Asthma and COPD as co-morbidities in patients hospitalised with Covid-19 disease: a global systematic review and meta-analysis

Abstract

Background Factors predisposing to increased mortality with COVID-19 infection have been identified as male sex, hypertension, obesity, and increasing age. Early studies looking at airway diseases gave some contradictory results. The purpose of our study was to determine global variation in studies in patients hospitalized with COVID-19 in the prevalence of COPD and asthma; and to determine whether the presence of asthma or COPD affected mortality in the same hospital population. Methods A systematic review and meta-analysis of the published literature of COPD and asthma as co-morbidities in patients hospitalized with COVID-19 was performed, looking firstly at the prevalence of these diseases in patients hospitalized with COVID-19, and secondly at the relative risk of death from any cause for patients with asthma or COPD. Results Prevalence of both airway diseases varied markedly by region, making meaningful pooled global estimates of prevalence invalid and not of clinical utility. For individual studies, the interquartile range for asthma prevalence was 4.21 to 12.39%, and for COPD, 3.82 to 11.85%. The relative risk of death with COPD for patients hospitalized with COVID-19 was 1.863 (95% CI 1.640–2.115), while the risk with asthma was 0.918 (95% CI 0.767 to 1.098) with no evidence of increased mortality. Conclusions For asthma and COPD, prevalence in patients hospitalized with COVID-19 varies markedly by region. We found no evidence that asthma predisposed to increased mortality in COVID-19 disease. For COPD, there was clear evidence of an association with increased mortality. Trial registration The trial was registered with PROSPERO: registration number CRD42021289886.

A COVID–19-fertőzéssel és -immunizációval szerzett tapasztalatok felnőtt cystás fibrosisos betegcsoportban

“…Számos vizsgálat és metaanalízis [3][4][5] foglalkozik a krónikus obstruktív tüdőbetegségben és asthma bronchia léban szenvedők COVID-19-fertőzéseinek sajátosságaival, ugyanakkor lényegesen kevesebb ismeretanyag áll rendelkezésre a ritkább, de szintén krónikus lefolyást mutató tüdőbetegségek és a SARS-CoV-2 kapcsolatáról. Ezért tartottuk fontos vizsgálati célpontnak a cystás fibrosisos betegek COVID-19-fertőzését.…”

“…A vakcinafejlesztéseknek köszönhetően napjainkig kb. 13,5 milliárd, új koronavírus elleni oltást adtak be [5]. A cystás fibrosisos betegek SARS-CoV-2 elleni immunizálásában -többek között az olasz egészségügyi minisztérium ajánlásával -az mRNS-alapú BNT162b2 (Pfizer-BioNTech, USA, Németország) [19] és mRNA-1273 (Moderna, USA) [20] vakcinák kerültek előtérbe.…”

The inflammatory microenvironment of the lung at the time of infection governs innate control of SARS-CoV-2 replication

“…Patient populations with pre-existing pulmonary diseases, although initially predicted to be more vulnerable to SCV2 infection, have unexpected heterogeneity in COVID-19 outcomes. While certain chronic lung diseases, including tuberculosis (TB) 28,29 and chronic obstructive pulmonary disease (COPD) 30–33 have been associated with increased severity of COVID-19 in most studies, other chronic pulmonary conditions, such as asthma 32–35 and cystic fibrosis (CF) 36–38 did not consistently correlate with worsened COVID-19 presentation and have even been associated with improved disease outcomes. The immunological factors in the lung that determine such variability in early viral control, and thus the likelihood of developing severe disease, are incompletely understood, and challenging to examine in clinical settings.…”

The effects of iron deficient and high iron diets on SARS-CoV-2 lung infection and disease

“…COVID-19 is often associated with a 'cytokine storm' and the life threatening, acute respiratory distress syndrome (ARDS). The severity of COVID-19 is influenced by a range of comorbidities [4][5][6], with a large body of literature suggesting that iron deficiency and iron overload may also contribute to disease severity [7][8][9][10][11][12][13][14][15][16][17][18][19].…”