The following article is a part of conference coverage from the American Thoracic Society International Conference, being held virtually from May 14 to May 19, 2021. 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 ATS 2021 .

Asthma and chronic obstructive pulmonary disease (COPD) do not appear to increase the risk of mortality in patients with COVID-19, according research presented at the American Thoracic Society (ATS) 2021 International Conference, held virtually from May 15 to 19, 2021.

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Investigators examined the association between COVID-19 and obstructive lung disease, including asthma and COPD, by analyzing data collected between March 1, 2020, through July 1, 2020 from the largest health system in New York. A total of 21,865 patients were included, of whom 2518 had obstructive lung disease and COVID-19. Of these patients, 1370 had asthma and COVID-19, 847 had COPD and COVID-19, and 301 had overlapping asthma and COPD. There were 19,347 patients with COVID-19 without either asthma or COPD.

Patients with COPD and COVID-19 were more likely to be intubated compared with the control group (odds ratio [OR], 1.346; P =.0095); however, there was no association between COPD and mortality in patients with COVID-19 (OR, 0.845; P =.1436). There was also no association between asthma and COVID-19 and intubation (OR, 1.175; P =.2193), and there was no statistical association between asthma and mortality in patients with COVID-19 (OR, 0.849; P =.2455).

Patients with asthma were at a decreased risk of dying from COVID-19 compared with patients with COPD and COVID-19, even after controlling for comorbid conditions (OR, 0.718; P =.0329). Patients presenting with asthma exacerbation or COPD exacerbation in the setting of COVID-19 infection were not at increased risk for death as compared with COPD or patients with asthma and COVID-19 (OR, 1.042; P =.8796 and OR, 0.95; P =.762, respectively).

“[P]resenting with an asthma exacerbation or COPD exacerbation in the setting of COVID-19 infection did not increase [a patient’s] odds of mortality,” concluded the authors. “As to why asthma patients were at decreased odds of dying compared to COPD patients may be related to the different pathophysiological mechanisms of asthma as compared to COPD or a small protective effect of inhaled corticosteroids.”


Schwartz J, Birnbaum BR, Ballenberger MC, Mahmoud OH, Mina BA. COVID-19 and obstructive lung disease: are COPD and asthma risk factors for severe COVID-19? Evaluating the data from the largest health system in New York State. Presented at: the American Thoracic Society (ATS) International Conference 2021; May 14-19, 2021. Abstract A1276. 

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