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

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.

Reference

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.