Asthma in patients with coronavirus disease 2019

Abstract

Background It is unclear if there is the influence of asthma on contracting COVID-19, or having worse outcomes from COVID-19 disease. Objective To explore the prevalence of asthma in COVID-19 patients and the relationship between asthma and COVID-19 patients with poor outcomes. Methods The pooled prevalence of asthma in COVID-19 patients and corresponding 95% confidence interval (CI) were estimated. The pooled effect size (ES) was used to evaluate the association between asthma and COVID-19 patients with poor outcomes. Results The pooled prevalence of asthma in COVID-19 patients worldwide was 8.3% (95% CI 7.6-9.0%) based on 116 articles (119 studies) with 403,392 cases. The pooled ES based on unadjusted effect estimates showed that asthma was not associated with the reduced risk of poor outcomes in COVID-19 patients (ES 0.91, 95% CI 0.78-1.06). Similarly, the pooled ES based on unadjusted effect estimates revealed that asthma was not associated with the reduced risk of mortality in COVID19 patients (ES 0.88, 95% CI 0.73-1.05). However, the pooled ES based on adjusted effect estimates indicated that asthma was significantly associated with the reduced risk of mortality in COVID-19 patients (ES 0.80, 95% CI 0.74-0.86). Conclusion The pooled prevalence of asthma in COVID-19 patients was similar to that in the general population, and asthma might be an independent protective factor for the death of COVID-19 patients, which suggests that we should pay high attention to COVID-19 patients with asthma and take locally tailored interventions and treatment. Further well-designed studies with large sample sizes are required to verify our findings.

Impact of asthma on COVID-19 mortality in the United States: Evidence based on a meta-analysis

“…The prevalence of comorbid asthma among coronavirus disease 2019 patients varied greatly across countries or regions worldwide. Previous meta-analyses have reported the inconsistent association between asthma and COVID-19 mortality in the whole regions [1] , [2] , [3] , which might be difficult in assessing the association on substantial variation of asthma prevalence among different countries. The strength of this study was that the included studies (56 eligible articles) with 426,261 cases were only conducted in the USA, which thought about the influences of this varied prevalence for asthma in regions among COVID-19 patients in the USA in terms of the relation between asthma and COVID-19 mortality.…”

“…I 2 statistic was applied to assess the heterogeneity among studies [13] . Sensitivity analysis by deleting one single study from overall pooled analysis each time was carried out to evaluate the robustness of the findings [2] . Begg’s rank correlation test was used to evaluate the potential publication bias [14] .…”

“…It has been reported that the prevalence of comorbid asthma among coronavirus disease 2019 (COVID-19) patients varied greatly across countries or regions worldwide [1] , [2] , [3] . Previous meta-analyses have investigated the association between asthma and COVID-19 mortality in the whole regions [1] , [2] , [3] , but the conclusions were inconsistent, which might suffer limitations from substantial variation of asthma prevalence among different countries. Moreover, a previous meta-analysis by Sunjaya et al reported that COVID-19 patients with asthma had a significantly increased risk for mortality in Asia, but not in Europe, North America and South America [4] .…”

COVID-19 Vaccination in Pregnancy, Paediatrics, Immunocompromised Patients, and Persons with History of Allergy or Prior SARS-CoV-2 Infection: Overview of Current Recommendations and Pre- and Post-Marketing Evidence for Vaccine Efficacy and Safety

“…A systematic review and meta-analysis based on 119 studies including a total of 403,392 cases showed that patients with COVID-19 had a pooled prevalence of asthma similar to that of the general population (8.3% vs 4.3-8.6%, respectively) and, therefore, asthma may not be associated with an increased risk of COVID-19. The meta-analysis was conducted in 116 of the 119 included studies and did not show a higher risk of poor COVID-19-related outcomes [111].…”

Association of infant antibiotic exposure and risk of childhood asthma: A meta-analysis

“…When HRs or RRs were provided, we assumed HRs were similar to RRs as previous studies did. 12,15 Since the prevalence/ incidence rate of asthma is generally low among included studies, we assumed that ORs approximated the RRs. 16,17 Heterogeneity was assessed by Cochrane Q test (P < 0.05 indicated statistically significant) and Higgins I 2 test (I 2 >50% and I 2 >75% indicated moderate and high heterogeneity, respectively).…”