Reduced risk of COVID-19 hospitalization in asthmatic and COPD patients: a benefit of inhaled corticosteroids?

ABSTRACT

Background: The comorbidities and clinical signs of coronavirus disease 2019 (COVID-19) patients have been reported mainly as descriptive statistics, rather than quantitative analysis even in very large investigations. The aim of this study was to identify specific patients’ characteristics that may modulate COVID-19 hospitalization risk.

Research design and methods: A pooled analysis was performed on high-quality epidemiological studies to quantify the prevalence (%) of comorbidities and clinical signs in hospitalized COVID-19 patients. Pooled data were used to calculate the relative risk (RR) of specific comorbidities by matching the frequency of comorbidities in hospitalized COVID-19 patients with those of general population.

Results: The most frequent comorbidities were hypertension, diabetes mellitus, and cardiovascular and/or cerebrovascular diseases. The RR of COVID-19 hospitalization was significantly (P < 0.05) reduced in patients with asthma (0.86, 0.77–0.97) or chronic obstructive pulmonary disease (COPD) (0.46, 0.40–0.52). The most frequent clinical signs were fever and cough.

Conclusion: The clinical signs of hospitalized COVID-19 patients are similar to those of other infective diseases. Patients with asthma or COPD were at lower hospitalization risk. This paradoxical evidence could be related with the protective effect of inhaled corticosteroids that are administered worldwide to most asthmatic and COPD patients.

KEYWORDS:

• Asthma
• copd
• covid-19
• hospitalization
• pooled analysis
• sars-CoV-2

Article highlights

• Comorbidities and clinical signs in COVID-19 have been reported mainly as descriptive statistics.

• This study identifies patients’ characteristics that modulate the risk of COVID-19 hospitalization.

• The most frequent comorbidities in COVID-19 were hypertension, diabetes mellitus, and cardiovascular and/or cerebrovascular diseases.

• Patients with asthma or COPD were at lower risk of COVID-19 hospitalization.

• Inhaled corticosteroids may have a protective effect against COVID-19 hospitalization.

Author contributions

All authors were involved in the conceptualization, design, analysis, and interpretation of the data, along with the drafting and critical revising of the manuscript. The authors read and approved the final version of the manuscript.

Acknowledgments

We thank GlaxoSmithKline (IT) for the unconditional support provided for this research. This manuscript was not funded.

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.

Additional information

Funding

This paper was not funded.