Characterizing the Association Between Asthma, and COVID-19 severity

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Authors
Almazloum, Bachar
Keyword
COVID-19 , Asthma , SARS-CoV-2 , Inhaled Corticosteroids , Severe COVID-19 , Long COVID , ARDS , Acute Respiratory Distress Syndrome
Abstract
BACKGROUND: Despite heterogeneity in outcomes in patients infected with SARS-CoV-2, few studies have investigated the risks of developing respiratory failure and death in COVID-19 patients with pre-existing asthma. This study evaluated the impact of asthma on patients with COVID-19. METHODS: This was a retrospective cohort study using data from the Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN) registry. CCEDRRN collected data from consecutive patients presenting to one of 52 participating emergency departments being tested for severe acute respiratory syndrome coronavirus 2 (SARS CoV-2). We included patients from March 1st, 2020, to December 31st, 2021. Those who were ≥18 years and testing positive for SARS CoV-2 were considered for inclusion. We excluded those who were below the age of 18 and asymptomatic patients. The primary outcome of interest was a composite of intubation or death in the hospital and the secondary outcome is severe COVID-19 as defined by the WHO. Multivariable modified Poisson regression was used to assess the association between asthma and the composite outcome while adjusting for possible confounding variables, including inhaled corticosteroid (ICS) use. RESULTS: There were 38,139 patients who met the study inclusion criteria. Among these 2,826 patients had asthma (7.41%). We found no evidence to suggest an association between asthma and intubation or death in the hospital (RR: 0.97; 95% CI: 0.86, 1.1). Patients who were 80+ years were the highest risk age group developing the primary outcome (RR: 10.54; 95% CI: 7.01, 15.85) compared with the reference group 18-29 years. ICS had a higher risk of developing the primary outcome compared to non-ICS users (RR: 1.12; 95% CI: 1.01, 1.25). CONCLUSION: No evidence was found to suggest that asthma is associated with death or intubation in the hospital or the development of severe COVID-19 among emergency department patients infected with SARS-CoV-2.
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