Marliere  2   3 , Dimitris Karamanis  4 , Cesar G Berto  2   3 , Rodolfo Estrada  5 , Matthew Langston  2   3 , George Ntaios  6 , Perminder Gulani  2   3 , Chirag D Shah  1   2 , Leonidas Palaiodimos  2   7
Affiliations
Review

Assessment of the Association of COPD and Asthma with In-Hospital Mortality in Patients with COVID-19. A Systematic Review, Meta-Analysis, and Meta-Regression Analysis

Felix M Reyes et al. J Clin Med. .

Abstract

Together, chronic obstructive pulmonary disease (COPD) and asthma account for the most common non-infectious respiratory pathologies. Conflicting preliminary studies have shown varied effect for COPD and asthma as prognostic factors for mortality in coronavirus disease 2019 (COVID-19). The aim of this study was to explore the association of COPD and asthma with in-hospital mortality in patients with COVID-19 by systematically reviewing and synthesizing with a meta-analysis the available observational studies. MEDLINE, Scopus, and medRxiv databases were reviewed. A random-effects model meta-analysis was used, and I-square was utilized to assess for heterogeneity. In-hospital mortality was defined as the primary endpoint. Sensitivity and meta-regression analyses were performed. Thirty studies with 21,309 patients were included in this meta-analysis (1465 with COPD and 633 with asthma). Hospitalized COVID-19 patients with COPD had higher risk of death compared to those without COPD (OR: 2.29; 95% CI: 1.79-2.93; I2 59.6%). No significant difference in in-hospital mortality was seen in patients with and without asthma (OR: 0.87; 95% CI: 0.68-1.10; I2 0.0%). The likelihood of death was significantly higher in patients with COPD that were hospitalized with COVID-19 compared to patients without COPD. Further studies are needed to assess whether this association is independent or not. No significant difference was demonstrated in COVID-19-related mortality between patients with and without asthma.

Keywords: COVID-19; asthma; chronic obstructive pulmonary disease (COPD); meta-analysis; mortality.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure A1
Figure A1
Funnel plots for (A) studies included in the COPD analyses; Egger’s test p = 0.139 and (B) studies included in the asthma analyses; Egger’s test p = 0.388.
Figure 1
Figure 1
PRISMA Flow Diagram.
Figure 2
Figure 2
Quality in Prognosis Studies—QUIPS Tool: Risk of Bias Assessment.
Figure 3
Figure 3
Overall analysis: COPD vs. no COPD for in-hospital mortality.
Figure 4
Figure 4
Analysis of the studies that included only general patient population: COPD vs. no COPD for in-hospital mortality.
Figure 5
Figure 5
COPD vs. no COPD for the outcome of admission in the ICU.
Figure 6
Figure 6
COPD vs. no COPD for the outcome of intubation.
Figure 7
Figure 7
Overall analysis: asthma vs. no asthma for in-hospital mortality.
Figure 8
Figure 8
Analysis of the studies that included only general patient population: asthma vs. no asthma for in-hospital mortality.
See this image and copyright information in PMC

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