Pre-existing COPD is associated with an increased risk of mortality and severity in COVID-19: a rapid systematic review and meta-analysis

Golam Rabbani, Sheikh Mohammed Shariful Islam, Muhammad Aziz Rahman, Nuhu Amin , Bushra Marzan, Rishad Choudhury Robin, Sheikh M. Alif

Research output: Contribution to journalArticleResearchpeer-review


The objective of this systematic review and meta-analysis was to investigate COVID-19 mortality and severity among patients with pre-existing COPD.
We performed systematic searches in Ovid Medline, Embase via Ovid, PubMed and Scopus from 15 December 2019 to 7 July 2020. Studies which reported the association and presented data on risk estimate (Hazard Ratio [HR]) with 95% confidence intervals (95%CIs) were extracted. A random-effects model was used to obtain the pooled estimates, and a pooled Risk Ratio (RR) was calculated. Study quality was assessed using a modified version of the Newcastle-Ottawa Scale. This review is registered with PROSPERO, CRD4202019099.
Our meta-analysis showed an increased likelihood of mortality in COVID-19 patients with pre-existing COPD (RR 3.18, 95% CI 2.11-4.80, HR 1.90, 95%CI 1.11-3.26). Furthermore, pooled estimate for the association between pre-existing COPD and severity due to COVID-19 was also significant (RR 3.63, 95%CI 2.48-5.31). Males had an increased risk of mortality (RR 1.20, 95%CI 1.12-1.29) compared to females.
We found that patients with pre-existing COPD had more than three times higher risk of mortality and severe COVID-19. There is a need to identify patients with pre-existing COPD during the pandemic so that early interventions can be aimed for this group of patients.
Original languageEnglish
Number of pages38
JournalExpert Review of Respiratory Medicine
Publication statusAccepted/In press - 18 Dec 2020

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