Clinical and inflammatory characteristics of patients with asthma in the Spanish MEGA project cohort

Abstract

Introduction The MEGA (MEchanism underlying the Genesis and evolution of Asthma) project is a multicenter cohort study carried out in eight Spanish hospitals, gathering clinical, physiological, and molecular data from patients with asthma and multimorbidities in order to gain insight into the different physiopathological mechanisms involved in this disorder. Material and Methods We report the baseline clinical and physiological characteristics and biomarker measures of adult participants in the project with the aim of better understanding the natural history and underlying mechanisms of asthma as well as the associated multimorbidities across different levels of severity. We carried out a detailed clinical examination, pulmonary function testing, measurement of fractional exhaled nitric oxide (FeNO), blood counts, induced sputum, skin prick tests, chest computed tomography scan, asthma questionnaires, and multimorbidity assessment in 512 asthmatic patients. Results When compared to patients with milder disease, severe asthmatic patients showed greater presence of symptoms, more exacerbations, lower asthma control, increased airflow obstruction, and higher frequency of chronic rhinosinusitis with nasal polyps, severe rhinitis, anxiety and depression, gastroesophageal reflux, and bronchiectasis. Conclusion The MEGA project succeeded in recruiting a high number of asthma patients, especially those with severe disease, who showed lower control and higher frequency of multimorbidities.

How reliably can algorithms identify eosinophilic asthma phenotypes using non‐invasive biomarkers?

“…Worse lung function is associated with eosinophilic phenotypes, 6,8,9 as demonstrated in our previous report characterising MEGA patients 5 . No differences in lung function were found in the present study, likely owing to the presence of sputum eosinophilia in all grades.…”

“…Patients from the MEGA cohort with a valid sputum analysis and an accurate asthma diagnosis were selected. 4 , 5 A total of 145 patients were included. A retrospective observational study was conducted by reviewing the MEGA cohort electronic database.…”

“…Patients from the MEGA cohort with a valid sputum analysis and an accurate asthma diagnosis were selected 4,5 . A total of 145 patients were included.…”

“… 4 As secondary outcomes, we evaluated the clinical characteristics, asthma severity, and lung function in these phenotypes. 4 , 5 …”

Chronic Rhinosinusitis and COVID-19

“…Moreover, in 545 severe asthmatic patients treated with biologics (many of them with CRSwNP) from a Spanish cohort, no increased risk for severe COVID-19 or mortality was found. 115 However, there are no formal studies investigating the influence of type 2 biologics on COVID-19 risk and severity in patients with CRSwNP. Although the European Academy of Allergy and Clinical Immunology position paper on managing CRS during the COVID-19 pandemic recommends that biologics be stopped until patients with COVID-19 symptoms complete recovery, 116 a riskebenefit assessment must be carefully conducted for CRSwNP patients treated with biologics.…”