SARS-CoV-2 Infection Does Not Necessarily Increase Asthma Exacerbation Risk

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Asthma is not a risk factor for SARS-CoV-2, and SARS-CoV-2 pneumonia may not induce severe asthma exacerbations.

Asthma is not a risk factor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), and SARS-CoV-2 pneumonia may not induce severe asthma exacerbation, according to the results of a retrospective cohort study published in The Journal of Allergy and Clinical Immunology: In Practice.

Viral infections are known to exacerbate asthma in adults, however these patients are rare in epidemiologic studies of SARS-CoV-2 pneumonia. Thus, it is unknown whether there is an association between SARS-CoV-2 infection and severe asthma exacerbation.

Researchers at Strasbourg University Hospital in France assessed the frequency of asthma exacerbation in 106 patients hospitalized for SARS-CoV-2 pneumonia between March 4 and April 6, 2020. Of these patients, 23 had asthma, with 63.6% considered well-controlled and 23.4% considered partially controlled. A total of 11 patients had ≥1 severe exacerbation in the previous year and 68.2% were considered to have allergic asthma because of their clinical history.

Overall, researchers found no significant difference between patients with asthma and those without in terms of severity (length of stay, maximal oxygen flow needed, noninvasive ventilation requirement, and intensive care unit transfer). Only 1 patient had a severe exacerbation during the last month before the onset of COVID-19 symptoms, 2 patients during prehospitalization, and 5 patients were treated with systemic corticosteroids and inhaled beta-2-agonists during hospitalization.

“The published risk factors associated with SARS-CoV-2 pneumonia (ie, hypertension, obesity, diabetes) were found in both asthmatic and nonasthmatic patients,” the researchers noted. “In contrast, we did not find the usual risk factors responsible for controlled asthma. This suggests that the COVID-19 infection was the main factor leading to hospitalization.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Grandbastien M, Piotin A, Godet J, et al. SARS-CoV-2 pneumonia in hospitalized asthmatic patients did not induce severe exacerbation [published online June 27, 2020]. J Allergy Clin Immunol Pract. doi:10.1016/j.jaip.2020.06.032