Does Asthma Increase the Mortality of Patients with COVID-19?: A Systematic Review and Meta-Analysis

Wang, Yuanyuan; Chen, Jingjing; Chen, Wei; Liu, Ling; Dong, Mei; Ji, Juan Juan; Hu, Die; Zhang, Nianzhi

doi:10.1159/000510953

Cited by 62 publications

(61 citation statements)

References 24 publications

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“…Since the outbreak there has been much debate about the extent to which asthma is a risk factor for susceptibility to SARS-CoV-2 infection or severe disease progression of COVID-19, and results of studies addressing these issues vary substantially [ [6] , [7] , [8] , [9] , [10] , [11] , [12] ]. Recent large studies and meta-analyses however suggest that asthma patients in general may not be at risk for severe COVID-19, which may be due to a potential protective effect of type 2 inflammation [ [13] , [14] , [15] , [16] , [17] ].…”

Section: Introductionmentioning

confidence: 99%

Poor outcome of SARS-CoV-2 infection in patients with severe asthma on biologic therapy

Eger¹,

Hashimoto²,

Braunstahl³

et al. 2021

Respiratory Medicine

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Section: Introductionmentioning

confidence: 99%

Poor outcome of SARS-CoV-2 infection in patients with severe asthma on biologic therapy

Eger¹,

Hashimoto²,

Braunstahl³

et al. 2021

Respiratory Medicine

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“…According to rank (with a cut off score 4), the enriched known or reported comorbid conditions or long-term complications are lupus erythematosus (Rank-1) [100], depressive disorder / mental depression (Rank-2) [30, 101], hepatitis C (Rank-3) [102], breast cancer (Rank-4) [75], arthritis (Rank-5) [103], asthma (Rank-6) [10, 77], liver cancer (Rank-6) [78], tuberculosis (Rank-7) [104, 105], diabetes (Rank-8) [82], myocardial infarction (Rank-9) [35, 106], macular degeneration (Rank-9) [80], chronic kidney disease (Rank-9) [56, 57], arteriosclerosis (Rank-10) [107], ulcerative colitis (Rank-10) [108], liver cirrhosis (Rank-11) [12, 109], sepsis / septicaemia /septic shock (Rank-11) [60, 81], other autoimmune diseases (Rank-12) [49, 50], cerebrovascular accident / stroke (Rank-13) [110], congenital anemia (Rank-13) [111], COPD (Rank-13) [86], multiple myeloma (Rank-14) [112], hypertensive disease (Rank-14) [9, 113], dyslipidemia (Rank-15) [93], metabolic syndrome X (Rank-15) [51, 114], osteoporosis (Rank-16) [91], prostate cancer (Rank-17) [115], psoriasis (Rank-17) [116], leukemia (Rank-18) [117, 118], long QT syndrome (Rank-18) [119], dementia (Rank-18) [120], schizophrenia (Rank-18) [121], intellectual disability (Rank-18) [122, 123], diabetic kidney disease/ diabetic nephropathy (Rank-18) [124]etc.…”

Section: Resultsmentioning

confidence: 99%

“…A meta-analysis on underlying comorbid conditions in expired COVID-19 patients reveals hypertension is the most common comorbidity (46%) in COVID-19 followed by diabetes (26%), cardiovascular diseases (21%), cerebrovascular disease (13%), cancers (11%), Lung disease (11%), COPD (8%), kidney disease (7%), liver disease (3%), and asthma (3%) [9]. However, another meta-analysis suggests that asthma as a comorbid condition may not increase the mortality (OR: 0.96) [10]. Increased aspartate aminotransferase is associated with high severity and death from COVID-19 (OR: 4.48) [11] and patients with cirrhosis showed worsening liver function and increased mortality [12].…”

Section: Introductionmentioning

confidence: 99%

A novel multi-omics-based identification of symptoms, comorbid conditions, and possible long-term complications in COVID-19

Barh

Tiwari

Andrade

et al. 2020

Preprint

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Till date the comprehensive clinical pictures, comorbid conditions, and long-term complications of COVID-19 are not known. Recently using a multi-omics-based strategy, we have predicted the drugs for COVID-19 management with ∼70% accuracy. Here, using a similar multi-omics-based bioinformatics approach and three-ways of analysis, we identified the symptoms, comorbid conditions, and short, mid and possible long-term complications of COVID-19 with ∼90% precision. In our analysis (i) we identified 27 parent, 170 child, and 403 specific conditions associated with COVID-19. (ii) Among the specific conditions, 36 are viral and 53 short-term, 62 short to mid to long-term, 194 mid to long-term, and 57 are congenital conditions. (iii) At a cut off “count of occurrence” of 4, we found ∼ 90% of the enriched conditions are associated with COVID-19. (iv) Except the dry cough and loss of taste, all other COVID-19 associated mild and severe symptoms are enriched. (v) Cardiovascular, pulmonary, metabolic, musculoskeletal, neuropsychiatric, kidney, liver, and immune system disorders are found as top comorbid conditions. (vi) Specific diseases such as myocardial infarction, hypertension, COPD, lung injury, diabetes, cirrhosis, mood disorders, dementia, macular degeneration, chronic kidney disease, lupus, arthritis etc. along with several other diseases are also enriched as top candidates. (vii) Interestingly, many cancers and congenital disorders associated with COVID-19 severity are also identified. (viii) Arthritis, dermatomyositis, glioma, diabetes, psychiatric disorder, cardiovascular diseases having bidirectional relationship with COVID-19 are also found as top ranked conditions. Based on the accuracy (∼90%) of this analysis, long presence of SARS-CoV-2 RNA in human, and our previously proposed “genetic remittance” assumption, we hypothesize that all the identified comorbid conditions including the short-long-mid and mid-long non-communicable diseases (NCDs) could also be long-term consequences in COVID-19 survivors and warrants long-term observational studies.

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“…Several studies explored the prevalence of asthma among children and adults with confirmed COVID-19 infection and failed to find an increased risk of contracting the infection or of adverse outcomes among asthmatic patients 27,28 . A recent review with meta-analysis done in adults with COVID-19 (744 asthmatic and 8151 non-asthmatic) showed that the presence of asthma had no significant effect on mortality (OR=0.96 [0.70-1.30], I 2 =0%, p=0.79), duration of hospitalization, or the risk of ICU admission 29 . However, COVID-19 infection was significantly underdiagnosed during the initial months of the pandemic due to limited availability of diagnostic tests, that led most countries to recommend home isolation without testing in case of non-severe symptoms consistent with COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Childhood asthma outcomes during the COVID-19 pandemic: Findings from the PeARL multi-national cohort

Papadopoulos

Mathioudakis

Čustović

et al. 2020

Preprint

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Objective: We evaluated the impact of COVID-19 pandemic on childhood asthma outcomes. Design: The PeARL multinational cohort included children with asthma and non-asthmatic controls recruited during the COVID-19 pandemic and compared current disease activity with data available from the previous year. Setting: Pediatric outpatient clinics. Participants: The study included 1,054 children with asthma and 505 non-asthmatic controls, aged between 4-18 years, from 25 pediatric departments, from 15 countries globally. Exposures: COVID-19 pandemic first wave, starting from the date of the first fatality in the respective country. Main outcomes and measures: We assessed the pandemic's impact on the frequency of respiratory infections, emergency presentations and hospital admissions in asthmatic versus non-asthmatic participants, controlling for confounding factors including the pandemic's duration and the frequency of such acute events during 2019. Using paired analyses, we evaluated the impact of the pandemic on the annualized frequency of asthma attacks and the previously mentioned acute events, asthma control, and pulmonary function in children with asthma, compared to their baseline disease activity, during the preceding year. Results: During the pandemic, children with asthma experienced fewer upper respiratory tract infections, episodes of pyrexia, emergency visits, hospital admissions, asthma attacks and hospitalizations due to asthma, in comparison to the preceding year. Sixty-six percent of asthmatic children had improved asthma control while in 33% the improvement exceeded the minimally clinically important difference. Pre-bronchodilatation FEV1 and peak expiratory flow rate were also improved during the pandemic. When compared to non-asthmatic controls, children with asthma were not found to be at increased risk of LRTIs, episodes of pyrexia, emergency visits or hospitalizations during the pandemic. However, an increased risk of URTIs emerged. Conclusions and relevance: Childhood asthma outcomes, including control, were improved during the first wave of the COVID-19 pandemic, probably because of reduced exposure to asthma triggers and increased treatment adherence. The decreased frequency of acute episodes does not support the notion that childhood asthma may be a risk factor for COVID-19. Furthermore, the potential for improving childhood asthma outcomes through environmental control becomes apparent.

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Does Asthma Increase the Mortality of Patients with COVID-19?: A Systematic Review and Meta-Analysis

Cited by 62 publications

References 24 publications

Poor outcome of SARS-CoV-2 infection in patients with severe asthma on biologic therapy

Poor outcome of SARS-CoV-2 infection in patients with severe asthma on biologic therapy

A novel multi-omics-based identification of symptoms, comorbid conditions, and possible long-term complications in COVID-19

Childhood asthma outcomes during the COVID-19 pandemic: Findings from the PeARL multi-national cohort

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