Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill.
Division of Epidemiology, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill.
J Allergy Clin Immunol. 2020 Aug;146(2):307-314.e4. doi: 10.1016/j.jaci.2020.06.010. Epub 2020 Jun 15.
The Centers for Disease Control and Prevention advises that patients with moderate to severe asthma belong to a high-risk group that is susceptible to severe coronavirus disease 2019 (COVID-19). However, the association between asthma and COVID-19 has not been well-established.
The primary objective was to determine the prevalence of asthma among patients with COVID-19 in a major US health system. We assessed the clinical characteristics and comorbidities in asthmatic and nonasthmatic patients with COVID-19. We also determined the risk of hospitalization associated with asthma and/or inhaled corticosteroid use.
Medical records of patients with COVID-19 were searched by a computer algorithm (March 1 to April 15, 2020), and chart review was used to validate the diagnosis of asthma and medications prescribed for asthma. All patients had PCR-confirmed COVID-19. Demographic and clinical features were characterized. Regression models were used to assess the associations between asthma and corticosteroid use and the risk of COVID-19-related hospitalization.
Of 1526 patients identified with COVID-19, 220 (14%) were classified as having asthma. Asthma was not associated with an increased risk of hospitalization (relative risk, 0.96; 95% CI, 0.77-1.19) after adjusting for age, sex, and comorbidities. The ongoing use of inhaled corticosteroids did not increase the risk of hospitalization in a similar adjusted model (relative risk, 1.39; 95% CI, 0.90-2.15).
Despite a substantial prevalence of asthma in our COVID-19 cohort, asthma was not associated with an increased risk of hospitalization. Similarly, the use of inhaled corticosteroids with or without systemic corticosteroids was not associated with COVID-19-related hospitalization.
美国疾病控制与预防中心建议，中重度哮喘患者属于易感染严重 2019 冠状病毒病（COVID-19）的高危人群。然而，哮喘与 COVID-19 之间的关联尚未得到充分证实。
本研究的主要目的是确定美国一家大型医疗系统中 COVID-19 患者中哮喘的患病率。我们评估了 COVID-19 患者中哮喘患者和非哮喘患者的临床特征和合并症。我们还确定了哮喘和/或吸入皮质类固醇使用与住院相关的风险。
通过计算机算法（2020 年 3 月 1 日至 4 月 15 日）搜索 COVID-19 患者的病历，并进行图表审查以验证哮喘的诊断和开具的哮喘药物。所有患者均经聚合酶链反应（PCR）确诊为 COVID-19。描述了人口统计学和临床特征。回归模型用于评估哮喘和皮质类固醇使用与 COVID-19 相关住院风险之间的关联。
在确定的 1526 例 COVID-19 患者中，220 例（14%）被归类为哮喘。在调整年龄、性别和合并症后，哮喘与住院风险增加无关（相对风险，0.96；95%CI，0.77-1.19）。在类似的调整模型中，吸入皮质类固醇的持续使用并未增加住院风险（相对风险，1.39；95%CI，0.90-2.15）。
尽管我们的 COVID-19 队列中哮喘的患病率相当高，但哮喘与住院风险增加无关。同样，使用吸入皮质类固醇（无论是否联合全身皮质类固醇）与 COVID-19 相关住院无关。
