Clinical Features and Outcomes Associated with Bronchial Asthma Among COVID-19 Hospitalized Patients

Abstract

Background

The impact of diagnosis treatment and bronchial asthma on coronavirus disease 2019 (COVID-19) associated outcomes remains unclear.

Objective

To identify the prevalence and outcomes associated with asthma among hospitalized patients with COVID-19.

Methods

Electronic health records of 130 patients with asthma among hospitalized patients with COVID-19 were reviewed. Two subgroups of asthmatic patients were compared according to clinical outcomes during hospitalization. Patients with death results, intubation, and/or need of intensive care unit (ICU) stay were grouped as asthmatic patients with severe COVID-19 outcomes, and the rest were grouped as asthmatic patients with non-severe COVID-19 outcomes. Multivariable analyses were conducted with logistic regression to identify independent risk factors for severe outcomes.

Results

The prevalence of asthma in COVID-19 hospitalized patients was 5%. The mean age was 59.4 years and 54% were women. 17% received treatment in GINA step 4–5 asthma at the time of admission. An allergic asthma phenotype was determined in 38%. There was no significant difference in hospital length of stay or need for intubation between asthmatic patients and global COVID-19 admitted patients. 17% of asthmatic patients developed a severe outcome, and 5% had a death result. Elevated Lactate Dehydrogenase (LDH) level, low transcutaneous pulse oximetry (SpO2), the coexistence of atrial fibrillation (AF), and need for moderate or high ICS at admission were independent risk factors for a worse outcome in asthmatics COVID-19 hospitalized patients.

Conclusion

The prevalence of asthma in COVID-19 hospitalized patients was 5%, consistent with the asthma prevalence in the general population. The asthmatic patients with the previous prescription of moderate or high doses of ICS and/or coexistence of atrial fibrillation at admission had a higher risk of the severe outcome.

Keywords:

• bronchial asthma
• COVID-19
• risk factors
• outcomes

Acknowledgments

We acknowledge Dra. Silvia Marset and Dr. José Castejón from Admissions and Clinical Documentation Department of La Fe University and Polytechnic Hospital, by providing data to this analysis. We are also thankful to all front-line healthcare workers of our hospital and clinical staff of Allergy Service, who made this research possible.

Disclosure

The authors declare that they have no conflicts of interest in this work.