Asthma in patients with suspected and diagnosed coronavirus disease 2019

Abstract

Background Asthma patients are comparatively susceptible to respiratory viral infections and more likely to develop severe symptoms than people without asthma. During the coronavirus disease 2019 (COVID-19) pandemic, it is necessary to adequately evaluate the characteristics and outcomes of the asthma population in the COVID-19 tested and diagnosed population. Objective We performed a study to assess the impact of asthma on COVID-19 diagnosis, presenting symptoms, disease severity, and cytokine profiles. Methods This was an analysis of a prospectively collected cohort of patients suspected of having COVID-19 who presented for COVID-19 testing at a tertiary medical center in Missouri, USA between March and September 2020. We classified and analyzed patients according to their preexisting asthma diagnosis and subsequent COVID-19 testing results. Results COVID-19 suspected patients (n=435) were enrolled in this study. The proportion of patients testing positive for COVID-19 was 69.2% and 81.9% in the asthma and non-asthma groups respectively. The frequency of relevant symptoms are similar between asthma groups with positive and negative COVID-19 test results. In the COVID-19 diagnosed population (n=343), asthma was not associated with several indicators of COVID-19 severity, including hospitalization, admission to an intensive care unit (ICU), mechanical ventilation, death due to COVID-19, and in-hospital mortality after multivariate adjustment. COVID-19 patients with asthma exhibited significantly lower levels of plasma interleukin (IL)-8 compared to patients without asthma (adjusted p=0.023). Conclusion The asthma population is facing a challenge in preliminary COVID-19 evaluation due to overlap in symptoms of COVID-19 and asthma. However, asthma does not increase the risk of COVID-19 severity if infected.

Prevalence of and factors associated with COVID-19 diagnosis in symptomatic patients followed in general practices in Germany between March 2020 and March 2021

“…Regarding asthma, a systematic review and meta-analysis of 131 studies (N = 410,382 patients) identified a substantial degree of variability in the prevalence of asthma among those diagnosed with COVID-19 (the prevalence ranged from 1.1% to 16.9%), while there was no significant difference in this prevalence with respect to COVID-19 severity (Liu et al, 2021). That being said, there is an overlap in the symptoms of COVID-19, asthma, and chronic sinusitis, and, for example, the prevalence of COVID-19 has been found to be significantly lower in asthma patients with suspected COVID-19 than in their counterparts without asthma (Cao et al, 2021). Moreover, as fear of being diagnosed with COVID-19 is relatively common in individuals with asthma or other conditions affecting the airway (de Boer et al, 2021;Mousing and Sørensen, 2021), adherence to preventive measures may be higher in these individuals than in the general population.…”

Pediatric Asthma Exacerbation in Children with Suspected and Confirmed Coronavirus Disease 2019 (COVID-19): An Observational Study from Saudi Arabia

“… 5 , 6 Comparing allergic triggers to the respiratory virus, asthma exacerbation-induced viral infections are usually longer and need intensive therapies. 7 , 8 It is now well established that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19) is milder in children than in adults and causes very low morbidity and mortality. 9–15 The data about the association between adult asthmatics and COVID-19 indicated that it could be a risk factor for severe disease, particularly, neutrophilic phenotype.…”

Asthma in patients admitted to emergency department for COVID-19: prevalence and risk of hospitalization

“…Current literature suggests that the prevalence of asthma among COVID-19 patients is similar to global one and that asthma does not appear to increase the risk of developing severe COVID-19. [ 1 – 8 ] Published data come from studies on patients admitted to hospital for COVID-19, whereas little or no evidence are available on the setting of emergency department (ED).…”