Abstract
Objective
As COVID-19 spreads across the world, there are concerns that people with asthma are at a higher risk of acquiring the disease, or of poorer outcomes. This systematic review aimed to summarize evidence on the risk of infection, severe illness and death from COVID-19 in people with asthma.
Data sources and study selection
A comprehensive search of electronic databases including preprint repositories and WHO COVID-19 database was conducted (until 26 May 2020). Studies reporting COVID-19 in people with asthma were included. For binary outcomes, we performed Sidik-Jonkman random effects meta-analysis. We explored quantitative heterogeneity by subgroup analyses, meta regression and evaluating the I2 statistic.
Results
Fifty-seven studies with an overall sample size of 587 280 were included. The prevalence of asthma among those infected with COVID-19 was 7.46% (95% CI = 6.25–8.67). Non-severe asthma was more common than severe asthma (9.61% vs. 4.13%). Pooled analysis showed a 14% risk ratio reduction in acquiring COVID-19 (95% CI = 0.80–0.94; p < 0.0001) and 13% reduction in hospitalization with COVID-19 (95% CI = 0.77–0.99, p = 0.03) for people with asthma compared with those without. There was no significant difference in the combined risk of requiring admission to ICU and/or receiving mechanical ventilation for people with asthma (RR = 0.87 95% CI = 0.94–1.37; p = 0.19) and risk of death from COVID-19 (RR = 0.87; 95% CI = 0.68–1.10; p = 0.25).
Conclusion
The findings from this study suggest that the prevalence of people with asthma among COVID-19 patients is similar to the global prevalence of asthma. The overall findings suggest that people with asthma have a lower risk than those without asthma for acquiring COVID-19 and have similar clinical outcomes.
Abbreviations: | ||
ACE-2: | = | angiotensin-converting-enzyme-2; |
CDC: | = | United States Center for Disease Control and Prevention; |
COPD: | = | chronic obstructive pulmonary disease; |
COVID-19: | = | coronavirus disease 2019; |
ICU: | = | intensive care unit; |
ICS: | = | inhaled corticosteroids; |
MERS: | = | Middle East Respiratory Syndrome; |
RRR: | = | relative risk reduction; |
SARS-CoV-1: | = | severe acute respiratory syndrome coronavirus 1; |
SARS-CoV-2: | = | severe acute respiratory syndrome coronavirus 2 |
Declaration of interest
The authors report no conflict of interest. AS is in receipt of a UNSW Scientia PhD scholarship.