Los Angeles—Keeping asthma well-controlled reduces the risk of severe COVID-19 outcomes in patients with both, according to a new study.
The report in The Journal of Allergy and Clinical Immunology: In Practice emphasizes the importance of continuing to take asthma-control medications during the pandemic, especially for asthma patients who require clinical care.
“Anyone with asthma should continue to work with their healthcare provider to ensure they are getting the best treatment for their asthma, which leads to better asthma control and decreases the likelihood of severe COVID-19 outcomes,” explained co-first author Zhanghua Chen, an assistant professor of population and public health sciences at the Keck School of Medicine of the University of Southern California. The large study was conducted by USC and Kaiser Permanente Southern California.
The team sought to conduct a population-based study to assess how asthma disease status and chronic obstructive pulmonary disease (COPD) influenced COVID-19 severity.
To do that, researchers identified 61,338 patients diagnosed with COVID-19 in a large, diverse integrated healthcare system. Information on asthma/COPD history, medication use, and covariates was extracted from electronic medical records.
Investigators categorized asthma patients into those with and without clinical visits for asthma 12 or fewer months prior to COVID-19 diagnosis; those groups were labeled as active and inactive asthma, respectively.
Defined as primary outcomes were COVID-19–related hospitalizations, intensive respiratory support (IRS), and intensive-care unit admissions within 30 days, and mortality within 60 days after COVID-19 diagnosis. The cohort was 53.9% female, 66% Hispanic, and had a mean age of 43.9 years.
Results indicate that patients with active asthma had increased odds of hospitalization, IRS, and intensive-care unit admission (odds ratio 1.47-1.66; P <.05) versus patients without asthma or COPD.
Although no increased risks were observed for patients with inactive asthma, chronic obstructive pulmonary disease was associated with increased risks of hospitalization, IRS, and mortality (odds ratio and hazard ratio 1.27-1.67; P <.05).
Researchers point out that, among active asthma patients, those using asthma medications had greater than 25% lower odds for severe COVID-19 outcomes than those without medication.
“Patients with asthma who required clinical care 12 or fewer months prior to COVID-19 or individuals with COPD history are at increased risk for severe COVID-19 outcomes,” the authors write. “Proper medication treatment for asthma may lower this risk.”
“This study went beyond examining asthma’s impact on COVID-19 outcomes, and instead focused on how COVID-19 outcomes might change for asthma patients depending on their level of asthma control,” said coauthor Anny H. Xiang, PhD, of the Kaiser Permanente Southern California Department of Research & Evaluation. “We also saw that even in patients with active asthma, if they were using asthma medications their odds of worsened COVID-19 outcomes decreased, which demonstrates just how important these medications are.”
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