Persons with active asthma, which needed clinical attention within the last one year, before they were diagnosed as COVID-19 positive were at a much higher risk of their infection progressing to severe disease, suggests a new retrospective study from the US published in The Journal of Allergy and Clinical Immunology: In Practice.¹

Data on COVID-19 patients who had pre-existing asthma or chronic obstructive pulmonary disease (COPD) was collated from the electronic medical records from Kaiser Permanente Southern California. These patients were further categorised into active asthma group, comprising of 2775 patients who had recently visited their doctor or healthcare facility for asthma. These included visits to the OPD (87%) or inpatient/emergency department (36%) or both (24%) in the last one year. The second group was the inactive asthma group, which included 2751 patients who did not require a doctor’s visit for asthma.

Data analysis revealed that compared to persons who did not have asthma or COPD, patients with active asthma were more likely to be hospitalized; they were also more likely to require respiratory support and intensive care within a month of COVID-19 diagnosis. However, no such risks were found for the patients with inactive asthma. COVID-19 associated mortality was found to be higher in COPD patients, but not asthma.

About 48% of patients in the inactive group were using asthma medication, whereas in the active asthma group, this number was 82.4%. Patients in the active asthma group who were using asthma medications were found to have lower risk of severe COVID- vis-à-vis those not taking asthma medications. They had 27% less chances of COVID-related hospitalization, 56% reduced probability of COVID-related ICU admission and reduced risk of death, which was nonsignificant.

It is well-established that people with moderate-to-severe or uncontrolled asthma are more likely to  be hospitalized from COVID-19. This study too has shown that patients who had active asthma were more likely to have poor COVID-19 related outcome. But, a pertinent finding was also that continuing with the asthma medications to control asthma reduced the risk of severe COVID-19 outcomes. Hence, patients with asthma must comply with the prescribed medications to keep their asthma under control, especially in the time of Covid.

 Reference

1. Huang BZ, et al. Asthma Disease Status, COPD, and COVID-19 severity in a large multiethnic population. J Allergy Clin Immunol Pract. 2021 Aug 6;S2213-2198(21)00834-5. doi: 10.1016/j.jaip.2021.07.030.