Risk of Stroke in COVID-19 Survivors With Asthma: A Nationwide, Population-Based Cohort Study

The impact of coronavirus disease 2019 (COVID-19) on stroke risk in adult individuals with asthma post-recovery remains unclear.

Using a longitudinal retrospective cohort design based on the Korean National Health Insurance Service claims database, we analyzed stroke risk in two parts. Study 1 examined stroke risk in individuals with asthma according to COVID-19 severity, and Study 2 compared stroke risk between individuals with asthma (asthma cohort) and the general population without asthma (general population cohort), considering COVID-19 severity. Both studies used propensity score matching and Cox proportional hazards regression models for risk estimation.

In Study 1, which evaluated stroke risk in the asthma cohort, the risk of stroke was significantly higher in the asthma cohort with severe COVID-19 compared to the asthma cohort without COVID-19 (adjusted hazard ratio [aHR], 1.88; 95% confidence interval [CI], 1.02-3.46). In Study 2, which evaluated stroke risk across six groups stratified by asthma status (asthma cohort and general population cohort) and COVID-19 severity (no, non-severe, and severe COVID-19), stroke risk was highest in the asthma cohort with severe COVID-19 (aHR, 3.42; 95% CI, 1.72-6.79, referring to the general population group without COVID-19), suggesting that severe COVID-19 has a more substantial effect on stroke risk in individuals with asthma.

This study highlights a significant association between severe COVID-19 and stroke occurrence in adults with asthma, emphasizing the need for ongoing stroke monitoring to improve long-term asthma outcomes during the COVID-19 endemic period.