Association of asthma comorbidity with poor prognosis of coronavirus disease 2019

• Published in: The World Allergy Organization journal Vol. 14; no. 8; p. 100576
• Main Authors: Kim, Sae-Hoon, Ji, Eunjeong, Won, Seung-Hyun, Cho, Jungwon, Kim, Yong-Hyun, Ahn, Soyeon, Chang, Yoon-Seok
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2021; Elsevier BV; World Allergy Organization; Elsevier
• Subjects: Age; Allergies; Asthma; Cohort analysis; Comorbidity; COVID-19; Diabetes; Disease control; Emergency medical care; Exacerbation; Hospitals; Infections; Medical prognosis; Morbidity; Mortality; Population; Regression analysis; Respiratory diseases; Risk factors; Severe acute respiratory syndrome coronavirus 2; Statistical significance; Survival analysis; United States > US; South Korea; COVID-19; Exacerbation; Asthma
• ISSN: 1939-4551; 1939-4551
• DOI: 10.1016/j.waojou.2021.100576

While global health agencies have listed asthma as a vulnerability for severe cases of coronavirus disease 2019 (COVID-19), the evidence supporting this is scarce. A nationwide cohort study was conducted using the validated Korean national health insurance claim data of patients diagnosed with COVID-19 between January 1 and April 8, 2020. Asthma comorbidity was determined using a diagnosis code assigned by the physician and the prescription of asthma-related medications. The clinical course of COVID-19 was classified into 3 severity grades according to the requirements for oxygen supply and mechanical ventilation. We also evaluated the association of asthma with overall and in-hospital mortality of COVID-19. Asthma morbidity was a significant risk factor for severe COVID-19 (grade 2 requiring oxygen supply) (adjusted odds ratio [aOR] = 1.341, 95% confidence interval [CI], 1.051−1.711, P = 0.018) and grade 3 requiring mechanical ventilation or leading to death (aOR = 1.723, 95% CI: 1.230−2.412, P = 0.002) multinomial logistic regression adjusting co-risk factors. Asthma was also significantly associated with mortality of COVID-19 (aOR = 1.453, 95% CI: 1.015−2.080, P = 0.041) and was revealed to have a shorter time to in-hospital mortality of COVID-19 (P < 0.001). Patients with recent asthma exacerbation showed more severe COVID-19 of grade 3 (OR = 7.371, 95% CI: 2.018−26.924, P = 0.003) and higher mortality (OR = 9.208, 95% CI: 2.597−32.646, P < 0.001) in univariable analysis, but the statistical significance was not found in multivariable analysis. Asthma morbidity was associated with severity and mortality of COVID-19. Patients with asthma should pay more attention to avoid worsening of COVID-19.