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#Grand Rounds

Asthma May Not Be a Significant Risk Factor for Severe COVID-19

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BACKGROUND AND PURPOSE:

  • Asthma is currently listed as a risk factor for severe COVID-19 by the CDC
    • However, numbers of individuals with asthma are low across many international studies
  • Broadhurst et al. (Annals of the American Thoracic Society, 2020) sought to determine, using larger datasets, if asthma is a risk factor for COVID-19
  • compared the prevalence of asthma among patients hospitalized for COVID-19 to that of the population asthma prevalence and to the 4-year average asthma prevalence in influenza hospitalizations in the United States

METHODS:

  • Literature review and meta-analysis
  • Data sources
    • PubMed, EMBASE, Cochrane, Medline, and MMWR through May 7, 2020
  •  Inclusion criteria
    • Published studies reporting COVID-19 hospitalizations with reported asthma prevalence
  • Study design
    • Three independent reviewers assessed studies for inclusion
    • Multivariable logistic regression used to determine the effect of asthma status on intubation status

RESULTS:

  • 15 studies were included
    • Asthma: 53 patients
    • No asthma: 383 patients
  • The proportion of asthmatics among hospitalized COVID-19 patients was similar to the population asthma prevalence
    • Asthma pooled prevalence 6.8% (95% CI, 3.7 to 10.7)
  • The number of people with asthma hospitalized for influenza (2019-2020) was much higher than the number of people with asthma hospitalized for COVID-19
    • Asthmatics hospitalized with influenza: 24.1%
    • Asthmatic hospitalized with COVID-19: 6.8%
  • COVID-19 patients with asthma were not more likely than non-asthmatics to be intubated
    • Odds ratio 0.69 (95% CI, 0.33 to 1.45)

CONCLUSION:

  • There is little evidence to suggest that people with asthma are at higher risk of severe COVID-19
  • The authors acknowledge that data is still limited however

While there is variable asthma prevalence among COVID-19 published studies, it appears similar to population prevalence, and certainly much lower than what would be expected during seasonal flu

The results of this study suggest that asthma does not appear to be a significant risk factor for developing severe COVID-19 requiring hospitalization or intubation.

Learn More – Primary Sources:

Asthma in COVID-19 Hospitalizations: An Overestimated Risk Factor?

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Related ObG Topics:

CDC Guidance on COVID-19 and Asthma
CDC Weekly Update: Which Comorbidities are Associated with COVID-19 in the US?
Characteristics and Outcomes for 5700 COVID-19 Patients Hospitalized in the New York City Area
What are the Strongest Predictors of COVID-19 Hospitalization and Critical Illness?

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