Background

An outbreak of Corona Virus Disease 2019 (COVID-19) has spread rapidly reaching over 3 million of confirmed cases worldwide. The association of respiratory diseases and smoking, both highly prevalent globally, with COVID-19 severity has not been elucidated. Given the gap in the evidence and the growing prevalence of COVID-19, the objective of this study was to explore the association of underlying respiratory diseases and smoking with severe outcomes in patients with COVID-19 infection.

Methods

A systematic search was performed to identify studies reporting prevalence of respiratory diseases and/or smoking in relation with disease severity in patients with confirm COVID-19, published between January 1 to April 15, 2020 in English language. Pooled odds-ratio (OR) and 95% confidence intervals (95% CI) were calculated.

Findings

Twenty two studies met the inclusion criteria. All the studies presented data of 13,184 COVID-19 patients (55% males). Patients with severe outcomes were older and a larger percentage were males compared with the non-severe. Pooled analysis showed that prevalence of respiratory diseases (OR 4.21; 95% CI, 2.9–6.0) and smoking (current smoking OR 1.98; 95% CI, 1.16–3.39 and former smoking OR 3.46; 95% CI, 2.46–4.85) were significantly associated with severe COVID-19 outcomes.

Interpretation

Results suggested that underlying respiratory diseases, specifically COPD, and smoking were associated with severe COVID-19 outcomes. These findings may support the planning of preventive interventions and could contribute to improvements in the assessment and management of patient risk factors in clinical practice, leading to the mitigation of severe outcomes in patients with COVID-19 infection.

中文翻译：

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潜在的呼吸系统疾病，特别是慢性阻塞性肺病和吸烟与严重的 COVID-19 结果有关：一项系统评价和荟萃分析。

背景

2019 年冠状病毒病 (COVID-19) 的爆发迅速蔓延，全球确诊病例超过 300 万。呼吸系统疾病和吸烟在全球都非常流行，与 COVID-19 严重程度之间的关联尚未得到阐明。鉴于证据不足和 COVID-19 患病率不断上升，本研究的目的是探讨潜在呼吸系统疾病和吸烟与 COVID-19 感染患者严重后果之间的关联。

方法

进行了系统搜索，以确定在 2020 年 1 月 1 日至 4 月 15 日期间以英文发表的报告呼吸系统疾病和/或吸烟与确诊 COVID-19 患者疾病严重程度相关的研究。计算合并比值比 (OR) 和 95% 置信区间 (95% CI)。

发现

22 项研究符合纳入标准。所有研究都提供了 13,184 名 COVID-19 患者（55% 为男性）的数据。与非严重患者相比，出现严重后果的患者年龄更大，男性比例更大。汇总分析表明，呼吸系统疾病的患病率（OR 4.21；95% CI，2.9-6.0）和吸烟（当前吸烟 OR 1.98；95% CI，1.16-3.39 和既往吸烟 OR 3.46；95% CI，2.46-4.85）是与严重的 COVID-19 结果显着相关。

解释

结果表明，潜在的呼吸系统疾病，特别是慢性阻塞性肺病和吸烟与严重的 COVID-19 结果有关。这些发现可能支持预防性干预措施的规划，并可能有助于改进临床实践中患者风险因素的评估和管理，从而减轻 COVID-19 感染患者的严重后果。