The impact of COVID-19 on patients with asthma

Abstract

BackgroundAn association between the severity of COVID-19 and the presence of certain chronic conditions has been suggested. However, unlike influenza and other viruses, the disease burden in patients with asthma has been less evident.ObjectiveTo understand the impact of COVID-19 in patients with asthma.MethodsUsing big data analytics and artificial intelligence through the SAVANA Manager® clinical platform, we analysed clinical data from patients with asthma from January 1st to May 10th, 2020.ResultsOut of 71 182 patients with asthma, 1006 (1.41%) suffered from COVID-19. Compared to asthmatic individuals without COVID-19, patients with asthma and COVID-19 were significantly older (55 versus 42 years), predominantly female (66% versus 59%), smoked more frequently, and had higher prevalence of hypertension, dyslipidemias, diabetes, and obesity. Allergy-related factors such as rhinitis and eczema were less common in asthmatic patients with COVID-19 (p<.001). Higher prevalence of these comorbidities was also observed in patients with COVID-19 who required hospital admission. The use of inhaled corticosteroids (ICS) was lower in patients who required hospitalisation due to COVID-19, as compared to non-hospitalised patients (48.3% versus 61.5%; OR: 0.58: 95% CI 0.44–0.77). Although patients treated with biologics (n=865; 1.21%) showed increased severity and more comorbidities at the ENT level, COVID-19-related hospitalisations in these patients were relatively low (0.23%).ConclusionPatients with asthma and COVID-19 were older and at increased risk due to comorbidity-related factors. ICS and biologics are generally safe and may be associated with a protective effect against severe COVID-19 infection.

Asthma and COVID-19: do we finally have answers?

“…This is exactly the approach taken by Choi et al and Izquierdo et al in the two real-life studies in this issue of the European Respiratory Journal [ 16 , 17 ]. While Choi et al included all COVID-19 cases in Korea (n=7590) by using a national claims database, Izquierdo et al .…”

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

“…Our study is amongst the largest of 6 published reports on patients with severe asthma treated with biologics and shows the worst outcome of COVID-19. The other studies in asthma patients on biologic treatment reported cases of COVID-19, but out of a total of 19 confirmed COVID-19 patients admitted to the hospital, only 2 were intubated, and 2 died [ 15 , [18] , [19] , [20] , [21] , [22] ]. Compared to these other studies, the COVID-19 cases in our study were clearly more severe.…”

“…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] ].…”

“…In most studies COVID-19 asthmatics had mild to moderate disease, and only a few reports have been published on patients with severe asthma and COVID-19 [ 15 , [18] , [19] , [20] , [21] , [22] , [38] ]. A growing number of these patients with severe asthma use monoclonal antibodies targeting immune globulin E (IgE), IL-5, IL-5 receptor alpha (Rα) or IL-4Rα [ 23 ].…”

Risikoabschätzung bei Patienten mit chronischen Atemwegs- und Lungenerkrankungen im Rahmen der SARS-CoV-2-Pandemie

“…Dabei werden häufig gestellte Fragen anhand von 13 exemplarischen Fallbeispielen beantwortet. [31], Belgien [32], Frankreich [33], Brasilien [34], Russland [35], Japan [36] und den USA [37 -42] [112 -114]. Aufgrund der geringen Anzahl an publizierten Fällen ist eine sichere Beurteilung allerdings nicht möglich, zudem müssen immer auch die Komorbiditäten der Patienten beachtet werden [115].…”