Predictors of severe COVID-19 in a registry-based Swedish cohort of patients with COPD

Stridsman, Caroline; Vanfleteren, Lowie E.G.W.; Konradsen, Jon R.; Fisk, Sten Axelsson; Pedroletti, Christophe; Sjöö, Yvonne; Syk, Jörgen; Sterner, Therese; Lindberg, Anne; Tunsäter, Alf; Nyberg, Fredrik; Ekberg-Jansson, Ann; Sundbaum, Johanna Karlsson

doi:10.1183/13993003.01920-2021

Cited by 9 publications

(17 citation statements)

References 16 publications

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“… 35 Surprisingly in our study, current smoking was an inverse predictor of severe COVID-19, and the same trend has been shown in a cohort of patients with COPD. 36 We can speculate that our results could be related to protective strategies, that is, current smokers with asthma might have followed basic infection-control measures such as social distancing, especially during the first months of the pandemic, thereby reducing the risk of the infection. However, in our analysis of fatal outcomes, current smoking was a strong predictor for death, also shown by others.…”

Section: Discussionmentioning

confidence: 91%

Uncontrolled asthma predicts severe COVID-19: a report from the Swedish National Airway Register

Sundbaum

Konradsen

Vanfleteren

et al. 2022

Ther Adv Respir Dis

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Background: Severe asthma increases the risk of severe COVID-19 outcomes such as hospitalization and death. However, more studies are needed to understand the association between asthma and severe COVID-19. Methods: A cohort of 150,430 adult asthma patients were identified in the Swedish National Airway Register (SNAR) from 2013 to December 2020. Data on body mass index, smoking habits, lung function, and asthma control test (ACT) were obtained from SNAR, and uncontrolled asthma was defined as ACT ⩽19. Patients with severe COVID-19 were identified following hospitalization or in death certificates based on ICD-10 codes U07.1 and U07.2. The Swedish Prescribed Drug register was used to identify comorbidities and data from Statistics Sweden for educational level. Multivariate logistic regression analyses were used to estimate associations with severe COVID-19. Results: Severe COVID-19 was identified in 1067 patients (0.7%). Older age (OR = 1.04, 95% CI = 1.03–1.04), male sex (1.42, 1.25–1.61), overweight (1.56, 1.27–1.91), obesity (2.12, 1.73–2.60), high-dose inhaled corticosteroids in combination with long-acting β-agonists (1.40, 1.22–1.60), dispensed oral corticosteroids ⩾2 (1.48, 1.25–1.75), uncontrolled asthma (1.64, 1.35–2.00), cardiovascular disease (1.20, 1.03–1.40), depression (1.47, 1.28–1.68), and diabetes (1.52, 1.29–1.78) were associated with severe COVID-19, while current smoking was inversely associated (0.63, 0.47–0.85). When comparing patients who died from COVID-19 with those discharged alive from hospital until 31 December 2020, older age, male sex, and current smoking were associated with COVID-19 death. Conclusion: Patients with uncontrolled asthma and high disease burden, including increased asthma medication intensity, should be identified as risk patients for severe COVID-19. Furthermore, current smoking is strongly associated with COVID-19 death in asthma.

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Section: Discussionmentioning

confidence: 91%

Uncontrolled asthma predicts severe COVID-19: a report from the Swedish National Airway Register

Sundbaum

Konradsen

Vanfleteren

et al. 2022

Ther Adv Respir Dis

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“…Previous studies in adults have reported this association. 11,12 Stridsman et al in their study of a cohort of adults with chronic obstructive pulmonary disease from a Swedish registry found underweight status among others to be a predictor of severe COVID-19. 12 Wu et al found that in adults, underweight was associated with a 2.85fold higher risk of death secondary to COVID-19 after adjusting for potential confounders.…”

Section: Discussionmentioning

confidence: 99%

“…11,12 Stridsman et al in their study of a cohort of adults with chronic obstructive pulmonary disease from a Swedish registry found underweight status among others to be a predictor of severe COVID-19. 12 Wu et al found that in adults, underweight was associated with a 2.85fold higher risk of death secondary to COVID-19 after adjusting for potential confounders. 11 Although the exact reasons for this association are unclear, we propose that poor nutritional status could result in impaired immune response thus making the host more vulnerable to severe disease.…”

Section: Discussionmentioning

confidence: 99%

Association of Area Deprivation Index With Severity of COVID-19 in Pediatric Patients: A Multisite Study of Racially and Ethnically Diverse Children

Acosta

Suresh

Ettinger

et al. 2023

Pediatric Infectious Disease Journal

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Area deprivation index (ADI) is associated with the risk of severe COVID-19 in adults. However, this association has not been established in children. Information on ADI, demographics, clinical features, disease severity, and outcomes was analyzed for 3434 children with COVID-19. A multivariate logistic regression revealed that non-Hispanic Asians, extremes of weight, and higher ADI were associated with severe disease.

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“…Факторы риска, связанные с тяжелым течением COVID-19 среди пациентов с ХОБЛ (n = 68 902), были оценены в исследовании Stridsman C и др. [18], которое показало, что тяжелая форма COVID-19 была связана с более старшим возрастом, мужским полом, более низким уровнем образования, недостаточным весом или ожирением, ОФВ1 менее 50% прогнозируемой и оценкой теста на ХОБЛ не менее 18 баллов.…”

Section: осложнения новой коронавирусной инфекции у пациентов с разли...unclassified

Complications of a New Coronavirus Infection in Patients With Different Phenotypes of Chronic Obstructive Pulmonary Disease

Likhonosova¹,

Lukina²,

Amosov³

2023

Rejr

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Predictors of severe COVID-19 in a registry-based Swedish cohort of patients with COPD

Cited by 9 publications

References 16 publications

Uncontrolled asthma predicts severe COVID-19: a report from the Swedish National Airway Register

Uncontrolled asthma predicts severe COVID-19: a report from the Swedish National Airway Register

Association of Area Deprivation Index With Severity of COVID-19 in Pediatric Patients: A Multisite Study of Racially and Ethnically Diverse Children

Complications of a New Coronavirus Infection in Patients With Different Phenotypes of Chronic Obstructive Pulmonary Disease

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