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哮喘是否会增加 COVID-19 患者的死亡率?一项系统评价和荟萃分析。

Does Asthma Increase the Mortality of Patients with COVID-19?: A Systematic Review and Meta-Analysis.

机构信息

Graduate School, Anhui University of Chinese Medicine, Hefei, China.

Department of Respiratory Medicine, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China.

出版信息

Int Arch Allergy Immunol. 2021;182(1):76-82. doi: 10.1159/000510953. Epub 2020 Sep 22.

Abstract

The purpose of this systematic review and meta-analysis was to explore the literature and collate data comparing the mortality of coronavirus disease 2019 (COVID-19) patients with and without asthma. The databases PubMed, Scopus, Embase, Google Scholar, and medRxiv.org were searched for studies comparing the clinical outcomes of asthmatic patients with those of nonasthmatic patients diagnosed with COVID-19. Mortality data were summarized using the Mantel-Haenszel OR with 95% CI in a random-effects model. Five retrospective studies met the inclusion criteria. A meta-analysis of data from 744 asthmatic patients and 8,151 nonasthmatic patients indicated that the presence of asthma had no significant effect on mortality (OR = 0.96; 95% CI 0.70-1.30; I2 = 0%; p = 0.79). Results were stable in a sensitivity analysis. A descriptive analysis of other clinical outcomes indicated no difference in the duration of hospitalization and the risk of intensive care unit (ICU) transfer between asthmatic and nonasthmatic patients. To conclude, preliminary data indicates that asthma as a comorbidity may not increase the mortality of COVID-19. Data on the influence of asthma on the risk of hospitalization, the duration of hospitalization, the requirement of ICU admission, and disease severity is still too limited to draw any strong conclusions. Further studies with a larger sample size are required to establish strong evidence.

摘要

本系统评价和荟萃分析的目的是探索文献并整理比较新冠肺炎(COVID-19)合并哮喘和不合并哮喘患者死亡率的资料。检索了 PubMed、Scopus、Embase、Google Scholar 和 medRxiv.org 数据库,以比较确诊 COVID-19 的哮喘患者与非哮喘患者的临床结局。使用 Mantel-Haenszel OR 汇总死亡率数据,采用随机效应模型进行 95%CI 分析。符合纳入标准的有 5 项回顾性研究。对 744 例哮喘患者和 8151 例非哮喘患者的数据进行荟萃分析表明,哮喘的存在对死亡率无显著影响(OR=0.96;95%CI 0.70-1.30;I2=0%;p=0.79)。敏感性分析结果稳定。对其他临床结局的描述性分析表明,哮喘和非哮喘患者的住院时间和转入重症监护病房(ICU)的风险无差异。总之,初步数据表明哮喘作为一种合并症可能不会增加 COVID-19 的死亡率。关于哮喘对住院风险、住院时间、入住 ICU 需求和疾病严重程度的影响的数据仍然非常有限,无法得出任何有力的结论。需要进一步进行更大样本量的研究,以确立有力的证据。

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本文引用的文献

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Factors associated with COVID-19-related death using OpenSAFELY.使用 OpenSAFELY 分析与 COVID-19 相关死亡的因素。
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J Allergy Clin Immunol Pract. 2020 Sep;8(8):2600-2607. doi: 10.1016/j.jaip.2020.06.032. Epub 2020 Jun 27.
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The Impact of Asthma on Mortality in Patients With COVID-19.哮喘对COVID-19患者死亡率的影响。
Chest. 2020 Dec;158(6):2290-2291. doi: 10.1016/j.chest.2020.05.575. Epub 2020 Jun 6.
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Association of asthma and its genetic predisposition with the risk of severe COVID-19.哮喘及其遗传易感性与重症 COVID-19 风险的关联。
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Int Arch Allergy Immunol. 2020;181(9):680-688. doi: 10.1159/000509057. Epub 2020 Jun 9.
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Asthma prolongs intubation in COVID-19.哮喘会延长新冠病毒感染疾病(COVID-19)患者的插管时间。
J Allergy Clin Immunol Pract. 2020 Jul-Aug;8(7):2388-2391. doi: 10.1016/j.jaip.2020.05.006. Epub 2020 May 14.

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