Asthma Patients with COVID-19 at Comparable Risk of Hospitalization

Patients hospitalized for COVID-19 who have asthma compared with COVID-19-infected patients without asthma have a comparable risk of ICU admission and mechanical ventilation and a lower risk of mortality, according to research presented at the 2021 American Academy of Allergy, Asthma and Immunology (AAAAI) Virtual Annual Meeting, February 26 – March 1, 2021.

Insight into the association of asthma with severe COVID-19, the study authors write, is essential to both patients and clinicians as the pandemic continues.

To investigate the relationship, the researchers, from Boston, conducted a multicenter, matched cohort study using data from the Mass General Brigham Health Care System (MGBHCS).

Participants were adults (≥18 years of age) with confirmed COVID-19 seen at MGBHCS between March 4, 2020, and July 2, 2020. Patients with chronic obstructive pulmonary disease, interstitial lung disease, or cystic fibrosis were excluded. Asthma was defined as ≥2 diagnosis codes for asthma and the filling of an asthma prescription in the year prior to COVID-19 infection.

Up to 5 comparators without asthma were matched to each patient with asthma with respect to age (within 5 years), sex, and date of positive COVID-19 test (within 7 days). The primary study outcomes included hospitalization, mechanical ventilation, and death. Participants were followed for these outcomes from their COVID-19 diagnosis until July 2, 2020.

Of the 562 patients with asthma, 199 were hospitalized, 15 received mechanical ventilation, and 7 died. Of the 2686 matched comparators, 487 were hospitalized, 107 received mechanical ventilation, and 69 died. The adjusted hazard ratios (HRs) among patients with asthma were:

• Hospitalization: HR, 0.99 (95% CI, 0.80-1.22)
• Mechanical ventilation: HR, 0.69 (95% CI, 0.36- 1.29)
• Death: HR, 0.30 (95% CI, 0.11-0.800)

Based on these results from a large Boston-based healthcare system, the study authors conclude that the presence and absence of asthma are linked to comparable risks of hospitalization and use of mechanical ventilation in individuals with COVID-19. Perhaps paradoxically, the presence of asthma is associated with a lower risk for mortality among individuals with COVID-19.

Robinson L, Wang L, Fu X, et al. COVID-19 severity in asthma patients: a multicenter matched cohort study. Presented at: the American Academy of Allergy, Asthma & Immunology (AAAAI) Virtual Annual Meeting; February 26-March 1, 2021. Abstract L22.

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