Medical Student, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo (SP), Brazil.
MD, PhD. Full Professor of Internal Medicine, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo (SP), Brazil; and Clinical Chief, Irmandade da Santa Casa de Misericórdia de São Paulo (ISCMSP), São Paulo (SP) Brazil.
Sao Paulo Med J. 2022 Sep-Oct;140(5):651-657. doi: 10.1590/1516-3180.2021.0403.R2.15122021.
The frequency of coronavirus disease 2019 (COVID-19) cases among asthmatics has been reported to be reduced. However, the findings regarding the association between asthma and the risk of severe COVID-19 have been divergent.
To investigate whether asthma is associated with a reduced risk of development of severe COVID-19.
Retrospective analysis on COVID-19 surveillance databases at two tertiary-level hospitals in São Paulo, Brazil.
The medical records of patients hospitalized due to COVID-19 between March and August 2020 were reviewed in accordance with the clinical, laboratorial, radiological and epidemiological criteria for COVID-19, and for comorbidities.
Among the adult patients included (> 18 years of age) there were 52 asthmatics and 1,318 non-asthmatics. Their median ages and interquartile ranges (IQR) were, respectively, 54 (41-69) and 60 (44-72) years. At least one comorbidity was seen in 73% of asthmatics and 56% of the non-asthmatics. Among the asthmatics, most presented mild asthma (92%) and the prevalence of chronic obstructive pulmonary disease (COPD) was high (27%). The asthmatics presented an unadjusted odds ratio (OR) for severe COVID-19 of 0.89 (95% confidence interval, CI 0.5-1.56); and OR 0.88 (95% CI 0.5 -1.68) after multivariable adjustment. Age > 60 years, male sex, hypertension, diabetes, cancer and homelessness were covariates associated with increased odds for severe COVID-19. Kaplan-Meier estimated survival over hospitalization of up to 30 days did not differ between the groups (log-rank P = 0.09).
The association between asthma and decreased risk of severe COVID-19 or increased survival was statistically non-significant.
据报道，患有哮喘的 2019 年冠状病毒病（COVID-19）病例频率降低。然而，关于哮喘与 COVID-19 严重程度风险之间的关联的研究结果存在分歧。
研究哮喘是否与 COVID-19 严重程度的发展风险降低相关。
对巴西圣保罗两家三级医院的 COVID-19 监测数据库进行回顾性分析。
根据 COVID-19 的临床、实验室、放射学和流行病学标准以及合并症，对因 COVID-19 住院的患者的病历进行了回顾。
在纳入的成年患者（>18 岁）中，有 52 例哮喘患者和 1318 例非哮喘患者。他们的中位年龄和四分位间距（IQR）分别为 54（41-69）和 60（44-72）岁。哮喘患者中有 73%至少有一种合并症，而非哮喘患者中有 56%。在哮喘患者中，大多数为轻度哮喘（92%），慢性阻塞性肺疾病（COPD）的患病率较高（27%）。哮喘患者 COVID-19 重症的未调整比值比（OR）为 0.89（95%置信区间，0.5-1.56）；多变量调整后为 0.88（95%置信区间，0.5-1.68）。年龄>60 岁、男性、高血压、糖尿病、癌症和无家可归是与 COVID-19 重症风险增加相关的协变量。在住院治疗 30 天内的生存估计Kaplan-Meier曲线没有显示两组之间存在差异（对数秩 P=0.09）。
哮喘与 COVID-19 重症风险降低或生存时间延长之间的关联在统计学上无显著性。
