Asthma, COPD Disease Severity May Increase Risk of Developing Severe COVID-19

Disease severity of both chronic obstructive pulmonary disease (COPD) and asthma may increase the risk of the development of severe coronavirus disease 2019 (COVID-19), according to results of an analysis presented at the American Academy of Allergy, Asthma & Immunology (AAAAI) Virtual Annual Meeting held February 26 to March 1, 2021.

Researchers evaluated patients who were diagnosed with COVID-19 between March 1, 2020, and August 31, 2020. They sought to explore whether the treatment and disease severity of patients with asthma and/or COPD can affect the severity of COVID-19 infection in a large, diverse population of patients from Kaiser Permanente Southern California. Electronic health records were used to obtain data on history of COPD and asthma, corticosteroid and bronchodilator use, and covariates such as demographics, other comorbidities, and lifestyle factors. Severe COVID-19 was characterized by hospitalization within 30 days following a diagnosis of the infection.

A total of 77,034 adult patients with COVID-19 were evaluated — 45.4% of whom were men and 65% of whom were Hispanic. The mean patient age was 42.9 years. Of these patients, 7868 patients were hospitalized within 30 days of COVID-19 diagnosis. The presence of asthma and COPD was reported among 14.5% and 12.6% of patients, respectively. After adjusting for coviariates, asthma and COPD were both associated with hospitalization (risk ratio [RR], 1.09; 95% CI, 1.02-1.17 and RR, 1.10; 95% CI, 1.04-1.16, respectively).

The associations were greater and statistically significant among those who were middle-aged (defined as 35-64 years of age) and those who were obese (P interaction, ≤.01). Based on asthma subtype, only nonallergic asthma was linked to hospitalization among patients with COVID-19 (RR, 1.11; 95% CI, 1.03-1.20). Additionally, among patients with asthma and/or COPD, those who had used both corticosteroids and bronchodilators for 6 months or less prior to COVID-19 diagnosis were at a higher risk for hospitalization.

The investigators concluded that among patients with asthma and/or COPD, disease severity, rather than corticosteroid utilization, may increase an individual’s risk of developing severe COVID-19.

Reference

Huang B, Chen Z, Sidell M, et al. Association of asthma, COPD and medication history with the risk of severe COVID-19. Presented at: the American Academy of Allergy, Asthma & Immunology (AAAAI) Virtual Annual Meeting; February 26-March 1, 2021. Abstract L39.