Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Respir Care. 2021 Dec;66(12):1912-1923. doi: 10.4187/respcare.09113. Epub 2021 Sep 28.
We conducted this systematic review to evaluate whether asthma increases the risk of severe disease and adverse outcomes among subjects with COVID-19.
We queried the PubMed and Embase databases for studies indexed through December 2020. We included studies providing data on severe disease, hospitalization, ICU care, need for mechanical ventilation, or mortality among subjects with COVID-19 with and without asthma. We calculated the relative risk for each reported outcome of interest and used random effects modeling to summarize the data.
We retrieved 1,832 citations, and included 90 studies, in our review. Most publications reported data retrieved from electronic records of retrospective subject cohorts. Only 25 studies were judged to be of high quality. Subjects with asthma and COVID-19 had a marginally higher risk of hospitalization (summary relative risk 1.13, 95% CI 1.03-1.24) but not for severe disease (summary relative risk 1.17, 95% CI 0.62-2.20), ICU admission (summary relative risk 1.13, 95% CI 0.96-1.32), mechanical ventilation (summary relative risk 1.05, 95% CI 0.85-1.29), or mortality (summary relative risk 0.92, 95% CI 0.82-1.04) as compared to subjects with COVID-19 without asthma.
Comorbid asthma increases risk of COVID-19-related hospitalization but not severe disease or other adverse outcomes in subjects with COVID-19.
我们进行了这项系统评价，以评估哮喘是否会增加 COVID-19 患者发生严重疾病和不良结局的风险。
我们在 PubMed 和 Embase 数据库中检索了截至 2020 年 12 月的研究。我们纳入了提供 COVID-19 患者合并和不合并哮喘的严重疾病、住院、重症监护病房（ICU）治疗、需要机械通气或死亡率数据的研究。我们计算了每个报告的感兴趣结局的相对风险，并使用随机效应模型汇总数据。
我们检索到 1832 条引用，纳入了本综述中的 90 项研究。大多数出版物报告的数据来自回顾性队列患者电子记录的检索结果。只有 25 项研究被认为是高质量的。患有哮喘和 COVID-19 的患者住院的风险略高（汇总相对风险 1.13，95%置信区间 1.03-1.24），但严重疾病（汇总相对风险 1.17，95%置信区间 0.62-2.20）、入住 ICU（汇总相对风险 1.13，95%置信区间 0.96-1.32）、机械通气（汇总相对风险 1.05，95%置信区间 0.85-1.29）或死亡率（汇总相对风险 0.92，95%置信区间 0.82-1.04）的风险并不高于没有哮喘的 COVID-19 患者。
合并哮喘会增加 COVID-19 患者 COVID-19 相关住院的风险，但不会增加严重疾病或其他不良结局的风险。
