Prevalence and mortality of Lung Comorbidities Among Patients with COVID-19: A systematic review and meta-analysis

Abstract

Background COVID-19 infections are seen across all age groups but they have shown to have a predisposition for the elderly and those with underlying comorbidities. Patients with severe COVID-19 infections and comorbidities are more prone to respiratory distress syndrome (ARDS), mechanical ventilator use and ultimately succumb to these complications. Little evidence exists of the prevalence of underlying lung comorbidities among COVID-19 patients and associated mortality. Methods We performed a systematic review of the literature including PubMed (Medline), Embase (Ovid), Google Scholar and Cochrane Library. The last date for our search was 29th April 2020. We included all original research articles on COVID-19 and calculated prevalence of chronic lung disease patients among COVID-19 patients using random effects model. Further we assessed for mortality rates among COVID-19 patients associated with these lung comorbidities. Results The authors identified 29 articles that reported prevalence of chronic lung conditions among COVID-19 patients. Among those, 26 were from China and 3 from the United States. The pooled prevalence of lung comorbidities including Asthma, COPD, and lung cancer was 3% (95% CI=0-14%), 2.2% (95% CI=0.02-0.03%) and 2.1% (95% CI=0.00-0.21%) respectively. Mortality rates associated with these comorbidities was 30% (41/137) for COPD and 19% (7/37) for lung cancer respectively. No mortality rates were reported for patients with asthma. Conclusion This study offers latest evidence of prevalence of chronic lung conditions among patients with COVID-19. Asthma, followed by COPD and lung cancer, was the most common lung comorbidity associated with COVID-19, while the higher mortality rate was found in COPD. Future studies are needed to assess other lung comorbidities and associated mortality among patients diagnosed with COVID-19.

COVID-19 and lung cancer: update on the latest screening, diagnosis, management and challenges

“…53 In the COVID-19 era, new concerns have been raised about the possible consequences of these comorbidities on the risk of severe COVID-19 infections and outcomes. 54 For example, COPD and smoking-related illnesses are shown to be linked to a four-fold increase in the risk of COVID-19, 55 and its associated severity and morbidity. This is mostly due to the increased expression of angiotensin-converting enzyme-2 receptors by type 2 pneumocytes in the lower respiratory tract, which provides a binding site and a port of entry for the viral particles.…”

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

“…COPD, on the contrary, significantly worsens clinical outcomes among COVID-19 patients by a magnitude much larger than that for asthma [7 & ,8-11]. Despite this, the prevalence of COPD might be lower than asthma among patients with COVID-19, and some reviews with a limited number of studies suggest wide variability in estimates with summary prevalence of around 2-3% [8,12,13].…”