Real-life survey on severe asthma patients during COVID-19 lockdown in Italy

ABSTRACT

Introduction: The SARS-CoV-2 pandemic has deeply revolutionized our lives and consequently the management of patients, specifically ones with severe asthma.

Objective: A survey was conducted to evaluate the effects on adherence, exacerbations and quality of life in patients with severe asthma during the COVID-19 pandemic period.

Methods: 100 severe asthma patients, who accepted to participate to the survey, were asked to respond to different questionnaires in order to assess asthma symptoms (Asthma Control Test – ACT, and Asthma Control Quality – ACQ) and rino-sinusal ones (Sino-nasal outcome test – SNOT-22).

Results: 31 out of 100 patients reported worsening of respiratory symptoms requiring a step-up in therapy dosage or frequency during the observational period; however, exacerbation rate was very low. Only 17 (17%) of the 100 participants experienced a severe asthma exacerbation. Moreover, there was no confirmed diagnosis of COVID-19 in this population.

Conclusion: Patients with severe asthma did not show higher rates of exacerbations during the pandemic outbreak as well as no increased risk of contracting COVID-19 infection or developing the disease. Self-administration of biological drugs could be useful to maintain high rates of adherence to therapy, and, at the same time, to decrease the risk of exacerbations or Intensive Care Unit (ICU) room access.

KEYWORDS:

• Adherence
• biologicals
• COVID-19
• pandemic
• real life
• severe asthma

Article highlights

• In recent studies, allergic diseases, asthma, and COPD were not considered as risk factors for SARS-CoV-2 infection. The protocol of lockdown in force in Italy did not allow access to the hospital for severe asthma patients with the previous modalities. In this new clinical scenario, we performed a survey by remote on severe asthma patients to evaluate the effects on adherence, exacerbations and quality of life during COVID-19 pandemic

• 31 out 100 patients reported a worsening of respiratory asthma symptoms requiring a step-up in therapy dosage or frequency during the observational period; however, exacerbation rate was very low. Only 17 (17%) participants experienced a severe asthma exacerbation requiring the use of systemic corticosteroids in 16 cases (16%) and an emergency department visit or hospitalization only in one case (1%).

• Rate of patients’ adherence to biological drug administrations was very high (82%) also during pandemic outbreak. Only 18% of patients discontinued treatment in this group of patients

• Globally, in our population the concomitant use of monoclonal antibodies blocking Ig-E or IL-5/IL-5r did not represent a risk factor to infection or development of disease.

• As known, well-controlled asthma patients have a lower risk to present exacerbations and/or undergo hospitalization. At the moment, our data encourage the continuation of therapy in patients treated with biologics.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request

Additional information

Funding

This paper was not funded.