Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.
J Asthma. 2022 Mar;59(3):442-450. doi: 10.1080/02770903.2020.1857396. Epub 2021 Mar 2.
The evidence pertaining to the effects of asthma on Coronavirus disease 2019 outcomes has been unclear. To improve our understanding of the clinically important association of asthma and Coronavirus disease 2019.
A matched cohort study was performed using data from the Mass General Brigham Health Care System (Boston, MA). Adult (age ≥18 years) patients with confirmed Coronavirus disease 2019 and without chronic obstructive pulmonary disease, cystic fibrosis, or interstitial lung disease between March 4, 2020 and July 2, 2020 were analyzed. Up to five non-asthma comparators were matched to each asthma patient based on age (within 5 years), sex, and date of positive test (within 7 days). The primary outcomes were hospitalization, mechanical ventilation, and death, using multivariable Cox-proportional hazards models accounting for competing risk of death, when appropriate. Patients were followed for these outcomes from diagnosis of Coronavirus disease 2019 until July 2, 2020.
Among 562 asthma patients, 199 (21%) were hospitalized, 15 (3%) received mechanical ventilation, and 7 (1%) died. Among the 2686 matched comparators, 487 (18%) were hospitalized, 107 (4%) received mechanical ventilation, and 69 (3%) died. The adjusted Hazard Ratios among asthma patients were 0.99 (95% Confidence Internal 0.80, 1.22) for hospitalization, 0.69 (95% Confidence Internal 0.36, 1.29) for mechanical ventilation, and 0.30 (95% Confidence Internal 0.11, 0.80) for death.
In this matched cohort study from a large Boston-based healthcare system, asthma was associated with comparable risk of hospitalization and mechanical ventilation but a lower risk of mortality.
哮喘对 2019 年冠状病毒病（Coronavirus disease 2019，COVID-19）结局的影响证据尚不明确。为了更好地了解哮喘与 2019 年冠状病毒病之间的重要临床关联。
使用马萨诸塞州总医院布赖根妇女医院（波士顿）的医疗保健系统的数据进行了匹配队列研究。分析了 2020 年 3 月 4 日至 2020 年 7 月 2 日期间患有确诊 COVID-19 且无慢性阻塞性肺疾病、囊性纤维化或间质性肺病的成年（年龄≥18 岁）患者。根据年龄（5 年内）、性别和阳性检测日期（7 天内），为每位哮喘患者匹配了多达 5 名非哮喘对照者。主要结局是住院、机械通气和死亡，使用多变量 Cox 比例风险模型，在适当情况下考虑死亡的竞争风险。从 COVID-19 诊断到 2020 年 7 月 2 日，对患者进行了这些结局的随访。
在 562 名哮喘患者中，有 199 名（21%）住院，15 名（3%）接受机械通气，7 名（1%）死亡。在 2686 名匹配的对照者中，有 487 名（18%）住院，107 名（4%）接受机械通气，69 名（3%）死亡。哮喘患者的调整后的危险比为：住院（0.99；95%置信区间，0.801.22）、机械通气（0.69；95%置信区间，0.361.29）和死亡（0.30；95%置信区间，0.11~0.80）。
在这项来自大型波士顿医疗保健系统的匹配队列研究中，哮喘与住院和机械通气的风险相当，但死亡率较低。
