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严重哮喘患者接受生物制剂治疗后感染 SARS-CoV-2。

SARS-Cov-2 Infection in Severe Asthma Patients Treated With Biologics.

机构信息

2nd Respiratory Medicine Department, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Pulmonary Department, General Hospital G. Papanikolaou, Aristotle University of Thessaloniki, Thessaloniki, Greece.

出版信息

J Allergy Clin Immunol Pract. 2022 Oct;10(10):2588-2595. doi: 10.1016/j.jaip.2022.05.041. Epub 2022 Jun 23.

Abstract

BACKGROUND

At the beginning of the pandemic, there have been considerable concerns regarding coronavirus disease 2019 (COVID-19) severity and outcomes in patients with severe asthma treated with biologics.

OBJECTIVE

To prospectively observe a cohort of severe asthmatics treated with biologics for the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and disease severity during the COVID-19 pandemic.

METHODS

Physicians from centers treating patients with severe asthma all over Greece provided demographic and medical data regarding their patients treated with biologics. Physicians were also asked to follow up patients during the pandemic and to perform a polymerase chain reaction test in case of a suspected SARS-Cov-2 infection.

RESULTS

Among the 591 severe asthmatics (63.5% female) included in the study, 219 (37.1%) were treated with omalizumab, 358 (60.6%) with mepolizumab, and 14 (2.4%) with benralizumab. In total, 26 patients (4.4%) had a confirmed SARS-CoV-2 infection, 9 (34.6%) of whom were admitted to the hospital because of severe COVID-19, and 1 required mechanical ventilation and died 19 days after admission. Of the 26 infected patients, 5 (19.2%) experienced asthma control deterioration, characterized as exacerbation that required treatment with systemic corticosteroids. The scheduled administration of the biological therapy was performed timely in all patients with the exception of 2, in whom it was postponed for 1 week according to their doctors' suggestion.

CONCLUSION

Our study confirms that despite the initial concerns, SARS-CoV-2 infection is not more common in asthmatics treated with biologics compared with the general population, whereas the use of biologic treatments for severe asthma during the COVID-19 pandemic does not seem to be related to adverse outcomes from severe COVID-19.

摘要

背景

在大流行开始时,人们对接受生物制剂治疗的重度哮喘患者感染 2019 年冠状病毒病(COVID-19)的严重程度和结局存在相当大的担忧。

目的

前瞻性观察接受生物制剂治疗的重度哮喘患者队列,观察他们在 COVID-19 大流行期间感染严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)和疾病严重程度的风险。

方法

来自希腊各地治疗重度哮喘患者的中心的医生提供了有关接受生物制剂治疗的患者的人口统计学和医疗数据。医生还被要求在大流行期间对患者进行随访,并在疑似 SARS-CoV-2 感染的情况下进行聚合酶链反应(PCR)检测。

结果

在纳入研究的 591 例重度哮喘患者(63.5%为女性)中,219 例(37.1%)接受奥马珠单抗治疗,358 例(60.6%)接受美泊利珠单抗治疗,14 例(2.4%)接受贝那利珠单抗治疗。共有 26 例患者(4.4%)被确诊为 SARS-CoV-2 感染,其中 9 例(34.6%)因严重 COVID-19 住院,1 例需要机械通气,入院后 19 天死亡。在 26 例感染患者中,5 例(19.2%)出现哮喘控制恶化,表现为需要全身皮质类固醇治疗的加重。除 2 例外,所有患者都及时进行了生物治疗的计划治疗,根据医生的建议,这 2 例患者将治疗推迟了 1 周。

结论

我们的研究证实,尽管存在最初的担忧,但与普通人群相比,接受生物制剂治疗的哮喘患者感染 SARS-CoV-2 的情况并不更为常见,而在 COVID-19 大流行期间对重度哮喘使用生物制剂治疗似乎与严重 COVID-19 的不良结局无关。

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