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

Alqahtani, Jaber S; Oyelade, Tope; Aldhahir, Abdulelah M.; Alghamdi, Saeed M; Almehmadi, Mater; Alqahtani, Abdullah S; Quaderi, Shumonta; Mandal, Swapna; Hurst, John R.

doi:10.1101/2020.03.25.20043745

Cited by 274 publications

(334 citation statements)

References 54 publications

(47 reference statements)

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“…The mortality of included patients in our study was 17.9% which was comparable with previous studies. Increased age and comorbidities have been acknowledged as independent risk factors of mortality in COVID-19 patients [23,24]. Our results showed that the incidence of complicated underlying diseases including hypertension, chronic lung disease and cardiovascular disease was higher in non-survivor group.…”

Section: Discussionmentioning

confidence: 49%

CONUT score is associated with mortality in patients with COVID-19: a retrospective study in Wuhan

Wang

Yue

et al. 2020

Preprint

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Background The coronavirus disease 2019 (COVID-19) pneumonia, outbreak in Wuhan, China, has led to a global pandemic. The high mortality of COVID-19 patients makes it significant to evaluate possible disease progression. This study was designed to explore the prognostic value of Controlling Nutritional Status (CONUT) score in patients with COVID-19. Methods Patients diagnosed with COVID-19 of a single center in Wuhan, China from January 2020 to February 2020 were enrolled in this study. Logistic regression analysis was performed to find independent risk factor of mortality. Receiver operating characteristics (ROC) curve was drawn to evaluate the prognostic value of CONUT score. Results Among 442 included patients, there were 79 non-survivors with mortality of 17.9%. Compared with survivors, the median age (p < 0.001) and male ratio (p = 0.042) were higher in non-survivors. Non-survivors had higher incidence of comorbidities including hypertension (p < 0.001), chronic lung disease (p = 0.001) and cardiovascular disease (p = 0.005). Complications such as respiratory failure(p < 0.001), acute kidney injury (AKI) (p < 0.001) occurred more frequently in non-survivors. Multivariate logistic regression analysis showed that CONUT (p = 0.002), lactate dehydrogenase (LDH) (p < 0.001), C-reactive protein (CRP) (p = 0.020) were risk factor of mortality in COVID-19 patients. Area under the ROC curve (AUC) of CONUT and Nutrition risk screening 2002 (NRS2002) score were 0.813 and 0.795, respectively. Comprised of CONUT, LDH, CRP, the constructed prognostic model had higher AUC of 0.923 (Z = 3.5210, p < 0.001). Conclusion CONUT is an independent risk factor of mortality in COVID-19 patients. Evaluating CONUT is beneficial for clinicians to predict the progression of COVID-19 patients and strengthen monitoring and management to improve prognosis.

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Section: Discussionmentioning

confidence: 49%

CONUT score is associated with mortality in patients with COVID-19: a retrospective study in Wuhan

Wang

Yue

et al. 2020

Preprint

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“…However, as summarized in Table 1, the clinical implications may be broader and go beyond MS. Notable, in patients with chronic obstructive pulmonary disease (COPD), COVID-19 infection is associated with substantial severity and mortality rates (14). Therefore, a causative link between LPS derived from bacterial colonization and infection of the lungs in COPD patients and COVID-19 severity could also be proposed here.…”

Section: Discussionmentioning

confidence: 99%

“…Related to this, is the finding that there is a correlation between LPS levels and bacterial loads during pneumonia (15). Moreover, compared to former and never smokers with COPD, current smokers are at greater risk of severe COVID-19 complications and higher mortality rate (14), and intriguingly, bacterial LPS is an active component of cigarette smoke (16). Increased endotoxin levels are also observed in patients with inflammatory bowel disease (IBD) (17).…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 Spike protein binds to bacterial lipopolysaccharide and boosts proinflammatory activity

Petruk

Puthia

Petrlova

et al. 2020

Preprint

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ABSTRACTThere is a well-known and established link between high lipopolysaccharide (LPS) levels in blood and the metabolic syndrome (MS). MS is a risk factor for developing severe COVID-19 and acute respiratory distress syndrome (ARDS). Here we define an interaction between SARS-CoV-2 Spike (S) protein and LPS and its link to aggravated inflammation in vitro and in vivo. Electrophoresis under native conditions demonstrated that SARS-CoV-2 S protein binds to Escherichia coli LPS, forming high molecular weight aggregates. Microscale thermophoresis analysis further defined the interaction, having a KD of ~47 nM, similar to the observed affinity between LPS and the human receptor CD14. Moreover, S protein, when combined with low levels of LPS, boosted nuclear factor-kappa B (NF-κB) and cytokine responses in monocytic THP-1 cells and human blood, respectively. In an experimental model of localized inflammation, employing NF-κB reporter mice and in vivo bioimaging, S protein in conjunction with LPS significantly increased the inflammatory response when compared with S protein and LPS alone. Apart from providing information on LPS as a ligand for S protein, our results are of relevance for studies on comorbidities involving bacterial endotoxins, such as the MS, or co-existing acute and chronic infections in COVID-19 patients.

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“…The use of the nomogram score in estimating the risk of patients diagnosed with mild or moderate harboring severe probability to direct clinical treatment is a new concept [7] . Previous studies have attempted to use multivariate risk analysis to evaluate patient's condition changes [8][9][10] . However, the signi cance of accurately assessing that a patient may develop into severe or extremely critical illness is still lacking.…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of a Nomogram to Predict Deteriorating Trajectory in Patients with COVID-19 Infection: A Population-Based Prospective Study

Wei

Zhu²,

Li³

et al. 2020

Preprint

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Background Most of the patients with COVID-19 infection are mild to moderate initially. However, there is no effective prediction for the patients to develop into severe or extremely severe. This study aims to develop an effective clinical prediction model.Methods A single-center, retrospective, observational study conducted. A nomogram was conducted based on the results of multivariate logistic regression analysis. Results A total of 483 patients diagnosed mild to moderate were included, among these patients 62 developed severe or extremely critical illness. Seven variables including hyperlipidemia, vomiting, diarrhea, lymphocyte, imaging and mentality were associated with deteriorating trajectory. The ROC curve showed that model was robust, for which the area under the curve of the training set and the validation set are 0.873 and 0.813.Conclusions For patients with mild to moderate COVID-19 infection, nomogram score can effectively predict the possibility of patients developing into severe or extremely critical.

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

Cited by 274 publications

References 54 publications

CONUT score is associated with mortality in patients with COVID-19: a retrospective study in Wuhan

CONUT score is associated with mortality in patients with COVID-19: a retrospective study in Wuhan

SARS-CoV-2 Spike protein binds to bacterial lipopolysaccharide and boosts proinflammatory activity

Development and Validation of a Nomogram to Predict Deteriorating Trajectory in Patients with COVID-19 Infection: A Population-Based Prospective Study

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