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Ann Allergy Asthma Immunol
. 2021 Feb 24;S1081-1206(21)00138-1.
doi: 10.1016/j.anai.2021.02.020. Online ahead of print.
Asthma in COVID-19 suspected and diagnosed patients
Lijuan Cao 1 , Sandra Lee 1 , James G Krings 2 , Adriana M Rauseo 3 , Daniel Reynolds 2 , Rachel Presti 3 , Charles Goss 4 , Philip A Mudd 5 , Jane A O'Halloran 3 , Leyao Wang 6
Affiliations
- PMID: 33639262
- DOI: 10.1016/j.anai.2021.02.020
Abstract
Background: Asthma patients are comparatively susceptible to respiratory viral infections and more likely to develop severe symptoms than people without asthma. During the coronavirus disease 2019 (COVID-19) pandemic, it is necessary to adequately evaluate the characteristics and outcomes of the asthma population in the COVID-19 tested and diagnosed population.
Objective: We performed a study to assess the impact of asthma on COVID-19 diagnosis, presenting symptoms, disease severity, and cytokine profiles.
Methods: This was an analysis of a prospectively collected cohort of patients suspected of having COVID-19 who presented for COVID-19 testing at a tertiary medical center in Missouri, USA between March and September 2020. We classified and analyzed patients according to their preexisting asthma diagnosis and subsequent COVID-19 testing results.
Results: COVID-19 suspected patients (n=435) were enrolled in this study. The proportion of patients testing positive for COVID-19 was 69.2% and 81.9% in the asthma and non-asthma groups respectively. The frequency of relevant symptoms are similar between asthma groups with positive and negative COVID-19 test results. In the COVID-19 diagnosed population (n=343), asthma was not associated with several indicators of COVID-19 severity, including hospitalization, admission to an intensive care unit (ICU), mechanical ventilation, death due to COVID-19, and in-hospital mortality after multivariate adjustment. COVID-19 patients with asthma exhibited significantly lower levels of plasma interleukin (IL)-8 compared to patients without asthma (adjusted p=0.023).
Conclusion: The asthma population is facing a challenge in preliminary COVID-19 evaluation due to overlap in symptoms of COVID-19 and asthma. However, asthma does not increase the risk of COVID-19 severity if infected.
Keywords: Asthma; COVID-19; SARS-CoV-2; St. Louis; clinical symptoms; cytokine; interleukin (IL)-8; respiratory viral infection; severe outcomes.