Chronic obstructive pulmonary disease in China: a nationwide prevalence study

Fang, Liwen; Gao, Pei; Bao, Heling; Tang, Xun; Wang, Baohua; Feng, Yanping; Cong, S; Juan, Juan; Fan, Jing; Lu, Ke; Wang, Ning; Hu, Yonghua; Wang, Lınhong

doi:10.1016/s2213-2600(18)30103-6

Cited by 314 publications

(390 citation statements)

References 28 publications

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“…Moreover, the prevalence of COPD among the studied population was higher in men than in women, and increased with age. This finding aligns with many previous studies conducted in both high-income and low and middle-income countries [3,4,6,11,12]. The much higher prevalence of COPD in the present study may possibly result from the higher prevalence of current smoking (62.1% among males) in the participant population, as smoking plays a critical role in lung disease development [22].…”

Section: Discussionsupporting

confidence: 92%

“…The present study also demonstrates a markedly higher prevalence of spirometry-defined COPD among the surveyed population relative to the rest of China, underscoring COPD's high prevalence in rural southwest China: the overall prevalence of COPD was greater than the prevalence observed in two national COPD prevalence studies (8.6 and 13.6%) [6,14], studies in other regions of China (9.8%) [10], as well as results from the global and regional estimates of COPD (11.7%) [3]. Moreover, the prevalence of COPD among the studied population was higher in men than in women, and increased with age.…”

Section: Discussionsupporting

confidence: 48%

“…COPD prevalence has also increased, with the prevalence of COPD among people aged 40 years and over increasing from 2.7% in 1990 to 13.6% in 2015. COPD prevalence in China is also higher in rural areas than urban ones (13.7% vs. 8.6%) [5,6].…”

Section: Introductionmentioning

confidence: 96%

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Socioeconomic variations in chronic obstructive pulmonary disease prevalence, diagnosis, and treatment in rural Southwest China

et al. 2020

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Background: Chronic obstructive pulmonary disease (COPD) is a major and growing cause of morbidity and mortality throughout the world. However, there remains a limited understanding of the association between individual socioeconomic status (SES) and COPD diagnosis and treatment worldwide, including in China. This study investigates socioeconomic variations in prevalence, diagnosis, and treatment of COPD in rural China. Methods: The present study employed a cross-sectional survey design. The study population was composed of Han majority as well as Na Xi and Bai ethnic minority individuals 35 years of age and older living in Yunnan Province from 2017 to 2019. In total, 7534 individuals consented to participate in the study and complete a structured interview as well as a post-bronchodilator spirometry test. Multivariate logistic regression was used to analyze the association between individual socioeconomic status variables and the prevalence, diagnosis, and treatment of COPD. Results: The age-standardized prevalence of COPD in the present study was 14.3%. Prevalence differed by gender: prevalence for men was 17.1%, versus 11.4% for women (P = 0.0001). Overall, levels of diagnosis and treatment of COPD for participants with COPD were 24.2 and 23.1%, respectively. Multivariate logistic regression indicated that higher educational levels and good access to medical services was associated with an overall lower risk of COPD (P = 0.032 vs. P = 0.018) as well as a higher probability of COPD diagnosis among those with COPD (P = 0.0001 vs. P = 0.002). Participants with COPD with higher educational levels (P = 0.0001) and higher annual household incomes (P = 0.0001) as well as good access to medical services (P = 0.016) were more likely to receive COPD medications and treatment than their counterparts. While Na Xi and Bai participants had a higher probability of having COPD (P = 0.0001), they had a lower probability of having received a diagnosis or treatment for COPD than Han participants (P = 0.0001 vs. P = 0.0012). Conclusions: Future interventions to further control COPD and improve diagnosis and treatment should focus on ethnic minority communities, and those with low education levels, low annual household incomes, and poor access to medical services.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 48%

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Socioeconomic variations in chronic obstructive pulmonary disease prevalence, diagnosis, and treatment in rural Southwest China

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“…Furthermore, the prevalence of current smokers in COVID-19 patients was 9% (95% CI, 4%-14%), and this was also associated with greater severity (22.30%) and mortality (38.5%). We report a low prevalence of COPD patients in COVID-19 case series compared to the latest COPD prevalence rate in China, which was 13.6% (95% CI 12�0-15�2) and the global prevalence of COPD (9-10%) [33,34]. There was a low heterogeneity among the studies, which was 41.90%, p 0.04.…”

Section: Plos Onementioning

confidence: 63%

Prevalence, Severity and Mortality associated with COPD and Smoking in patients with COVID-19: A Rapid Systematic Review and Meta-Analysis

Oyelade²,

et al. 2020

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BackgroundCoronavirus disease 2019 is an evolving infectious disease that dramatically spread all over the world in the early part of 2020. No studies have yet summarized the potential severity and mortality risks caused by COVID-19 in patients with chronic obstructive pulmonary disease (COPD), and we update information in smokers. MethodsWe systematically searched electronic databases from inception to March 24, 2020. Data were extracted by two independent authors in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study quality was assessed using a modified version of the Newcastle-Ottawa Scale. We synthesized a narrative from eligible studies and conducted a meta-analysis using a random-effects model to calculate pooled prevalence rates and 95% confidence intervals (95%CI). ResultsIn total, 123 abstracts were screened and 61 full-text manuscripts were reviewed. A total of 15 studies met the inclusion criteria, which included a total of 2473 confirmed COVID-19 patients. All studies were included in the meta-analysis. The crude case fatality rate of COVID-19 was 7.4%. The pooled prevalence rates of COPD patients and smokers in COVID-19 cases were 2% (95% CI, 1%-3%) and 9% (95% CI, 4%-14%) respectively. COPD patients were at a higher risk of more severe disease (risk of severity = 63%, (22/35) PLOS ONEPLOS ONE | https://doi.

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“…Notwithstanding the commonness of circulatory and endocrine comorbidities, patients with COVID-19 rarely reported having comorbid respiratory diseases ( particularly COPD). The reasons underlying this observation have been scant, but could have arisen from the lack of awareness and the lack of spirometric testing in community settings that collectively contributed to the under-diagnosis of respiratory diseases [33]. It should be stressed that the observed frequency of comorbidity may also reflect the transmission dynamics within particular age groups, case detection or testing practices or hospital admission policies during the early phases of the epidemic.…”

Section: Discussionmentioning

confidence: 99%

Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis

et al. 2020

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Background: The coronavirus disease 2019 outbreak is evolving rapidly worldwide. Objective: To evaluate the risk of serious adverse outcomes in patients with COVID-19 by stratifying the comorbidity status. Methods: We analysed data from 1590 laboratory confirmed hospitalised patients from 575 hospitals in 31 provinces/autonomous regions/provincial municipalities across mainland China between 11 December 2019 and 31 January 2020. We analysed the composite end-points, which consisted of admission to an intensive care unit, invasive ventilation or death. The risk of reaching the composite end-points was compared according to the presence and number of comorbidities. Results: The mean age was 48.9 years and 686 (42.7%) patients were female. Severe cases accounted for 16.0% of the study population. 131 (8.2%) patients reached the composite end-points. 399 (25.1%) reported having at least one comorbidity. The most prevalent comorbidity was hypertension (16.9%), followed by diabetes (8.2%). 130 (8.2%) patients reported having two or more comorbidities. After adjusting for age and smoking status, COPD (HR (95% CI) 2.681 (1.424-5.048)), diabetes (1.59 (1.03-2.45)), hypertension (1.58 (1.07-2.32)) and malignancy (3.50 (1.60-7.64)) were risk factors of reaching the composite end-points. The hazard ratio (95% CI) was 1.79 (1.16-2.77) among patients with at least one comorbidity and 2.59 (1.61-4.17) among patients with two or more comorbidities. Conclusion: Among laboratory confirmed cases of COVID-19, patients with any comorbidity yielded poorer clinical outcomes than those without. A greater number of comorbidities also correlated with poorer clinical outcomes. This article has supplementary material available from

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Chronic obstructive pulmonary disease in China: a nationwide prevalence study

Abstract: Chinese Central Government, the Ministry of Science and Technology of The People's Republic of China, and the National Natural Science Foundation of China.

Cited by 314 publications

References 28 publications

Socioeconomic variations in chronic obstructive pulmonary disease prevalence, diagnosis, and treatment in rural Southwest China

Socioeconomic variations in chronic obstructive pulmonary disease prevalence, diagnosis, and treatment in rural Southwest China

Prevalence, Severity and Mortality associated with COPD and Smoking in patients with COVID-19: A Rapid Systematic Review and Meta-Analysis

Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis

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