Extreme temperature increases the risk of COPD morbimortality: A systematic review and meta-analysis

This systematic review examines how extreme temperatures impact chronic obstructive pulmonary disease (COPD) morbidity and mortality, focusing on identifying vulnerable subpopulations.

We conducted a systematic literature search from January 1, 2000, to November 6, 2024, across databases like PubMed, MEDLINE and EMBASE, Web of Science, and Scopus, focusing on observational studies that quantitatively defined extreme temperatures and their impacts on COPD morbidity and mortality. Out of 3140 records, 25 studies met the inclusion criteria. We extracted data on study characteristics, effect estimates, and confounders, employing methods to assess the risk of bias and synthesize results.

We observed that extreme heat increased the relative risk (RR) for COPD morbimortality by 1.16-fold (95 % CI: 1.08-1.26; p < 0.05), and extreme cold increased the RR by 1.32-fold (95 % CI: 1.20-1.46;). Extreme heat was associated with a 1.19-fold (95 % CI: 1.09-1.30; p < 0.05) increase in COPD mortality. In contrast, extreme cold was associated with both COPD morbidity and mortality, with morbidity increasing by 1.47-fold (95 % CI: 1.26-1.71; p < 0.05) and mortality by 1.23-fold (95 % CI: 1.10-1.38; p < 0.05). Extreme heat poses a higher risk for female COPD patients compared to males. Moreover, extreme heat and cold were associated with morbimortality risk among older adults. Asian populations were sensitive to both temperature extremes, whereas Europeans were predominantly susceptible to extreme cold.

This variability in response to extreme temperatures affects COPD morbidity and mortality, emphasizing the need for tailored medical and emergency responses to effectively mitigate health risks during extreme weather events.