From the Division of Allergic Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
Allergy Asthma Proc. 2021 Jul 1;42(4):267-273. doi: 10.2500/aap.2021.42.210041.
It remains unclear if asthma is a risk factor associated with worse outcomes among patients with coronavirus disease 2019 (COVID-19). We performed a comprehensive database search for studies published from January 1, 2019, to October 2, 2020. We included studies that evaluated outcomes among patients with COVID-19 and underlying asthma. Outcomes of interest included the need for hospitalization, length of hospitalization, intensive care unit (ICU) admission, and death. The meta-analysis was conducted by using random-effects methodology. A total of 389 studies were identified through data base searches. After abstract and full-text screening, 16 observational studies with 92,275 patients were included in the analysis. Of the 16 studies, 15 were retrospective and 1 was a prospective cohort study. The average age was 39.6 years, with 48% female patients. Six of the studies included pediatric patients, and one of these studies only evaluated pediatric patients. One study only evaluated pregnant patients. Among patients with COVID-19, the presence of asthma was not associated with any significant increase in risk of hospitalization (odds ratio [OR] 1.46 [95% confidence interval {CI}, 0.29-7.28]), length of hospitalization (1.59 days [-0.55 to 3.74]), ICU admission (OR 1.65 [95% CI, 0.56-4.17]), or death (OR 0.73 [95% CI, 0.38-1.40]). The overall risk of bias of the included studies was high. Among the patients with COVID-19, asthma did not seem to significantly increase the risk of hospitalization, length of hospitalization, ICU admission, or death.
对于患有 2019 冠状病毒病（COVID-19）的患者，哮喘是否为预后不良的危险因素尚不清楚。我们对 2019 年 1 月 1 日至 2020 年 10 月 2 日期间发表的研究进行了全面的数据库检索。我们纳入了评估 COVID-19 合并基础哮喘患者结局的研究。我们关注的结局包括住院需求、住院时间、重症监护病房（intensive care unit，ICU）入住和死亡。Meta 分析采用随机效应模型进行。通过数据库检索共确定 389 项研究。经过摘要和全文筛选，纳入了 16 项观察性研究，共 92275 例患者。在这 16 项研究中，15 项为回顾性研究，1 项为前瞻性队列研究。平均年龄为 39.6 岁，女性患者占 48%。6 项研究纳入了儿科患者，其中 1 项仅评估儿科患者。1 项研究仅评估了孕妇。在 COVID-19 患者中，哮喘的存在与住院风险增加无显著相关性（比值比[odds ratio，OR]1.46[95%置信区间{confidence interval，CI}，0.29-7.28]）、住院时间（1.59 天[-0.55 到 3.74]）、入住 ICU（OR 1.65[95%CI，0.56-4.17]）或死亡（OR 0.73[95%CI，0.38-1.40]）无关。纳入研究的总体偏倚风险较高。在 COVID-19 患者中，哮喘似乎并未显著增加住院、住院时间、入住 ICU 或死亡的风险。
