Department of Medicine, University of Verona, Verona, Italy.
Immunoallergology Unit, Careggi University Hospital, Florence, Italy.
Respir Med. 2021 Jan;176:106261. doi: 10.1016/j.rmed.2020.106261. Epub 2020 Nov 26.
Asthma prevalence among COVID-19 patients seems to be surprisingly low. However the clinical profile of COVID-19 asthmatic patients and potential determinants of higher susceptibility/worse outcome have been scarcely investigated. We aimed to describe the prevalence and features of asthmatic patients hospitalized for COVID-19 and to explore the association between their clinical asthma profile and COVID-19 severity.
Medical records of patients admitted to COVID-Units of six Italian cities major hospitals were reviewed. Demographic and clinical data were analyzed and compared according to the COVID-19 outcome (death/need for ventilation vs discharge at home without requiring invasive procedures).
Within the COVID-Units population (n = 2000) asthma prevalence was 2.1%. Among the asthmatics the mean age was 61.1 years and 60% were females. Around half of patients were atopic, blood eosinophilia was normal in most of patients. An asthma exacerbation in the 6 months before the Covid-Unit admittance was reported by 18% of patients. 24% suffered from GINA step 4-5 asthma, and 5% were under biologic treatment. 31% of patients were not on regular treatment and a negligible use of oral steroid was recorded. Within the worse outcome group, a prevalence of males was detected (64 vs 29%, p = 0.026); they suffered from more severe asthma (43 vs 14%, p = 0.040) and were more frequently current or former smokers (62 vs 25%, p = 0.038).
Our report, the first including a large COVID-19 hospitalized Italian population, confirms the low prevalence of asthma. On the other side patients with GINA 4/5 asthma, and those not adequately treated, should be considered at higher risk.
COVID-19 患者中的哮喘患病率似乎出人意料地低。然而，COVID-19 哮喘患者的临床特征和更高易感性/更差结局的潜在决定因素尚未得到充分研究。我们旨在描述因 COVID-19 住院的哮喘患者的患病率和特征，并探讨其临床哮喘特征与 COVID-19 严重程度之间的关系。
回顾了意大利六个主要城市 COVID 病房的患者病历。根据 COVID-19 结局（死亡/需要通气与在家中出院而无需侵入性程序）分析和比较了人口统计学和临床数据。
在 COVID 病房人群（n=2000）中，哮喘患病率为 2.1%。在哮喘患者中，平均年龄为 61.1 岁，女性占 60%。大约一半的患者是特应性的，大多数患者的血液嗜酸性粒细胞正常。18%的患者在入住 COVID 病房前 6 个月有哮喘加重。24%的患者患有 GINA 步骤 4-5 哮喘，5%的患者接受生物治疗。31%的患者未接受常规治疗，仅记录到口服类固醇的轻微使用。在结局较差的患者中，检测到男性的患病率更高（64%比 29%，p=0.026）；他们患有更严重的哮喘（43%比 14%，p=0.040），并且更频繁地是当前或曾经的吸烟者（62%比 25%，p=0.038）。
我们的报告是首次纳入了大量意大利 COVID-19 住院患者，证实了哮喘的低患病率。另一方面，GINA 4/5 哮喘和治疗不充分的患者应被视为更高风险。
