COVID-19 severity in asthma patients: a multi-center matched cohort study

Abstract

Objective

The evidence pertaining to the effects of asthma on Coronavirus disease 2019 outcomes has been unclear. To improve our understanding of the clinically important association of asthma and Coronavirus disease 2019.

Methods

A matched cohort study was performed using data from the Mass General Brigham Health Care System (Boston, MA). Adult (age ≥18 years) patients with confirmed Coronavirus disease 2019 and without chronic obstructive pulmonary disease, cystic fibrosis, or interstitial lung disease between March 4, 2020 and July 2, 2020 were analyzed. Up to five non-asthma comparators were matched to each asthma patient based on age (within 5 years), sex, and date of positive test (within 7 days). The primary outcomes were hospitalization, mechanical ventilation, and death, using multivariable Cox-proportional hazards models accounting for competing risk of death, when appropriate. Patients were followed for these outcomes from diagnosis of Coronavirus disease 2019 until July 2, 2020.

Results

Among 562 asthma patients, 199 (21%) were hospitalized, 15 (3%) received mechanical ventilation, and 7 (1%) died. Among the 2686 matched comparators, 487 (18%) were hospitalized, 107 (4%) received mechanical ventilation, and 69 (3%) died. The adjusted Hazard Ratios among asthma patients were 0.99 (95% Confidence Internal 0.80, 1.22) for hospitalization, 0.69 (95% Confidence Internal 0.36, 1.29) for mechanical ventilation, and 0.30 (95% Confidence Internal 0.11, 0.80) for death.

Conclusions

In this matched cohort study from a large Boston-based healthcare system, asthma was associated with comparable risk of hospitalization and mechanical ventilation but a lower risk of mortality.

Keywords:

• Coronavirus
• asthma
• allergy
• SARS-CoV-2

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

No specific funding was received for this project. Dr. Robinson was supported by National Institutes of Health T32 HL116275. Dr. Camargo was supported, in part, by grant R01AI127507 from the National Institutes of Health. Dr. Blumenthal was supported by National Institutes of Health K01AI125631, the American Academy of Allergy Asthma and Immunology Foundation (AAAAI), and the Massachusetts General Hospital Claflin Distinguished Scholars Award. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, AAAAI Foundation, nor the MGH.