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哮喘和 COPD 患者因吸入皮质类固醇而降低 COVID-19 住院风险?

Reduced risk of COVID-19 hospitalization in asthmatic and COPD patients: a benefit of inhaled corticosteroids?

机构信息

Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy.

Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.

出版信息

Expert Rev Respir Med. 2021 Apr;15(4):561-568. doi: 10.1080/17476348.2021.1850275. Epub 2020 Dec 3.

Abstract

: The comorbidities and clinical signs of coronavirus disease 2019 (COVID-19) patients have been reported mainly as descriptive statistics, rather than quantitative analysis even in very large investigations. The aim of this study was to identify specific patients' characteristics that may modulate COVID-19 hospitalization risk.: A pooled analysis was performed on high-quality epidemiological studies to quantify the prevalence (%) of comorbidities and clinical signs in hospitalized COVID-19 patients. Pooled data were used to calculate the relative risk (RR) of specific comorbidities by matching the frequency of comorbidities in hospitalized COVID-19 patients with those of general population.: The most frequent comorbidities were hypertension, diabetes mellitus, and cardiovascular and/or cerebrovascular diseases. The RR of COVID-19 hospitalization was significantly (P < 0.05) reduced in patients with asthma (0.86, 0.77-0.97) or chronic obstructive pulmonary disease (COPD) (0.46, 0.40-0.52). The most frequent clinical signs were fever and cough.: The clinical signs of hospitalized COVID-19 patients are similar to those of other infective diseases. Patients with asthma or COPD were at lower hospitalization risk. This paradoxical evidence could be related with the protective effect of inhaled corticosteroids that are administered worldwide to most asthmatic and COPD patients.

摘要

: 新冠肺炎(COVID-19)患者的合并症和临床症状主要以描述性统计数据报告,即使在非常大的调查中也是如此,而不是定量分析。本研究的目的是确定可能调节 COVID-19 住院风险的特定患者特征。: 对高质量的流行病学研究进行了汇总分析,以量化住院 COVID-19 患者合并症的患病率(%)和临床症状。通过将住院 COVID-19 患者的合并症频率与一般人群的频率进行匹配,汇总数据用于计算特定合并症的相对风险(RR)。: 最常见的合并症是高血压、糖尿病和心血管及/或脑血管疾病。哮喘(0.86,0.77-0.97)或慢性阻塞性肺疾病(COPD)(0.46,0.40-0.52)患者 COVID-19 住院的 RR 显著降低(P < 0.05)。最常见的临床症状是发热和咳嗽。: 住院 COVID-19 患者的临床症状与其他传染病相似。哮喘或 COPD 患者的住院风险较低。这种矛盾的证据可能与吸入性皮质类固醇的保护作用有关,全世界大多数哮喘和 COPD 患者都在使用吸入性皮质类固醇。

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