Health-related risk of SARS-CoV-2 infection in chronic obstructive pulmonary disease patients: A systematic review

Chronic obstructive pulmonary disease (COPD) is one of the most commonly identified co-morbidities with high morbidity and mortality risk in patients with Coronavirus Disease-19 (COVID-19) infection. The objective of the current study is to review the primary risk factors involved in the development of COVID-19 infections in COPD patients along with an insight on the effect of COPD medications in the development of this disease. The systematic search was performed on electronic databases such as PubMed, LitCovid, COVID-evidence, clinical trials, and Science Direct. ICU intervention and the use of invasive ventilators on the worsening of symptoms were the main inclusion parameters for the current review. Key findings indicate that the occurrence of COVID-2019 in COPD patients was low due to less availability of data. However, the risk of severity (66%) and mortality (58.62%) was high, suggesting that COPD patients with confirmed COVID-19 were at higher risk of disease. In regards to COVID-19, Angiotensin-converting enzyme-2 (ACE-2), one of the identified target receptors of the COVID-19 responsible for the infection, was observed to increase in COPD patients. COPD is thus a risk factor for developing extreme and critical forms of COVID-19 compared with the other groups, which further leads to requiring admission to an ICU and the use of invasive ventilators on the worsening of symptoms with high mortality rates. This systematic review, which together with ACE-2, will explain the severity and rate of mortality along with the risk factors of COVID-19 in COPD patients, the use of nebulizers with mesh to prevent transmission, and adherence to medication in the world’s current pandemic situation. © 2022 Meenakshi, et al.