Association of asthma comorbidity with poor prognosis of coronavirus disease 2019
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Sae-Hoon Kim1,2,3, Eunjeong Ji4, Seung-Hyun Won4
1Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
Insights
Asthma increases the risk of severe coronavirus disease 2019 (COVID-19) and mortality. Individuals with asthma should take precautions to prevent COVID-19 complications.
Area of Science:
- Epidemiology
- Pulmonology
- Infectious Diseases
Background:
- Global health agencies identify asthma as a risk factor for severe COVID-19.
- Empirical evidence supporting this association remains limited.
Purpose of the Study:
- To investigate the association between asthma and the severity and mortality of coronavirus disease 2019 (COVID-19).
Main Methods:
- A nationwide cohort study utilized Korean national health insurance data from January 1 to April 8, 2020.
- Asthma comorbidity was identified through diagnosis codes and medication prescriptions.
- COVID-19 severity was graded based on oxygen support and mechanical ventilation needs; mortality was also assessed.
Main Results:
- Asthma significantly increased the risk of severe COVID-19 (grade 2 and 3) and overall mortality.
- Individuals with asthma had a shorter time to in-hospital mortality following COVID-19 diagnosis.
- Recent asthma exacerbations were linked to more severe COVID-19 and higher mortality in univariable analysis.
Conclusions:
- Asthma is a significant risk factor for increased severity and mortality in COVID-19 patients.
- Asthma patients require heightened vigilance to mitigate adverse COVID-19 outcomes.
Background:
While global health agencies have listed asthma as a vulnerability for severe cases of coronavirus disease 2019 (COVID-19), the evidence supporting this is scarce.
Methods:
A nationwide cohort study was conducted using the validated Korean national health insurance claim data of patients diagnosed with COVID-19 between January 1 and April 8, 2020. Asthma comorbidity was determined using a diagnosis code assigned by the physician and the prescription of asthma-related medications. The clinical course of COVID-19 was classified into 3 severity grades according to the requirements for oxygen supply and mechanical ventilation. We also evaluated the association of asthma with overall and in-hospital mortality of COVID-19.
Results:
Asthma morbidity was a significant risk factor for severe COVID-19 (grade 2 requiring oxygen supply) (adjusted odds ratio [aOR] = 1.341, 95% confidence interval [CI], 1.051-1.711, P = 0.018) and grade 3 requiring mechanical ventilation or leading to death (aOR = 1.723, 95% CI: 1.230-2.412, P = 0.002) multinomial logistic regression adjusting co-risk factors. Asthma was also significantly associated with mortality of COVID-19 (aOR = 1.453, 95% CI: 1.015-2.080, P = 0.041) and was revealed to have a shorter time to in-hospital mortality of COVID-19 (P < 0.001). Patients with recent asthma exacerbation showed more severe COVID-19 of grade 3 (OR = 7.371, 95% CI: 2.018-26.924, P = 0.003) and higher mortality (OR = 9.208, 95% CI: 2.597-32.646, P < 0.001) in univariable analysis, but the statistical significance was not found in multivariable analysis.
Conclusion:
Asthma morbidity was associated with severity and mortality of COVID-19. Patients with asthma should pay more attention to avoid worsening of COVID-19.
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