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Differences in Mortality Among Patients With Asthma and COPD Hospitalized With COVID-19
Yunqing Liu1, Haseena Rajeevan2, Michael Simonov3
1Department of Biostatistics, Yale School of Public Health, New Haven, Conn.
Summary
Patients with chronic obstructive pulmonary disease (COPD) face higher COVID-19 mortality, while asthma patients show reduced risk. Type 2 inflammation, common in asthma, may offer protection against severe coronavirus disease 2019 (COVID-19).
Area of Science:
- Pulmonology
- Infectious Diseases
- Immunology
Background:
- The risk of severe coronavirus disease 2019 (COVID-19) in patients with asthma and/or chronic obstructive pulmonary disease (COPD) is not well-established.
- Understanding these risks is crucial for managing patients with pre-existing respiratory conditions during the pandemic.
Purpose of the Study:
- To compare in-hospital COVID-19 outcomes among patients with asthma, COPD, and no airway disease.
- To identify factors influencing COVID-19 severity in patients with airway diseases.
Main Methods:
- A retrospective cohort study included 8,395 patients hospitalized with COVID-19 from March 2020 to April 2021.
- International Classification of Diseases, 10th Revision codes identified airway disease diagnoses.
- Mortality and Sequential Organ Failure Assessment (SOFA) scores were compared; logistic regression adjusted for confounders.
Main Results:
- Patients with COPD had higher SOFA scores (median 0.86) and increased adjusted mortality (OR 1.40; P < .01).
- Asthma patients exhibited lower SOFA scores (median 0.15) and decreased adjusted mortality (OR 0.65; P = .01).
- Blood eosinophil counts ≥200 cells/μL were linked to lower mortality across groups; asthma patients showed protection even without eosinophilia.
Conclusions:
- COVID-19 severity is increased in COPD patients and decreased in asthma patients, independent of clinical confounders.
- These findings suggest intrinsic immunological factors, like type 2 inflammation, influence COVID-19 severity in airway diseases.
- Asthma, including non-eosinophilic types, appears protective against severe COVID-19.
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