Chronic obstructive pulmonary disease (COPD) is associated with a greater than 5-fold increased risk for severe coronavirus disease 2019 (COVID-19), according to the results of a meta-analysis published in a letter to Respiratory Medicine.

The study authors performed an electronic search in Medline, Scopus, and Web of Science using the keywords “chronic obstructive pulmonary disease,” “COPD,” or “clinical characteristics” and “coronavirus 2019,” “COVID-19,” “2019-nCoV,” or “SARS-CoV-2” for literature available from 2019 to March 9, 2020.

A total of 87 articles were initially identified, and 80 were excluded because they were not related to COVID-19, did not provide relevant data, or were review or editorial articles. The remaining 7 studies included data from 1592 patients with COVID-19, including 314 individuals with severe disease.

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Although only 1 study reported individual odds ratio (OR) as a significant predictor of COPD, when the data of the individual studies was pooled, COPD was significantly associated with severe COVID-19 (OR, 5.69; 95% CI, 2.49-13.00; 12 = 0.0%; Cochran’s Q, P =.95).

Based on these findings, the study authors concluded that patients with a history of COPD should be encouraged to adopt more restrictive measures to minimize risk for exposure to severe acute respiratory syndrome coronavirus 2 and contact with people suspected of having or confirmed to have COVID-19. “Clinicians should also carefully monitor all COPD patients with suspected infection, and finally, it may be advisable to consider COPD as a variable in future risk stratification models,” the study authors wrote.

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Lippi G, Henry BM. Chronic obstructive pulmonary disease is associated with severe coronavirus disease 2019 [published online March 24, 2020]. Res Med. doi:10.1016/j.rmed.2020.105941