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Asthma in COVID-19: a systematic review and meta-analysis

Published online: February 1, 2021

The impact of asthma on coronavirus disease 2019 (COVID-19) remains largely unknown. A better understanding of the relationship between COVID-19 and asthma may also provide new insights into the pathophysiology and clinical aspects of COVID-19. The aim of this article was to investigate the impact of asthma on COVID-19 by analyzing the asthma prevalence among COVID-19 patients and comparing outcomes between asthma and non-asthma patients, thereby providing reference for the treatment of COVID-19 patients with comorbid asthma.

In this systematic review and meta-analysis by Liu et al in The Journal of Allergy and Clinical Immunology: In Practice. the authors searched PubMed, Embase, Web of Science, Biorxiv and Medrxiv for studies reporting asthma prevalence in general COVID-19 patients or comparing outcomes between asthma and non-asthma patients, and excluded duplicate publications, reviews, editorials, comments, single case reports or small case series (<10 cases). The pooled estimate of effect was determined using random-effects-models.

Based on 131 studies (410,382 patients), there is great variability in the prevalence of comorbid asthma among COVID-19 patients in different countries or regions, ranging from 1.1% to 16.9%. No significant difference in asthma prevalence was found between hospitalized and non-hospitalized (RR: 1.15, 95% confidence interval: 0.92-1.43), severe and non-severe (RR: 1.21, 95% confidence interval: 0.92-1.57), ICU and non-ICU (RR: 1.19, 95% confidence interval: 0.92-1.54,), dead and survived (RR: 0.90, 95% confidence interval: 0.73-1.11), or intubated/mechanically ventilated and non-intubated/mechanically ventilated (RR: 0.91, 95% confidence interval: 0.71-1.17) COVID-19 patients. Asthmatic patients had a lower risk of death compared with non-asthmatic patients (RR: 0.65, 95% confidence interval: 0.43-0.98). Asthma was not associated with higher risk of intubation or mechanical ventilation (RR: 1.03, 95% confidence interval: 0.72-1.46).

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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