Asthma is associated with increased risk of intubation but not hospitalization or death in coronavirus disease 2019

Rosenthal, Jamie A.; Awan, Seemal F; Fintzi, Jonathan; Keswani, Anjeni; Ein, Daniel

doi:10.1016/j.anai.2020.10.002

Cited by 21 publications

(16 citation statements)

References 7 publications

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“…After evaluating and assessing as much as 257 potential studies, 201 studies were removed due to outcome of interest being not available. In the end, what underlay this meta-analysis were eligible fifty-six articles with 426,261 COVID-19 patients [5] , [6] , [7] , [8] , [9] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] . The detail of selection process is shown by a chart flow in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

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

Han

Hou

et al. 2022

International Immunopharmacology

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Section: Resultsmentioning

confidence: 99%

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

Han

Hou

et al. 2022

International Immunopharmacology

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“…There were a total of 1,678,992 participants across the included studies, with a mean age range of 45.7–81.9 years. Of the included studies, 10 ( 38 , 42 , 46 , 48 , 51 , 55 , 56 , 58 , 66 , 69 ) examined outcomes in both asthma and COPD, seven ( 21 , 43 , 50 , 52 , 63 , 64 ) examined outcomes exclusively in asthma, and the remaining 20 studies ( 37 , 39 – 41 , 44 , 45 , 47 , 49 , 53 , 57 , 59 – 62 , 65 , 67 , 68 , 70 , 71 ) reported on outcomes exclusively regarding COPD. All but one study was classified as having low risk of bias (see Supplementary Table 4 for full QUIPS scoring).…”

Section: Resultsmentioning

confidence: 99%

The Risk of COVID-19 Related Hospitalsation, Intensive Care Unit Admission and Mortality in People With Underlying Asthma or COPD: A Systematic Review and Meta-Analysis

et al. 2021

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Background: Several underlying diseases have been associated with unfavorable COVID-19 related outcomes including asthma and Chronic Obstructive Pulmonary Disease (COPD), however few studies have reported risks that are adjusted for confounding variables. This study aimed to examine the adjusted risk of COVID-19 related hospitalsation, intensive care unit (ICU) admission, and mortality in patients with vs. without asthma or COPD.Methods: A systematic review of major databases was undertaken for studies published between 1/12/2019 and 19/4/2021. Studies reporting the adjusted (for one or more confounder) risks of either hospitalsation, ICU admission, or mortality in asthmatics or COPD patients (control group = no asthma or no COPD) were identified. Risk of bias was determined via the QUIPS tool. A random effect meta-analysis was undertaken.Findings: 37 studies were eligible for analysis, with a total of 1,678,992 participants. The pooled ORs of COVID-19 hospitalsation in subjects with asthma and COPD was 0.91 (95% CI 0.76–1.09) and 1.37 (95% CI 1.29–1.46), respectively. For ICU admission, OR in subjects with asthma and COPD was 0.89 (95% CI 0.74–1.07) and 1.22 (95% CI 1.04–1.42), respectively. For mortality, ORs were 0.88 (95% CI 0.77–1.01) and 1.25 (95% CI 1.08–1.34) for asthma and COPD, respectively. Further, the pooled risk of mortality as measured via Cox regression was 0.93 (95% CI 0.87–1.00) for asthma and 1.30 (95% CI 1.17–1.44) for COPD. All of these findings were of a moderate level of certainty.Interpretation: COPD was significantly associated with COVID-19 related hospital admission, ICU admission, and mortality. Asthma was not associated with negative COVID-19 related health outcomes. Individuals with COPD should take precautions to limit the risk of COVID-19 exposure to negate these potential outcomes. Limitations include differing population types and adjustment for differing cofounding variables. Practitioners should note these findings when dealing with patients with these comorbidities.Review Protocol Registration:https://www.crd.york.ac.uk/prospero/.

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“…People with asthma are generally more susceptible to respiratory viral infections compared to people without asthma due to an abnormal airway epithelium and less effective or deficient anti-viral innate immune responses. 2 3 In the setting of respiratory viral infections, which include human rhinovirus, respiratory syncytial virus, seasonal coronaviruses, and many others, asthma patients usually exhibit more severe and longer durations of respiratory symptoms compared to healthy individuals and may experience asthma exacerbations. 4 , 5 , 6 …”

Section: Introductionmentioning

confidence: 99%

“…18 19 However, interestingly, a large cohort study from England identified asthma patients with recent oral corticosteroid use as being at increased risk for death due to COVID-19, while other studies found that asthma prolonged endotracheal intubation times. 20 , 21 , 22 , 23 …”

Section: Introductionmentioning

confidence: 99%

Asthma in patients with suspected and diagnosed coronavirus disease 2019

Cao

Lee

Krings

et al. 2021

Annals of Allergy, Asthma & Immunology

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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.

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Asthma is associated with increased risk of intubation but not hospitalization or death in coronavirus disease 2019

Cited by 21 publications

References 7 publications

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

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

The Risk of COVID-19 Related Hospitalsation, Intensive Care Unit Admission and Mortality in People With Underlying Asthma or COPD: A Systematic Review and Meta-Analysis

Asthma in patients with suspected and diagnosed coronavirus disease 2019

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