Accumulating Impact of Smoking and Co-morbidities on Severity and Mortality of COVID-19 Infection: A Systematic Review and Meta-analysis

Rupesh Kumar; Avdhesh Kumar Rai; Mayur Mausoom Phukan; Anowar Hussain; Debajit Borah; Bhaskarjyoti Gogoi; Poulomi Chakraborty; Alak Kumar Buragohain

doi:10.2174/1389202922666210921101728

Accumulating Impact of Smoking and Co-morbidities on Severity and Mortality of COVID-19 Infection: A Systematic Review and Meta-analysis

Curr Genomics. 2021 Dec 30;22(5):339-352. doi: 10.2174/1389202922666210921101728.

Authors

Rupesh Kumar^{1

2}, Avdhesh Kumar Rai³, Mayur Mausoom Phukan⁴, Anowar Hussain⁵, Debajit Borah¹, Bhaskarjyoti Gogoi¹, Poulomi Chakraborty¹, Alak Kumar Buragohain¹

Affiliations

¹ Department of Bio-Technology, The Assam Royal Global University, Guwahati-781035, Assam, India.
² Department of Medical Laboratory Technology, The Assam Royal Global University, Guwahati-781035, Assam, India.
³ DBT Centre for Molecular Biology and Cancer Research, Dr. B. Borooah Cancer Institute, Guwahati-781001, Assam, India.
⁴ Department of Forest Science, Nagaland University (Central), Lumami-798627, Nagaland, India.
⁵ Division of Life Sciences, Institute of Advanced Study in Science and Technology, Gauhati-781035, Assam, India.

Abstract

Background: High prevalence, severity, and formidable morbidity have marked the recent emergence of the novel coronavirus disease (COVID-19) pandemic. The significant association with the pre-existing co-morbid conditions has increased the disease burden of this global health emergency, pushing the patients, healthcare workers and facilities to the verge of complete disruption.

Methods: Meta-analysis of pooled data was undertaken to assess the cumulative risk assessment of multiple co-morbid conditions associated with severe COVID-19. PubMed, Scopus, and Google Scholar were searched from January 1^st to June 27^th 2020 to generate a well-ordered, analytical, and critical review. The exercise began with keying in requisite keywords, followed by inclusion and exclusion criteria, data extraction, and quality evaluation. The final statistical meta-analysis of the risk factors of critical/severe and non-critical COVID-19 infection was carried out on Microsoft Excel (Ver. 2013), MedCalc (Ver.19.3), and RevMan software (Ver.5.3).

Results: We investigated 19 eligible studies, comprising 12037 COVID-19 disease patients, representing the People's Republic of China (PRC), USA, and Europe. 18.2% (n = 2200) of total patients had critical/severe COVID-19 disease. The pooled analysis showed a significant association of COVID-19 disease severity risk with cardiovascular disease (RR: 3.11, p < 0.001), followed by diabetes (RR: 2.06, p < 0.001), hypertension (RR: 1.54, p < 0.001), and smoking (RR: 1.52, p < 006).

Conclusion: The review involved a sample size of 12037 COVID-19 patients across a wide geographical distribution. The reviewed reports have focussed on the association of individual risk assessment of co-morbid conditions with the heightened risk of COVID-19 disease. The present meta-analysis of cumulative risk assessment of co-morbidity from cardiovascular disease, diabetes, hypertension, and smoking signals a novel interpretation of inherent risk factors exacerbating COVID-19 disease severity. Consequently, there exists a definite window of opportunity for increasing survival of COVID-19 patients (with high risk and co-morbid conditions) by timely identification and implementation of appropriately suitable treatment modalities.

Keywords: COVID-19; Co-morbidity; SARS-CoV-2; acute cardiac injury; hypertension; risk factor; smoking.

Publication types

Systematic Review