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Multiple manifestations of uncontrolled asthma increase the risk of severe COVID-19

Stina Selberg1, Johanna Karlsson Sundbaum2, Jon R Konradsen3

  • 1Department of Public Health and Clinical Medicine, Division of Medicine/the OLIN-unit, Umeå University, Umeå, Sweden.

Respiratory Medicine
|June 4, 2023
PubMed

Insights

Uncontrolled asthma increases COVID-19 severity risk. Multiple asthma symptoms and obesity significantly elevate the danger of severe COVID-19 outcomes, necessitating careful patient assessment.

Area of Science:

  • Pulmonology
  • Infectious Diseases
  • Epidemiology

Background:

  • Asthma control is crucial for predicting severe COVID-19 outcomes.
  • Uncontrolled asthma presents unique risks in the context of viral infections.

Purpose of the Study:

  • To investigate the association between clinical characteristics of uncontrolled asthma and severe COVID-19.
  • To evaluate the impact of multiple uncontrolled asthma manifestations on COVID-19 severity.

Main Methods:

  • Utilized the Swedish National Airway Register (SNAR) from 2014-2020, identifying 24,533 adult patients with uncontrolled asthma (Asthma Control Test [ACT] ≤19).
  • Linked SNAR data with national registers to identify 221 patients with severe COVID-19.
  • Employed Poisson regression analyses, assessing uncontrolled asthma manifestations (ACT ≤15, frequent exacerbations, prior hospitalizations) stepwise.

Main Results:

  • Obesity emerged as the strongest independent risk factor for severe COVID-19 in both sexes, more pronounced in men.
  • Patients with severe COVID-19 had more frequent multiple manifestations of uncontrolled asthma: one (45.7%), two (18.1%), and three (5.0%) compared to controls.
  • Increasing numbers of uncontrolled asthma manifestations correlated with significantly higher risks of severe COVID-19 (RR 1.49 to 2.96), adjusted for sex, age, and BMI.

Conclusions:

  • Multiple manifestations of uncontrolled asthma and obesity are critical factors in assessing COVID-19 risk.
  • These factors substantially increase the likelihood of severe COVID-19 outcomes, underscoring the need for comprehensive risk evaluation.
Abstract

Keywords:
AsthmaAsthma control test (ACT)COVID-19ExacerbationObesityQuality registerRegister studiesUncontrolled asthma

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