Atopy Status of Patients With Asthma and Exacerbation Rates Post COVID-19

coronavirus disease 2019 covid lungs illustration
3D Rendering,COVID-19 virus infection of human lungs
Does the allergic status of patients with asthma affect asthma exacerbation rates and outcomes following COVID-19?

The following article is a part of conference coverage from the American Academy of Allergy, Asthma & Immunology Annual Meeting, being held in Phoenix, Arizona, from February 25 to 28, 2022. The team at Pulmonology Advisor will be reporting on the latest news and research conducted by leading experts in the field. Check back for more from the AAAAI 2022 Virtual Annual Meeting.

Asthma exacerbations occur at a significantly lower rate for patients with asthma who have COVID-19 when those patients also have allergic rhinitis vs when they do not have allergic rhinitis. These were among study findings being presented at the American Association of Allergy, Asthma & Immunology (AAAAI) 2022 Annual Meeting, held in Phoenix, Arizona, from February 25 to 28.

Asthma symptoms may be exacerbated and prolonged by COVID-19 in some but not all patients with asthma. Researchers sought to examine the effect of the allergic status of patients with asthma on asthma exacerbation rates and outcomes following COVID-19. In this prospective cohort study, conducted at a tertiary care medical center in 2020 between February and April, 193 patients with COVID-19 who also had asthma were followed for asthma exacerbation symptoms for 4 to 8 months (mean duration 211 days) following their positive COVID-19 test. Researchers utilized logistic regression to compare asthma patients with and without allergic rhinitis for asthma outcomes after experiencing COVID-19. Statistics were adjusted for use of inhaled-corticosteroids, BMI, and demographics.

 Of the patients studied, 55 (28.5%) had asthma with allergic rhinitis and 138 (71.5%) had asthma without allergic rhinitis. Gender distribution, BMI, and age were similar between cohorts, but the asthma exacerbation rate was significantly lower in patients with vs without allergic rhinitis (54.5% vs 68.1%, respectively; adjusted P =.046). No difference was observed between cohorts for use of oral steroids after COVID-19, frequency of specialist visits, uncontrolled asthma duration, or step-up therapy.

Researchers found, “Allergic-asthma patients had a significantly lower asthma exacerbation rate than non-atopic patients.” They further noted, “This finding is supported by previous literature highlighting the significance of the Th2 inflammatory in protecting against COVID-19 respiratory inflammation, theoretically because of the allergic cytokine increase that results in decreased virus entry through the [angiotensin-converting enzyme 2] pathway.


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Jaswaney R, Foster K, Moore D, Andy-Nweye A, Mahdavinia M. Allergic asthma patients experience lower rates of asthma exacerbation compared to non-allergic asthma patients following COVID-19 infection. Presented at: American Academy of Allergy, Asthma & Immunology (AAAAI) 2022 Annual Meeting; February 25–28, 2022; Phoenix, AZ. Abstract 173.