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. 2021 Apr 1;203(7):893-905.
doi: 10.1164/rccm.202008-3266OC.

Asthma in Adult Patients with COVID-19. Prevalence and Risk of Severe Disease

Paul D Terry  1 , R Eric Heidel  2 , Rajiv Dhand  3
Affiliations

Asthma in Adult Patients with COVID-19. Prevalence and Risk of Severe Disease

Paul D Terry et al. Am J Respir Crit Care Med. .

Abstract

Rationale: Health outcomes of people with coronavirus disease (COVID-19) range from no symptoms to severe illness and death. Asthma, a common chronic lung disease, has been considered likely to increase the severity of COVID-19, although data addressing this hypothesis have been scarce until very recently.Objectives: To review the epidemiologic literature related to asthma's potential role in COVID-19 severity.Methods: Studies were identified through the PubMed (MEDLINE) and medRxiv (preprint) databases using the search terms "asthma," "SARS-CoV-2" (severe acute respiratory syndrome coronavirus 2), and "COVID-19," and by cross-referencing citations in identified studies that were available in print or online before December 22, 2020.Measurements and Main Results: Asthma prevalence data were obtained from studies of people with COVID-19 and regional health statistics. We identified 150 studies worldwide that allowed us to compare the prevalence of asthma in patients with COVID-19 by region, disease severity, and mortality. The results of our analyses do not provide clear evidence of increased risk of COVID-19 diagnosis, hospitalization, severity, or mortality due to asthma.Conclusions: These findings could provide some reassurance to people with asthma regarding its potential to increase their risk of severe morbidity from COVID-19.

Keywords: COVID-19; SARS-CoV-2; asthma; disease severity; mortality.

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Figures

Figure 1.
Figure 1.
Literature acquisition flow diagram. COPD = chronic obstructive pulmonary disease; COVID-19 = coronavirus disease.
Figure 2.
Figure 2.
Prevalence ratios of asthma in hospitalized versus not hospitalized patients with COVID-19; pooled prevalence ratio = 1.06 (95% confidence interval, 0.94–1.19; P = 0.37). COVID-19 = coronavirus disease.
Figure 3.
Figure 3.
Prevalence ratios of asthma in “severe” versus “not severe” patients hospitalized with COVID-19; pooled prevalence ratio = 1.18 (95% confidence interval, 0.98–1.42; P = 0.07). COVID-19 = coronavirus disease.
Figure 4.
Figure 4.
Prevalence ratios of asthma by survival status (“died” vs. “survived”) in patients hospitalized with COVID-19; pooled prevalence ratio = 0.89 (95% confidence interval, 0.77–1.02; P = 0.09). COVID-19 = coronavirus disease.
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