Chest Diseases Department, Strasbourg University Hospital, Strasbourg, France.
Public Health Department, Strasbourg University Hospital, Strasbourg, France.
J Allergy Clin Immunol Pract. 2020 Sep;8(8):2600-2607. doi: 10.1016/j.jaip.2020.06.032. Epub 2020 Jun 27.
Viral infections are known to exacerbate asthma in adults. Previous studies have found few patients with asthma among severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia cases. However, the relationship between SARS-CoV-2 infection and severe asthma exacerbation is not known.
To assess the frequency of asthma exacerbation in patients with asthma hospitalized for SARS-CoV-2 pneumonia and compare symptoms and laboratory and radiological findings in patients with and without asthma with SARS-CoV-2 pneumonia.
We included 106 patients between March 4 and April 6, 2020, who were hospitalized in the Chest Diseases Department of Strasbourg University Hospital; 23 had asthma. To assess the patients' asthma status, 3 periods were defined: the last month before the onset of COVID-19 symptoms (p1), prehospitalization (p2), and during hospitalization (p3). Severe asthma exacerbations were defined according to Global INitiative for Asthma guidelines during p1 and p2. During p3, we defined severe asthma deterioration as the onset of breathlessness and wheezing requiring systemic corticosteroids and inhaled β2 agonist.
We found no significant difference between patients with and without asthma in terms of severity (length of stay, maximal oxygen flow needed, noninvasive ventilation requirement, and intensive care unit transfer); 52.2% of the patients with asthma had Global INitiative for Asthma step 1 asthma. One patient had a severe exacerbation during p1, 2 patients during p2, and 5 patients were treated with systemic corticosteroids and inhaled β2 agonist during p3.
Our results demonstrate that patients with asthma appeared not to be at risk for severe SARS-CoV-2 pneumonia. Moreover, SARS-CoV-2 pneumonia did not induce severe asthma exacerbation.
病毒感染已知可使成人哮喘恶化。以前的研究发现，在严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 肺炎病例中，哮喘患者很少。然而，SARS-CoV-2 感染与严重哮喘恶化之间的关系尚不清楚。
评估因 SARS-CoV-2 肺炎住院的哮喘患者哮喘恶化的频率，并比较 SARS-CoV-2 肺炎伴哮喘和不伴哮喘患者的症状、实验室和影像学表现。
我们纳入了 2020 年 3 月 4 日至 4 月 6 日期间在斯特拉斯堡大学医院胸科住院的 106 名患者；其中 23 名患有哮喘。为评估患者的哮喘状况，定义了 3 个时期：COVID-19 症状发作前的最后 1 个月 (p1)、住院前 (p2) 和住院期间 (p3)。p1 和 p2 期间根据全球哮喘倡议指南定义严重哮喘恶化。在 p3 期间，我们将严重哮喘恶化定义为出现呼吸困难和喘息，需要全身皮质类固醇和吸入β2 激动剂。
我们未发现哮喘患者与非哮喘患者在严重程度（住院时间、所需最大氧气流量、无创通气需求和转入重症监护病房）方面存在显著差异；哮喘患者中 52.2%为全球哮喘倡议第 1 步哮喘。1 名患者在 p1 期间出现严重恶化，2 名患者在 p2 期间出现严重恶化，5 名患者在 p3 期间接受全身皮质类固醇和吸入β2 激动剂治疗。
我们的结果表明，哮喘患者似乎不会因严重 SARS-CoV-2 肺炎而面临风险。此外，SARS-CoV-2 肺炎不会引起严重的哮喘恶化。
