Asthma Prolongs Intubation Time in COVID-19 Patients

By Megan Brooks

May 26, 2020

NEW YORK (Reuters Health) - Asthma may prolong the time a person hospitalized with COVID-19 is on a ventilator, a new study suggests.

"Although asthmatics might not be at higher risk to acquire the virus, once they do, asthmatics have a significantly more difficult time with . . . longer intubation and ICU admission," Dr. Mahboobeh Mahdavinia of Rush University Medical Center in Chicago told Reuters Health by email.

To assess the impact of preexisting asthma on COVID-19 outcomes, the researchers studied 935 patients with confirmed COVID-19, of whom 241 (25.8%) had a diagnosis of asthma.

Asthmatic patients with COVID-19 required intubation for about five days more on average than non-asthmatic patients with COVID-19 (P=0.01), the researchers report in The Journal of Allergy and Clinical Immunology: In Practice.

The longer intubation time with asthma was seen in people aged 18 to 64 but not in those age 65 and older. This suggests that "younger individuals with asthma may require extra attention as they could develop a sustained pulmonary failure with COVID-19 infection, leading to a prolonged mechanical ventilation," the researchers write.

The analysis was adjusted for both obesity and gender, which indicates that asthma is independently linked to intubation duration, they note.

There was a trend toward longer hospital stays among patients asthma in those 50 to 64 years old but not in the younger or older age groups.

Asthma was not associated with higher rate of death (1.1% vs. 3% in asthmatics vs. non-asthmatics, P=0.22) nor with acute respiratory distress syndrome (8.9% vs. 9.5%; P=0.92).

"This is the first report, to our knowledge, to study the role of asthma on the outcome of COVID-19 patients," Dr. Mahdavinia and colleagues say.

"Clinicians should be diligent when counseling asthmatics about COVID. Also asthmatics need to have a lower threshold to seek help and to go to the ED if their breathing symptoms with COVID do not improve with their inhalers," Dr. Mahdavinia told Reuters Health.

The study had no commercial funding and the authors have no relevant disclosures.

SOURCE: The Journal of Allergy and Clinical Immunology: In Practice, online May 14, 2020.