过敏性鼻炎和哮喘对 COVID-19 感染、住院和死亡的影响。
Impact of Allergic Rhinitis and Asthma on COVID-19 Infection, Hospitalization, and Mortality.
机构信息
Department of Oto-Rhino-Laryngology, West China Hospital, Sichuan University, Chengdu, China; West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China; Department of Biostatistics, Princess Margaret Cancer Centre and Dalla Lana School of Public Health, Toronto, ON, Canada; Department of Oto-Rhino-Laryngology, Langzhong People's Hospital, Langzhong, China.
Department of Oto-Rhino-Laryngology, West China Hospital, Sichuan University, Chengdu, China.
出版信息
J Allergy Clin Immunol Pract. 2022 Jan;10(1):124-133. doi: 10.1016/j.jaip.2021.10.049. Epub 2021 Oct 30.
BACKGROUND
It remains unclear if patients with allergic rhinitis (AR) and/or asthma are susceptible to corona virus disease 2019 (COVID-19) infection, severity, and mortality.
OBJECTIVE
To investigate the role of AR and/or asthma in COVID-19 infection, severity, and mortality, and assess whether long-term AR and/or asthma medications affected the outcomes of COVID-19.
METHODS
Demographic and clinical data of 70,557 adult participants completed SARS-CoV-2 testing between March 16 and December 31, 2020, in the UK Biobank were analyzed. The rates of COVID-19 infection, hospitalization, and mortality in relation to pre-existing AR and/or asthma were assessed based on adjusted generalized linear models. We further analyzed the impact of long-term AR and/or asthma medications on the risk of COVID-19 hospitalization and mortality.
RESULTS
Patients with AR of all ages had lower positive rates of SARS-CoV-2 tests (relative risk [RR]: 0.75, 95% confidence interval [CI]: 0.69-0.81, P < .001), with lower susceptibility in males (RR: 0.74, 95% CI: 0.65-0.85, P < .001) than females (RR: 0.8, 95% CI: 0.72-0.9, P < .001). However, similar effects of asthma against COVID-19 hospitalization were only major in participants aged <65 (RR: 0.93, 95% CI: 0.86-1, P = .044) instead of elderlies. In contrast, patients with asthma tested positively had higher risk of hospitalization (RR: 1.42, 95% CI: 1.32-1.54, P < .001). Neither AR nor asthma had an impact on COVID-19 mortality. None of conventional medications for AR or asthma, for example, antihistamines, corticosteroids, or β2 adrenoceptor agonists, showed association with COVID-19 infection or severity.
CONCLUSION
AR (all ages) and asthma (aged <65) act as protective factors against COVID-19 infection, whereas asthma increases risk for COVID-19 hospitalization. None of the long-term medications had a significant association with infection, severity, and mortality of COVID-19 among patients with AR and/or asthma.
背景
目前尚不清楚过敏性鼻炎（AR）和/或哮喘患者是否易感染 2019 年冠状病毒病（COVID-19）、病情严重程度和死亡率。
目的
研究 AR 和/或哮喘在 COVID-19 感染、严重程度和死亡率中的作用，并评估长期 AR 和/或哮喘药物是否影响 COVID-19 的结局。
方法
分析 2020 年 3 月 16 日至 12 月 31 日期间在英国生物银行完成 SARS-CoV-2 检测的 70557 名成年参与者的人口统计学和临床数据。根据调整后的广义线性模型评估与预先存在的 AR 和/或哮喘相关的 COVID-19 感染、住院和死亡率。我们进一步分析了长期 AR 和/或哮喘药物对 COVID-19 住院和死亡率风险的影响。
结果
所有年龄段的 AR 患者 SARS-CoV-2 检测阳性率较低（相对风险 [RR]：0.75，95%置信区间 [CI]：0.69-0.81，P<.001），男性（RR：0.74，95%CI：0.65-0.85，P<.001）比女性（RR：0.8，95%CI：0.72-0.9，P<.001）的易感性较低。然而，哮喘对 COVID-19 住院的保护作用仅在年龄<65 岁的参与者中较为显著（RR：0.93，95%CI：0.86-1，P=.044），而在老年人中则不显著。相反，哮喘阳性患者住院风险较高（RR：1.42，95%CI：1.32-1.54，P<.001）。AR 或哮喘均未对 COVID-19 死亡率产生影响。AR 或哮喘的常规药物，例如抗组胺药、皮质类固醇或β2 肾上腺素受体激动剂，均与 COVID-19 感染或严重程度无关。
结论
AR（所有年龄）和哮喘（<65 岁）是 COVID-19 感染的保护因素，而哮喘则增加 COVID-19 住院的风险。在 AR 和/或哮喘患者中，长期药物治疗与 COVID-19 的感染、严重程度和死亡率均无显著关联。
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