Obstructive lung diseases burden and COVID-19 in developing countries: a perspective

Abstract

Purpose of review: Asthma and chronic obstructive pulmonary disease (COPD) are widely prevalent disorders, and important contributors to morbidity and mortality, in both developing and developed countries. It is conjectured that these obstructive lung diseases may have had more deleterious effects in developing nations during the 2019 coronavirus disease (COVID-19) pandemic. We provide an evidence-based perspective on the relationship between asthma/COPD prevalence and COVID-19 burden, and the impact of comorbid asthma/COPD on selected COVID-19 outcomes and healthcare utilization, with special reference to developing countries.

Recent findings: Developing countries with higher COPD (but not asthma) prevalence appear to have higher COVID-19 related mortality. Patients with asthma (but not COPD) in developing countries may be less likely to acquire COVID-19. Published literature suggests that the overall impact of comorbid asthma or COPD on adverse COVID-19 outcomes may be broadly similar between developed and developing nations.

Summary: There is paucity of information on interaction between asthma/COPD and COVID-19 in developing countries. Limited data suggest minor differences between developed and developing nations. In view of inadequacies in healthcare preparedness and delivery in several developing countries, there is a need to generate quality evidence to assess impact of obstructive lung diseases and COVID-19 on each other.

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FIGURE 1

Scatterplot summarizing the relationship between national COVID-19 burden, and the corresponding national prevalence of asthma or chronic obstructive pulmonary disease (COPD), in developed (hollow grey circles) and developing (solid black circles) countries. Results from linear regression of data are depicted through straight lines in each graph.

FIGURE 2

Scatterplot summarizing the relationship between prevalence of comorbid asthma or chronic obstructive pulmonary disease (COPD) among COVID-19 patients in individual studies, and the corresponding national prevalence of asthma or COPD, for data from developed (hollow grey circles) and developing (solid black circles) countries. The diagonal line marks the position of equity wherein population prevalence is same as prevalence among COVID-19 patients.

FIGURE 3

Scatterplot summarizing the relationship between relative risk of selected adverse clinical outcomes among COVID-19 patients with comorbid asthma or chronic obstructive pulmonary disease (COPD) in individual studies, and the corresponding national prevalence of asthma or COPD, for data from developed (hollow grey circles) and developing (solid black circles) countries.