Prevalence and characterization of asthma in hospitalized and nonhospitalized patients with COVID-19

The Centers for Disease Control and Prevention advises that patients with moderate to severe asthma belong to a high-risk group that is susceptible to severe coronavirus disease 2019 (COVID-19). However, the association between asthma and COVID-19 has not been well-established. The primary objective...

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Published in:Journal of allergy and clinical immunology 2020-08, Vol.146 (2), p.307-314.e4
Main Authors: Chhiba, Krishan D., Patel, Gayatri B., Vu, Thanh Huyen T., Chen, Michael M., Guo, Amina, Kudlaty, Elizabeth, Mai, Quan, Yeh, Chen, Muhammad, Lutfiyya N., Harris, Kathleen E., Bochner, Bruce S., Grammer, Leslie C., Greenberger, Paul A., Kalhan, Ravi, Kuang, Fei Li, Saltoun, Carol A., Schleimer, Robert P., Stevens, Whitney W., Peters, Anju T.
Format: Article
Language:English
Subjects:
Administration, Inhalation
Adrenal Cortex Hormones - therapeutic use
Adult
Age Factors
Aged
allergic rhinitis
Anti-Asthmatic Agents - therapeutic use
asthma
Asthma - diagnosis
Asthma - drug therapy
Asthma - epidemiology
Asthma - physiopathology
Betacoronavirus - pathogenicity
Clinical Laboratory Techniques - methods
Comorbidity
Coronary Artery Disease - diagnosis
Coronary Artery Disease - epidemiology
Coronary Artery Disease - physiopathology
Coronavirus Infections - diagnosis
Coronavirus Infections - epidemiology
Coronavirus Infections - physiopathology
corticosteroid
COVID-19
COVID-19 Testing
Diabetes Mellitus - diagnosis
Diabetes Mellitus - epidemiology
Diabetes Mellitus - physiopathology
Female
Hospitalization - statistics & numerical data
Humans
Hypertension - diagnosis
Hypertension - epidemiology
Hypertension - physiopathology
Illinois - epidemiology
long-acting β-agonist
Male
Middle Aged
Models, Statistical
morbidity
Obesity - diagnosis
Obesity - epidemiology
Obesity - physiopathology
Pandemics
Pneumonia, Viral - diagnosis
Pneumonia, Viral - epidemiology
Pneumonia, Viral - physiopathology
Prevalence
Retrospective Studies
rhinosinusitis
Risk Factors
SARS-CoV-2
severity
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Summary:The Centers for Disease Control and Prevention advises that patients with moderate to severe asthma belong to a high-risk group that is susceptible to severe coronavirus disease 2019 (COVID-19). However, the association between asthma and COVID-19 has not been well-established. The primary objective was to determine the prevalence of asthma among patients with COVID-19 in a major US health system. We assessed the clinical characteristics and comorbidities in asthmatic and nonasthmatic patients with COVID-19. We also determined the risk of hospitalization associated with asthma and/or inhaled corticosteroid use. Medical records of patients with COVID-19 were searched by a computer algorithm (March 1 to April 15, 2020), and chart review was used to validate the diagnosis of asthma and medications prescribed for asthma. All patients had PCR-confirmed COVID-19. Demographic and clinical features were characterized. Regression models were used to assess the associations between asthma and corticosteroid use and the risk of COVID-19–related hospitalization. Of 1526 patients identified with COVID-19, 220 (14%) were classified as having asthma. Asthma was not associated with an increased risk of hospitalization (relative risk, 0.96; 95% CI, 0.77-1.19) after adjusting for age, sex, and comorbidities. The ongoing use of inhaled corticosteroids did not increase the risk of hospitalization in a similar adjusted model (relative risk, 1.39; 95% CI, 0.90-2.15). Despite a substantial prevalence of asthma in our COVID-19 cohort, asthma was not associated with an increased risk of hospitalization. Similarly, the use of inhaled corticosteroids with or without systemic corticosteroids was not associated with COVID-19–related hospitalization.
ISSN:0091-6749
1097-6825
DOI:10.1016/j.jaci.2020.06.010