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Asthma Phenotypes and COVID-19 Risk: A Population-based Observational Study
Chloe I Bloom1, Paul Cullinan2, Jadwiga A Wedzicha1
1Airways Disease Section and.
American Journal of Respiratory and Critical Care Medicine
|October 20, 2021
Summary
Patients with more severe asthma showed increased risks for severe COVID-19 outcomes, including hospitalization and ICU admission. However, type 2 inflammation did not appear to be a contributing factor to severe coronavirus disease (COVID-19) risk.
Area of Science:
- Respiratory Medicine
- Infectious Diseases
- Epidemiology
Background:
- Studies suggest asthma patients face higher risks for severe COVID-19.
- Limited data exists on specific asthma phenotypes and COVID-19 risk specificity.
- Need to compare asthma-related COVID-19 risks with other respiratory infections.
Purpose of the Study:
- To investigate the impact of asthma phenotype on COVID-19 outcomes.
- To compare hospitalization rates for COVID-19 with influenza and pneumonia in asthma patients.
- To determine if asthma-related risks for severe COVID-19 are specific.
Main Methods:
- Utilized electronic medical records for asthma patients and matched controls.
- Linked patient data with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing, hospital, and mortality data.
- Phenotyped asthma based on medication, exacerbation history, and type 2 inflammation, analyzed using Cox regression.
Main Results:
- All asthma patients had a higher risk of COVID-19 diagnosis.
- Specific asthma phenotypes (e.g., frequent exacerbations, specific medication use) were linked to increased COVID-19 hospitalization.
- These phenotypes also showed increased hospitalization risk for influenza and pneumonia.
- Severe asthma phenotypes were associated with higher ICU admission or mortality risk.
- Atopy and blood eosinophil counts were not linked to severe COVID-19 outcomes.
Conclusions:
- More severe asthma is associated with more severe COVID-19 outcomes.
- Type 2 inflammation is not a significant factor in severe COVID-19 outcomes for asthma patients.
- The risk of COVID-19 hospitalization is comparable to that of influenza or pneumonia.
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