COVID-19 Hospitalization, Severity Risk May Not Be Higher in Patients With Asthma

Patients with asthma who test positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVD-19), may not have a higher risk of hospitalization or severe outcomes associated with COVID-19 compared with SARS-CoV-2-positive patients without asthma, according to study results published in the Annals of Allergy, Asthma, and Immunology.

The retrospective study was an analysis of electronic medical record data of 727 patients with confirmed SARS-CoV-2. Of these patients, a total of 105 (14.4%) patients had a diagnosis of asthma, based on International Classification of Diseases, Tenth Revision codes and confirmed by clinical history by a board-certified allergist.

A multivariable logistic regression model adjusted for age, body mass index (BMI), race, and number of comorbidities was used to examine the association between asthma and hospitalization. Additionally, an adjusted proportional odds model was used to examine the association between asthma and COVID-19-related outcome severity. A Fisher’s exact test was used to assess the association between asthma and the need for intubation.

Approximately 37.6% (n=274) of patients included in the study were admitted to the hospital but did not require care in the intensive care unit (ICU). The 9.3% (n=68) of patients who did require ICU care were discharged, whereas 8.3% (n=61) died.

In the patients with asthma, a similar proportion of patients received care as an outpatient and inpatient (14.6% vs 14.2%, respectively). While the adjusted odds of hospitalization were 1.4 times higher in patients with asthma vs those without asthma, the difference was not statistically insignificant (95% CI, 0.82-2.4; P =.22). The adjusted odds of death vs hospitalization or ICU admission was 1.3 times higher for patients with asthma, but this difference was also not statistically significant (95% CI, 0.6-2.8; P =.48).

Factors associated with increased odds of hospitalization included age, number of comorbidities, and race (non-white vs white, P =.01). The odds of intubation were significantly higher in patients with vs without asthma (odds ratio [OR], 2 fold; 95% CI, 1-4-fold; P =.047). There was no difference between the 2 groups, however, in terms of intubation duration (P =.44) or hospitalization (P =.44).

Study limitations included its single-center design as well as its retrospective nature, which the researchers said precluded their ability “to make any causative associations,” but that the findings add “to the growing literature that patients with asthma may not be at higher risk of severe outcomes with COVID-19.”

Reference

Rosenthal JA, Awan SF, Fintzi J, Keswani A, Ein D. Asthma is associated with increased risk of intubation but not hospitalization or death in COVID-19. Published online October 12, 2020. Ann Allergy Asthma Immunol. doi:10.1016/j.anai.2020.10.002