Asthma in Adult Patients with COVID-19. Prevalence and Risk of Severe Disease

Terry, Paul; Heidel, R. Eric; Dhand, Rajiv

doi:10.1164/rccm.202008-3266oc

Cited by 81 publications

(75 citation statements)

References 123 publications

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“…In a study in South Korea, the prevalence of asthma among Covid-19 patients was 2.9% [36], somewhat similar to another review which finds that asthma is a pre-morbid condition in about 1.6% of the Covid-19 patients [37]. Another systematic review of the link between asthma and Covid-19 finds a somewhat higher prevalence of asthma among Covid-19 patients (7.46%) [38] echoing the heterogeneity of prevalence across different countries and regions as reported in another systematic review [39].…”

Section: Covid-19 and Asthmasupporting

confidence: 78%

Covid-19 and non-communicable diseases: evidence from a systematic literature review

Nikoloski

Alqunaibet²,

Alfawaz³

et al. 2021

BMC Public Health

108

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Background Since early 2020, the Covid-19 pandemic has engulfed the world. Amidst the growing number of infections and deaths, there has been an emphasis of patients with non-communicable diseases as they are particularly susceptible to the virus. The objective of this literature review is to systematize the available evidence on the link between non-communicable diseases and Covid-19. Methods We have conducted a systematic review of the literature on Covid-19 and non-communicable diseases from December, 2019 until 15th of November, 2020. The search was done in PubMed and in doing so we used a variety of searching terms in order to isolate the final set of papers. At the end of the selection process, 45 papers were selected for inclusion in the literature review. Results The results from the review indicate that patients with certain chronic illnesses such as diabetes, hypertension (and other cardiovascular diseases), chronic respiratory illnesses, chronic kidney and liver conditions are more likely to be affected by Covid-19. More importantly, once they do get infected by the virus, patients with chronic illnesses have a much higher likelihood of having worse clinical outcomes (developing a more severe form of the disease or dying) than an average patient. There are two hypothesized channels that explain this strong link between the chronic illnesses enumerated above and Covid 19: (i) increased ACE2 (angiotensin-converting enzyme 2) receptor expressions, which facilitates the entry of the virus into the host body; and (ii) hyperinflammatory response, referred to as “cytokine storm”. Finally, the literature review does not find any evidence that diabetes or hypertension related medications exacerbate the overall Covid-19 condition in chronic illness patients. Conclusions Thus, the evidence points out to ‘business as usual’ disease management model, although with greater supervision. However, given the ongoing Covid-19 vulnerabilities among people with NCDs, prioritizing them for the vaccination process should also figure high on the agenda on health authorities.

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Section: Covid-19 and Asthmasupporting

confidence: 78%

Covid-19 and non-communicable diseases: evidence from a systematic literature review

Nikoloski

Alqunaibet²,

Alfawaz³

et al. 2021

BMC Public Health

108

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“…Other studies did not provide clear evidence of increased risk of COVID-19 severity, hospitalization, or mortality in asthmatic patients. [29][30][31] The data on SCSs in asthma and COVID-19 are scarce. The results of the Randomized Evaluation of Covid-19 Therapy (RECOVERY) trial 32 showed that oral or intravenous administration of dexamethasone significantly reduces 28-day mortality among patients admitted to hospital with COVID-19 receiving invasive mechanical ventilation or oxygen, whereas Williamson et al 16 using the OpenSAFELY platform to examine factors associated with COVID-19-related death reported that severe asthma defined by recent SCS use was associated with increased mortality.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 risk and outcomes in adult asthmatic patients treated with biologics or systemic corticosteroids: Nationwide real-world evidence

Adir

Humbert

Saliba

2021

Journal of Allergy and Clinical Immunology

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Background Managing severe asthma during the SARS-CoV-2 pandemic is challenging, particularly due to safety concerns regarding the use of systemic corticosteroids and biologics. Objectives To determine the association between biologics or systemic corticosteroids use with PCR positivity for SARS-CoV-2 and COVID-19 outcomes among asthmatic patients Methods We used the computerized database of Clalit Health Services, the largest healthcare provider in Israel, to identify all asthmatic adult patients who underwent PCR testing for SARS-CoV-2, between 1 st of March 2020 and 7th December 2020. A cohort approach was used to assess the association between biologics use and steroids treatment and COVID-19 severity and 90-day mortality. Results Overall, 8,242 out of 80,602 tested asthmatics had positive PCR testing for SARS-CoV-2. Both biologics and systemic corticosteroids were not associated with increased risk of SARS-CoV-2 infection. Multivariate analyses revealed that biologics were not associated with a significant increased risk of moderate-severe COVID-19, nor with the composite endpoint of moderate-severe COVID-19 or all-cause mortality within 90 days. Chronic systemic corticosteroids use was associated with significant increased risk of all tested outcome. Recent (within the prior 120 days) systemic corticosteroids use, but not former use, was significantly associated with increased risk of both moderate-severe COVID-19 and the composite of moderate-severe COVID-19 or all-cause mortality. Conclusion Biologics approved for asthma and systemic corticosteroids are not associated with increased risk of SARS-CoV-2 infection. By contrast, systemic corticosteroids are independent risk factor for worst COVID-19 severity and all-cause mortality. Our findings underscore the risk of recent or current exposure to systemic corticosteroids in asthmatics infected with SARS-CoV-2.

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“…The regional asthma comorbidity rates were estimated as follows: East Asia and the Pacific, 2.2%; Europe, 6.4%; Latin America and the Caribbean, 3.5%; the Middle East and North Africa, 4.9%; North America, 10.2% [44]. Very recently, Terry et al performed a systematic review and meta-analysis of 150 studies and did not find clear evidence of increased risk of COVID-19 diagnosis in asthmatics [45].…”

Section: Susceptibility Of Patients With Asthma To Covid-19 Infectionmentioning

confidence: 99%

Asthma and COVID-19: a dangerous liaison?

Lombardi

Gani²,

Berti

et al. 2021

asthma res and pract

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The coronavirus disease 2019 (COVID-19) pandemic, caused by the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), provoked the most striking international public health crisis of our time. COVID-19 can cause a range of breathing problems, from mild to critical, with potential evolution to respiratory failure and acute respiratory distress syndrome. Elderly adults and those affected with chronic cardiovascular, metabolic, and respiratory conditions carry a higher risk of severe COVID-19. Given the global burden of asthma, there are well-founded concerns that the relationship between COVID-19 and asthma could represent a “dangerous liaison”.Here we aim to review the latest evidence on the links between asthma and COVID-19 and provide reasoned answers to current concerns, such as the risk of developing SARS-CoV-2 infection and/or severe COVID-19 stratified by asthmatic patients, the contribution of type-2 vs. non-type-2 asthma and asthma-COPD overlap to the risk of COVID-19 development. We also address the potential role of both standard anti-inflammatory asthma therapies and new biological agents for severe asthma, such as mepolizumab, reslizumab, and benralizumab, on the susceptibility to SARS-CoV-2 infection and severe COVID-19 outcomes.

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Asthma in Adult Patients with COVID-19. Prevalence and Risk of Severe Disease

Cited by 81 publications

References 123 publications

Covid-19 and non-communicable diseases: evidence from a systematic literature review

Covid-19 and non-communicable diseases: evidence from a systematic literature review

COVID-19 risk and outcomes in adult asthmatic patients treated with biologics or systemic corticosteroids: Nationwide real-world evidence

Asthma and COVID-19: a dangerous liaison?

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