S25 The impact of COVID-19 on the UK severe asthma population

IntroductionSevere asthma patients were assumed to be at greater risk of morbidity from infection with the novel severe acute respiratory syndrome coronavirus (COVID-19), hence, in the UK, were advised to shield. Community data on COVID-19 infection in severe asthmatics is lacking. We assessed the b...

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Published in:Thorax 2021-02, Vol.76 (Suppl 1), p.A18-A18
Main Authors: Smith, SJ, Busby, J, Heaney, LG, Pfeffer, PE, Jackson, DJ, Yang, JF, Fowler, SJ, Menzies-Gow, A, Idris, E, Brown, T, Gore, R, Faruqi, S, Dennison, P, Dodd, JW, Doe, S, Mansur, AH, Priyadarshi, R, Holmes, J, Hearn, A, Al-Aqqad, H, Loewenthal, L, Cooper, A, Fox, L, Selvan, M, Crooks, MG, Thompson, A, Higbee, D, Fawdon, M, Nathwani, V, Holmes, L, Chaudhuri, R
Format: Article
Language:English
Subjects:
Asthma
Coronaviruses
COVID-19
Infections
Mental health
Severe acute respiratory syndrome
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Summary:IntroductionSevere asthma patients were assumed to be at greater risk of morbidity from infection with the novel severe acute respiratory syndrome coronavirus (COVID-19), hence, in the UK, were advised to shield. Community data on COVID-19 infection in severe asthmatics is lacking. We assessed the burden of shielding, the impact of COVID-19 and the effect of asthma medication on the UK severe asthma population.MethodsAdults previously consented to inclusion in the UK Severe Asthma Registry (UKSAR) across 14 centres were contacted in June 2020 to collect data on potential COVID-19 infection, asthma control and shielding. Electronic records, where available, were reviewed for confirmation. Data was combined with clinical data from the UKSAR. Univariate and multivariate logistic regression analyses were performed to identify risk factors for COVID-19 infection.Results1365 patients were included. 1268 (93%) were advised to shield, 1131 (89%) patients who received shielding advice followed it. Men (OR 0.4, p=0.045) and those in non-shielding households (OR 0.27, p=0.001) were less likely to follow shielding advice. 544 (47%) of patients advised to shield reported worsening of mental health; females (OR 1.59, p=0.001) and those with history of anxiety or depression (OR 2.12 p=0.001) were at greater risk.97 (7.1%) patients had suspected/confirmed COVID-19 infection, 19 (1.39%) PCR/serology confirmed infection, 13(0.95%) were hospitalised and 2 patients (0.15%) died (table 1).918 (67%) were on biologic therapy, 515 (37%) maintenance oral corticosteroid (mOCS). Multivariate analysis showed neither biologic therapy (OR 0.73, p=0.165) nor mOCS (OR 1.18, p=0.427) increased the risk of COVID-19 infection. Patients on biologics were less likely to require an acute course of corticosteroids for asthma symptoms (OR 0.6, p=0.002) while patients on mOCS were more likely (OR 1.96 p≤0.001).Inhaled corticosteroids (ICS) were not associated with COVID-19 infection, including high dose (2000 mcg BDP equivalent) (OR 0.64, p=0.234). Hospitalised patients were on lower median doses of ICS vs non-hospitalised patients (1000 vs 2000 mcg BDP equivalent, p=0.002).Abstract S25 Table 1Characteristics of severe asthma patients with suspected or confirmed mild (ambulatory) or severe (hospitalised) COVID-19 infection Mild COVID-19 (n= 84) Hospitalised with COVID-19 (n= 13) p-value Age (Years) (mean [SD])50.5 (13.8)55.6 (13.7)0.215 Male Gender (n [%])39 (46.4%)4 (30.8%)0.290 BMI (kg-m2) (mea
ISSN:0040-6376
1468-3296
DOI:10.1136/thorax-2020-BTSabstracts.31