Meta-analysis Of Correlation Between COPD And Adverse Outcomes In Patients With COVID-19

Objective:The influence of chronic obstructive pulmonary disease(COPD)on coronavirus disease2019(COVID-19)is controversial.The purpose of this meta-analysis is to investigate whether there is a correlation between COPD and the adverse outcome of COVID-19 patients,and to determine the size of the correlation,so as to provide a theoretical basis for implementing stricter preventive measures for COPD patients.Methods:We conducted a comprehensive literature search on foreign databases Pub Med,Cochrane database,and chinese databases CNKI,Wanfang Medical Network,searched the relevant research available from December 15 th,2019 to March 12 th,2022,extracted the data from the included documents and analyzed them with Rev Man5.4 software.Results:Meta-analysis was conducted on 65 studies that met the inclusion criteria.The results showed that compared with patients without COPD,COVID-19 patients with COPD had higher risk of needing mechanical ventilation or hospitalization in ICU(RR = 1.79,95%CI= 1..36,2.36,p<0.00001)and higher risk of death(RR = 2.04,95%CI = 1.68,2.47,p<0.00001;HR = 1.47,95%CI = 1.27,1.72,p<0.00001).Subgroup analysis showed that in Asian group,the risk of COVID-19 patients with COPD requiring mechanical ventilation or hospitalization in ICU was higher than that of patients without COPD(RR = 2.57,95%CI =1.59,4.15,P < 0.00001),and the risk of death is also high(RR = 2.76,95%CI = 2.06,3.70,P < 0.00001;HR = 2.21,95%CI = 1.75,2.79,P < 0.00001).In American group,the risk of COVID-19 patients with COPD requiring mechanical ventilation or being admitted to ICU was not statistically significant(RR = 1.34,95% CI = 0.81,2.21,p=0.26),but the risk of death was higher than that of patients without COPD(RR = 1.86,95% CI = 1.38,2.50,P < 0.00001;HR = 1.23,95%CI = 1.06,1.43,P = 0.008).In the European group,COVID-19 patients with COPD have a higher risk of needing mechanical ventilation or being admitted to ICU for treatment(RR = 1.51,95% CI = 1.01,2.24,p=0.04),and the risk of death is not statistically significant(RR = 1.69,95% CI = 1.43,2.06,P < 0.04;HR = 1.33,95%CI = 0.98,1.79,p=0.07).Conclusion:COPD increases the risk of adverse outcomes such as aggravation or death of COVID-19 patients.Compared with Europeans and Americans,this association is more significant among Asian people,although the degree of association is not very high.It is suggested that during the epidemic period of COVID-19,COPD patients should follow stricter preventive measures,especially timely vaccination.At the same time,we should pay attention to identify and distinguish COVID-19 from COPD.If COVID-19 is suspected,we should actively take SARS-Co V-2 test.For COPD patients who have been diagnosed with COVID-19,early intervention should be carried out to prevent the patients from getting worse or even dying.