Impact of asthma on COVID-19 mortality in the United States: Evidence based on a meta-analysis

• Published in: International immunopharmacology Vol. 102; p. 108390
• Main Authors: Han, Xueya, Xu, Jie, Hou, Hongjie, Yang, Haiyan, Wang, Yadong
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.01.2022; Elsevier BV
• Subjects: Asthma; Asthma - drug therapy; Asthma - epidemiology; Asthma - immunology; Confidence intervals; Coronaviruses; COVID-19; COVID-19 - immunology; COVID-19 - mortality; COVID-19 - virology; Heterogeneity; Humans; Males; Meta-analysis; Mortality; Prevalence; Prospective Studies; Protective Factors; Retrospective Studies; Risk management; SARS-CoV-2 - immunology; Sensitivity analysis; Statistical analysis; Subgroups; United States - epidemiology; USA; Viral diseases; United States; United States > US; COVID-19; USA; Mortality; Asthma; Meta-analysis
• ISSN: 1567-5769; 1878-1705
• DOI: 10.1016/j.intimp.2021.108390

[Display omitted] •Asthma was significantly associated with a reduced risk for COVID-19 mortality in the USA.•Age modulated the association of asthma with COVID-19 mortality in the USA.•Routine intervention and treatment for asthmatics with SARS-CoV-2 should be continued in the USA.•Further studies based on risk factors-adjusted estimates are warranted to confirm our findings. The aim of this study was to investigate the impact of asthma on the risk for mortality among coronavirus disease 2019 (COVID-19) patients in the United States by a quantitative meta-analysis. A random-effects model was used to estimate the pooled odds ratio (OR) with corresponding 95% confidence interval (CI). I2 statistic, sensitivity analysis, Begg’s test, meta-regression and subgroup analyses were also performed. The data based on 56 studies with 426,261 COVID-19 patients showed that there was a statistically significant association between pre-existing asthma and the reduced risk for COVID-19 mortality in the United States (OR: 0.82, 95% CI: 0.74–0.91). Subgroup analyses by age, male proportion, sample size, study design and setting demonstrated that pre-existing asthma was associated with a significantly reduced risk for COVID-19 mortality among studies with age ≥ 60 years old (OR: 0.79, 95% CI: 0.72–0.87), male proportion ≥ 55% (OR: 0.79, 95% CI: 0.72–0.87), male proportion ＜ 55% (OR: 0.81, 95% CI: 0.69–0.95), sample sizes ≥ 700 cases (OR: 0.80, 95% CI: 0.71–0.91), retrospective study/case series (OR: 0.82, 95% CI: 0.75–0.89), prospective study (OR: 0.83, 95% CI: 0.70–0.98) and hospitalized patients (OR: 0.82, 95% CI: 0.74–0.91). Meta-regression did reveal none of factors mentioned above were possible reasons of heterogeneity. Sensitivity analysis indicated the robustness of our findings. No publication bias was detected in Begg’s test (P = 0.4538). Our findings demonstrated pre-existing asthma was significantly associated with a reduced risk for COVID-19 mortality in the United States.