Profile of coronavirus disease enlightened asthma as a protective factor against death: An epidemiology study from Brazil during the pandemic

Abstract

IntroductionThe possibility that asthma is not a risk factor for the worst outcomes due to coronavirus disease (COVID-19) is encouraged. The increase in Th2 response dominance can downregulate the late phase of hyperinflammation, which is typically the hallmark of more severe respiratory viral infections, alongside lower angiotensin-converting enzyme receptors in patients with asthma due to chronic inflammation. Few studies associated asthma diagnosis and COVID-19 outcomes. In this context, we aimed to associate the asthma phenotype with the clinical signs, disease progression, and outcomes in patients with COVID-19.MethodsWe performed an epidemiologic study using patients’ characteristics from OpenDataSUS to verify the severity of COVID-19 among Brazilian hospitalized patients with and without the asthma phenotype according to the need for intensive care units, intubation, and deaths. We also evaluated the demographic data (sex, age, place of residence, educational level, and race), the profile of clinical signs, and the comorbidities.ResultsAsthma was present in 43,245/1,129,838 (3.8%) patients. Among the patients with asthma, 74.7% who required invasive ventilatory support evolved to death. In contrast, 78.0% of non-asthmatic patients who required invasive ventilatory support died (OR = 0.83; 95% CI = 0.79–0.88). Also, 20.0% of the patients with asthma that required non-invasive ventilatory support evolved to death, while 23.5% of non-asthmatic patients evolved to death (OR = 0.81; 95% CI = 0.79–0.84). Finally, only 11.2% of the patients with asthma who did not require any ventilatory support evolved to death, while 15.8% of non-asthmatic patients evolved to death (OR = 0.67; 95% CI = 0.62–0.72). In our multivariate analysis, one comorbidity and one clinical characteristic stood out as protective factors against death during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Patients with asthma were less prone to die than other patients (OR = 0.79; 95% CI = 0.73–0.85), just like puerperal patients (OR = 0.74; 95% CI = 0.56–0.97) compared to other patients.ConclusionAsthma was a protective factor for death in hospitalized patients with COVID-19 in Brazil. Despite the study’s limitations on patients’ asthma phenotype information and corticosteroid usage, this study brings to light information regarding a prevalent condition that was considered a risk factor for death in COVID-19, being ultimately protective.

Epidemiological Profile of Bechcet’s Disease in Hospitalized Patients Infected With SARS-CoV-2 in Brazil: A Serial Case Report and a Literature Review

“…Even, in the literature, some studies demonstrated only a higher prevalence of COVID-19 among patients with BD without impact on severity [10,27,31]. Moreover, it is important to highlight the need for a correct diagnosis even among those with a rare COVID-19 phenotype [35,36,45]. In brief, in Brazil, Boschiero et al ( 2022) evaluated a population of 1,851,592 hospitalized individuals due to COVID-19 with the data for COVID-19 and outcomes, among these individuals, 632,101/ (34.1%) deaths were observed [41].…”

Perfil Clínico Na Admissão De Pacientes Com Covid-19 E Fatores Associados À Gravidade Clínica

“…Um estudo brasileiro com as primeiras 250.000 internações por COVID-19 apontou a predominância do sexo masculino em 56%, presença de comorbidades em 84%, mortalidade hospitalar de 38%, sendo que 59% dos pacientes estavam na UTI (forma grave) e 80% dos óbitos foram em pacientes ventilados mecanicamente 21…”

Desenvolvimento de Modelos de Regressão Logística para Classificação Binária de Covid-19 e Previsão Estatística de Óbitos

“…Apesar do senso comum indicar que toda doença respiratória enquadraria o paciente no grupo de risco máximo de Covid-19, os resultados estatísticos obtidos vão ao encontro com a pesquisa de Sansone et al (2022), que classificou a asma como uma condição de fator protetor a essa doença. Para investigação dos resultados, expõe-se que o coeficiente dos pacientes com pré-existência de doença hepática é de 0,4538, com IC de 95% entre 0,4562 e 0,4515, e razão de chances de 1,5743, indicando que estes pacientes possuem significativamente mais chances de vir a óbito por Covid-19 quando comparados aos enfermos que não apresentam essa préexistência em seu quadro clínico.…”