Department of Medicine, Mount Sinai Morningside & Mount Sinai West Hospitals, Icahn School of Medicine at Mount Sinai, New York, New York.
Department of Pulmonary & Critical Care, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, New York.
Ann Allergy Asthma Immunol. 2021 Jul;127(1):42-48. doi: 10.1016/j.anai.2021.02.021. Epub 2021 Feb 27.
The impact of asthma diagnosis and asthma endotype on outcomes from coronavirus disease 2019 (COVID-19) infection remains unclear.
To describe the association between asthma diagnosis and endotype and clinical outcomes among patients diagnosed as having COVID-19 infection.
Retrospective multicenter cohort study of outpatients and inpatients presenting to 6 hospitals in the Mount Sinai Health System New York metropolitan region between March 7, 2020, and June 7, 2020, with COVID-19 infection, with and without a history of asthma. The primary outcome evaluated was in-hospital mortality. Secondary outcomes included hospitalization, intensive care unit admission, mechanical ventilation, and hospital length of stay. The outcomes were compared in patients with or without asthma using a multivariate Cox regression model. The outcomes stratified by blood eosinophilia count were also evaluated.
Of 10,523 patients diagnosed as having COVID-19 infection, 4902 were hospitalized and 468 had a diagnosis of asthma (4.4%). When adjusted for COVID-19 disease severity, comorbidities, and concurrent therapies, patients with asthma had a lower mortality (adjusted odds ratio [OR], 0.64 (0.53-0.77); P < .001) and a lower rate of hospitalization and intensive care unit admission (OR, 0.43 (0.28-0.64); P < .001 and OR, 0.51 (0.41-0.64); P < .001, respectively). Those with blood eosinophils greater than or equal to 200 cells/μL, both with and without asthma, had lower mortality.
Patients with asthma may be at a reduced risk of poor outcomes from COVID-19 infection. Eosinophilia, both in those with and without asthma, may be associated with reduced mortality risk.
哮喘诊断和哮喘表型对 2019 年冠状病毒病（COVID-19）感染结局的影响尚不清楚。
描述 COVID-19 感染患者中哮喘诊断和表型与临床结局之间的关系。
这是一项回顾性多中心队列研究，纳入了 2020 年 3 月 7 日至 6 月 7 日期间在纽约市西奈山卫生系统的 6 家医院就诊的门诊和住院 COVID-19 感染患者，其中包括有和无哮喘病史的患者。主要结局评估指标为住院死亡率。次要结局包括住院、入住重症监护病房、机械通气和住院时间。采用多变量 Cox 回归模型比较有和无哮喘患者的结局。还评估了按血嗜酸性粒细胞计数分层的结局。
在诊断为 COVID-19 感染的 10523 例患者中，有 4902 例住院，468 例诊断为哮喘（4.4%）。在调整 COVID-19 疾病严重程度、合并症和同时进行的治疗后，哮喘患者的死亡率较低（调整后的优势比[OR]，0.64（0.53-0.77）；P<0.001），住院率和入住重症监护病房率也较低（OR，0.43（0.28-0.64）；P<0.001 和 OR，0.51（0.41-0.64）；P<0.001，分别）。血嗜酸性粒细胞大于或等于 200 个细胞/μL 的患者，无论是否有哮喘，死亡率均较低。
哮喘患者 COVID-19 感染结局可能风险降低。嗜酸性粒细胞增多，无论是否有哮喘，都可能与降低死亡风险相关。
