Lira Tenório Martha Débora, Dos Santos Menezes Siqueira Gabriel Valentim, Costa Caldas Gustavo, Pacheco de Almeida Roque, Ribeiro de Jesus Amélia, Martins-Filho Paulo Ricardo
Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, SE, Brazil.
Investigative Pathology Laboratory, Federal University of Sergipe, Aracaju, SE, Brazil.
Eur Arch Otorhinolaryngol. 2024 Dec;281(12):6677-6686. doi: 10.1007/s00405-024-08893-6. Epub 2024 Aug 24.
The COVID-19 pandemic has resulted in significant global morbidity and mortality. The disease presents a broad clinical spectrum, significantly influenced by underlying comorbidities. While certain conditions are known to exacerbate COVID-19 outcomes, the role of chronic inflammatory airway diseases such as asthma and rhinitis in influencing disease severity remains controversial. This study investigates the association between asthma and allergic rhinitis and the severity of COVID-19 outcomes in a specific geographical region prior to widespread vaccine deployment.
We conducted a case-control study with unvaccinated adult patients who had laboratory-confirmed COVID-19 by polymerase chain reaction (PCR). Cases were defined as severe or critical COVID-19 patients requiring intensive care unit (ICU) admission, and controls were non-severe patients without signs of viral pneumonia or hypoxia. We utilized the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire to assess the presence of asthma and allergic rhinitis. The association between these chronic inflammatory airway diseases and the severity of COVID-19 was evaluated using multivariate logistic regression analysis.
A total of 122 patients were analyzed, with 61 in each group. The presence of asthma (9 patients) was associated with an increased likelihood of severe COVID-19 (OR = 13.0; 95% CI 1.27-133.74), while rhinitis (39 patients) was associated with a protective effect against severe outcomes (OR = 0.36; 95% CI 0.13-0.99). No significant association was found between the frequency of asthmatic episodes or the severity of rhinitis and the severity of COVID-19 outcomes.
This study underscores the divergent effects of chronic inflammatory airway diseases on COVID-19 severity, with asthma associated with a higher likelihood of severe outcomes and rhinitis potentially offering protective effects. These findings enhance our understanding of the complex interactions between respiratory allergies and COVID-19, emphasizing the importance of targeted clinical management and public health strategies.
新冠疫情已导致全球出现大量发病和死亡病例。该疾病临床表现多样，受基础合并症影响显著。虽然某些疾病已知会加重新冠疫情的后果，但哮喘和鼻炎等慢性炎症性气道疾病在影响疾病严重程度方面的作用仍存在争议。本研究调查了在广泛接种疫苗之前，特定地理区域内哮喘和过敏性鼻炎与新冠疫情严重程度之间的关联。
我们对未接种疫苗、经聚合酶链反应（PCR）实验室确诊为新冠的成年患者进行了病例对照研究。病例定义为需要入住重症监护病房（ICU）的重症或危重症新冠患者，对照组为无病毒性肺炎或缺氧迹象的非重症患者。我们使用儿童哮喘和过敏国际研究（ISAAC）问卷来评估哮喘和过敏性鼻炎的存在情况。使用多因素逻辑回归分析评估这些慢性炎症性气道疾病与新冠严重程度之间的关联。
共分析了122例患者，每组61例。哮喘患者（9例）出现重症新冠的可能性增加（OR = 13.0；95% CI 1.27 - 133.74），而鼻炎患者（39例）对重症结局具有保护作用（OR = 0.36；95% CI 0.13 - 0.99）。未发现哮喘发作频率或鼻炎严重程度与新冠结局严重程度之间存在显著关联。
本研究强调了慢性炎症性气道疾病对新冠严重程度的不同影响，哮喘与重症结局的可能性较高相关，而鼻炎可能具有保护作用。这些发现增进了我们对呼吸道过敏与新冠之间复杂相互作用的理解，强调了针对性临床管理和公共卫生策略的重要性。
