Asthma among hospitalized patients with COVID-19 and related outcomes

Stephanie Lovinsky-Desir, Deepti R Deshpande, Aliva De, Laurie Murray, Jeanette A Stingone, Angela Chan, Neha Patel, Nooralam Rai, Emily DiMango, Joshua Milner, Meyer Kattan, Stephanie Lovinsky-Desir, Deepti R Deshpande, Aliva De, Laurie Murray, Jeanette A Stingone, Angela Chan, Neha Patel, Nooralam Rai, Emily DiMango, Joshua Milner, Meyer Kattan

Abstract

Background: Several underlying conditions have been associated with severe acute respiratory syndrome coronavirus 2 illness, but it remains unclear whether underlying asthma is associated with worse coronavirus disease 2019 (COVID-19) outcomes.

Objective: Given the high prevalence of asthma in the New York City area, our objective was to determine whether underlying asthma was associated with poor outcomes among hospitalized patients with severe COVID-19 compared with patients without asthma.

Methods: Electronic heath records were reviewed for 1298 sequential patients 65 years or younger without chronic obstructive pulmonary disease who were admitted to our hospital system with a confirmed positive severe acute respiratory syndrome coronavirus 2 test result.

Results: The overall prevalence of asthma among all hospitalized patients with COVID-19 was 12.6%, yet a higher prevalence (23.6%) was observed in the subset of 55 patients younger than 21 years. There was no significant difference in hospital length of stay, need for intubation, length of intubation, tracheostomy tube placement, hospital readmission, or mortality between patients with and without asthma. Observations between patients with and without asthma were similar when stratified by obesity, other comorbid conditions (ie, hypertension, hyperlipidemia, and diabetes), use of controller asthma medication, and absolute eosinophil count.

Conclusions: Among hospitalized patients 65 years or younger with severe COVID-19, asthma diagnosis was not associated with worse outcomes, regardless of age, obesity, or other high-risk comorbidities. Future population-based studies are needed to investigate the risk of developing COVID-19 among patients with asthma once universal testing becomes readily available.

Keywords: New York City; SARS-CoV-2; coronavirus; respiratory disease.

Copyright © 2020 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Figures

Graphical abstract
Graphical abstract
Fig 1
Fig 1
Kaplan-Meier curve demonstrating no significant difference in hospital length of stay between patients with (N = 163) and without (N = 1135) asthma.
Fig 2
Fig 2
Kaplan-Meier curve demonstrating no significant difference in time to extubation between patients with (N = 163) and without (N = 1135) asthma.
Fig 3
Fig 3
Relationship between ZIP code asthma prevalence in adults and proportion of adult COVID-19 cases with asthma in ZIP codes with more than 50 COVID-19 cases at CUIMC.

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Source: PubMed

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