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Prevalence and characterization of asthma in hospitalized and nonhospitalized patients with COVID-19

      Background

      The Centers for Disease Control and Prevention advises that patients with moderate to severe asthma belong to a high-risk group that is susceptible to severe coronavirus disease 2019 (COVID-19). However, the association between asthma and COVID-19 has not been well-established.

      Objective

      The primary objective was to determine the prevalence of asthma among patients with COVID-19 in a major US health system. We assessed the clinical characteristics and comorbidities in asthmatic and nonasthmatic patients with COVID-19. We also determined the risk of hospitalization associated with asthma and/or inhaled corticosteroid use.

      Methods

      Medical records of patients with COVID-19 were searched by a computer algorithm (March 1 to April 15, 2020), and chart review was used to validate the diagnosis of asthma and medications prescribed for asthma. All patients had PCR-confirmed COVID-19. Demographic and clinical features were characterized. Regression models were used to assess the associations between asthma and corticosteroid use and the risk of COVID-19–related hospitalization.

      Results

      Of 1526 patients identified with COVID-19, 220 (14%) were classified as having asthma. Asthma was not associated with an increased risk of hospitalization (relative risk, 0.96; 95% CI, 0.77-1.19) after adjusting for age, sex, and comorbidities. The ongoing use of inhaled corticosteroids did not increase the risk of hospitalization in a similar adjusted model (relative risk, 1.39; 95% CI, 0.90-2.15).

      Conclusions

      Despite a substantial prevalence of asthma in our COVID-19 cohort, asthma was not associated with an increased risk of hospitalization. Similarly, the use of inhaled corticosteroids with or without systemic corticosteroids was not associated with COVID-19–related hospitalization.

      Key words

      Abbreviations used:

      BMI (Body mass index), CAD (Coronary artery disease), CDC (Centers for Disease Control and Prevention), COPD (Chronic obstructive pulmonary disease), COVID-19 (Coronavirus disease 2019), DM (Diabetes mellitus), HTN (Hypertension), ICD-10 (International Classification of Diseases, Tenth Revision), ICS (Inhaled corticosteroid), ICU (Intensive care unit), LABA (Long-acting β-agonist), OSA (Obstructive sleep apnea), RR (Relative risk), SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2)
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