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COPD and asthma predict the outcomes of COVID-19, experts say

Published online: July 1, 2021

Some patients with COVID-19 have poor clinical outcomes. It is important to identify who might develop poor outcomes and the main predictors. According to previously published information, many of these patients have at least 1 underlying disease, including cardiovascular diseases, diabetes, and cancer. The respiratory tract is the first portal against the SARS-CoV-2 infection, and therefore one might suggest that underlying chronic respiratory diseases would predict worse clinical outcomes. However, published findings have not been consistent.  

In an article published in The Journal of Allergy and Clinical Immunology: In Practice, Wei-jie Guan, Jian-xing He and colleagues used the national electronic database (which included 39,420 cases) from mainland China to evaluate if chronic respiratory diseases affected the clinical outcomes of COVID-19. They followed hospitalized patients with COVID-19 until day 30 after hospital admission. There were 3 main chronic respiratory diseases analyzed in this study: chronic obstructive pulmonary disease (COPD), asthma, and bronchiectasis. The main outcome parameter was the composite of 3 variables - invasive ventilation, admission to intensive care unit, or death within 30 days after hospitalization. They also analyzed the association between chronic respiratory diseases and each of these outcomes.
In patients who had chronic respiratory disease, COPD was more common than bronchiectasis and asthma. After accounting for the influence of age, sex and other underlying diseases, they found that patients with COPD were 1.7 times and patients with asthma were 1.45 times more likely to reach the composite endpoint compared with those without. However, patients with chronic respiratory diseases were not more likely to die from COVID-19 compared to those without. Interestingly, the authors found that patients with 2 or more chronic respiratory diseases did not have a greater risk of reaching the composite endpoint compared to those with a single chronic respiratory disease alone; however, this finding was inconclusive because the number of patients included in the analysis was small. Overall, this work showed that COPD and asthma could predict worse clinical outcomes of COVID-19, and therefore patients with COPD and asthma should actively take protective measures to prevent COVID-19 infection.

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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