Hospitalized COVID-19 Patients With Asthma May Not Have Worse Outcomes

By Lisa Rapaport

September 10, 2020

(Reuters Health) - Hospitalized COVID-19 patients aged 65 and under who have asthma don't appear to have worse outcomes than their counterparts without asthma, a recent study suggests.

Researchers examined electronic health records for 1,298 patients 65 and under who were hospitalized with COVID-19 in New York City between February 11 and May 7, 2020. Overall, 163 patients (12.6%) had an asthma diagnosis.

There was no statistically significant difference in length of stay, hospital readmission, intubation, tracheostomy tube placement or mortality between patients with and without asthma, researchers report in the Journal of Allergy and Clinical Immunology.

"Early in the pandemic I believe that public health officials assumed that asthma was a risk factor for severe COVID-19 disease based on the history of asthma and other respiratory viral infections," said lead study author Dr. Stephanie Lovinsky-Desir of the pediatric pulmonary medicine division at Columbia University Irving Medical Center in New York City.

Results of the current study, however, suggest that asthma patients who get COVID-19 don't have a higher risk of mortality than the general population, Dr. Lovinsky-Desir said by email.

Asthma was more common in the youngest patients in the study. Among patients under 21 years old, 24% had asthma, compared with 13% of older patients.

Researchers found no difference in outcomes based on whether people with asthma had comorbidities including obesity, diabetes mellitus, hypertension, or hyperlipidemia.

In addition, researchers stratified asthma patients by severity based on whether they used controller medications and still found no significant difference in outcomes.

Although more patients with asthma were hospitalized with COVID-19 relative to the prevalence of asthma in the community, asthma was not associated with worse COVID-19 outcomes even when people had severe asthma, the study team concludes.

One limitation of the study, however, is that researchers were unable to determine the risk of developing severe COVID-19 among people with asthma. Although researchers did have data on obesity and pre-COVID eosinophil counts, they were also unable to completely characterize asthma phenotypes.

The study also relied on ICD codes to identify asthma cases, which isn't very sensitive or specific, said Dr. Fernando Holguin, a professor of medicine and pediatrics in the division of pulmonary sciences at the University of Colorado, in Aurora.

"The take-home message is that asthma is not, as stated by the CDC, a condition associated with worse COVID outcomes," Dr. Holguin, who wasn't involved in the study, said by email. "For patients, this means not to fear stepping outdoors, as long as social distancing guidelines and mask use are followed. Also, patients should maintain use of their medications."

SOURCE: Journal of Allergy and Clinical Immunology, online August 5, 2020.