Among patients with asthma who contract COVID-19, those with allergic and eosinophilic phenotypes have less severe outcomes from COVID-19 infection and a lower risk of hospital admissions; in contrast, patients with asthma who are older or have cardiovascular comorbidities, aspirin exacerbated respiratory disease (AERD), or eosinopenia tend to have more severe outcomes, according to a retrospective study of Spanish patients published in the Journal of Asthma and Allergy.

Asthma is characterized by chronic airway inflammation and a poor antiviral immune response; however, most studies do not include asthma as a comorbidity associated with the risk of severity of COVID-19 infection. Therefore, researchers in Spain aimed to determine the relationship between COVID-19 severity and asthma, specifically examining the effects of atopy, certain clinical and demographic characteristics, phenotypes, and laboratory data.

The analysis was conducted using medical records data collected from March 2020 to April 2021on a cohort of 201 adults with asthma who contracted COVID-19. All patients were being followed for asthma at 13 allergy departments in Spain. The researchers analyzed lung function test and asthma control test (ACT) results from before and after patients contracted COVID-19.  Approximately 30% of these patients were admitted for bilateral pneumonia.


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The researchers found that advanced age, elevated D-dimer, lower numbers of lymphocytes and eosinophils, heart diseases, and hypertension were associated with severe COVID-19. However, patients exhibiting allergic and mixed allergic/eosinophilic phenotypes and their biomarkers (total IgE, aeroallergens sensitizations, allergic rhinitis, and blood eosinophilia) were associated with fewer hospital admissions. Notably, poor asthma control and lower forced expiratory volume in the first second (FEV1) were associated with a worse prognosis of COVID-19.

“Our study reinforces the hypothesis about the protector factor of eosinophils and T2 cytokines in COVID-19,” concluded the researchers. “Our study also shows that severe disease with poorer lung function and poor control, old age and cardiovascular comorbidities are associated with a more severe course of COVID-19,” the researchers added.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 

Reference

Habernau Mena A, García-Moguel I, Vazquez de la Torre Gaspar M, et al. COVID-19 course in allergic asthma patients: A Spanish cohort analysis. J Asthma Allergy. Published online February 22, 2022. doi:10.2147/JAA.S344934