COVID deaths among people with asthma, multiple sources

MORTALITY:
– Adults with asthma have a similar risk of dying from COVID compared with people without asthma.(1)
– when hospitalised for COVID, People with severe asthma (16yo +) are more likely to die than people without asthma (adjusted Hazard Ratio 1.96; 95% CI 1.25-3.08).(2)
– In a Scottish study, the risk of death from COVID was increased in asthmatic patients with a 2-year history of 3 course or more of oral corticosteroids (adjusted HR 1.39) or asthma hospitalisation (adjusted HR 1.84) compared to patients without asthma. (3, supplementary material table S7)

– In a large national cohort study in England:(4)
– increased risk of COVID death in Adults with asthma prescribed medium and high ICS (adjusted HRs 1.18 and 1.36 respectively) compared to adults without asthma, but no significant increase in people with asthma prescribed low ICS.
– increased risk of COVID death in adults with asthma prescribed 0 (adjusted HR 1.10), 1 (adjusted HR 1.20), 2 or more (adjusted HR 1.60) courses of OCS in the year prior to the pandemic compared to adults without asthma.
Concl: People with asthma who recently required higher ICS dosage-based therapies (ie, have more severe disease) or who experience one or more exacerbations per year (ie, have poorly-controlled asthma) as measured by OCS prescriptions, are potentially at increased risk of death from COVID (particularly those that required 2 or more courses of OCS).(4)

Categories: COVID
Author: Agnes
Entry Date: 13/04/2022
Source 1 Name: Sunjaya AP, Allida SM, Di Tanna GL, Jenkins CR. Asthma and Coronavirus Disease 2019 Risk: a systematic review and meta-analysis. European Respiratory Journal. 2021:2101209.
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Source 2 Name: Bloom CI, Drake TM, Docherty AB, Lipworth BJ, Johnston SL, Nguyen-Van-Tam JS, et al. Risk of adverse outcomes in patients with underlying respiratory conditions admitted to hospital with COVID-19: a national, multicentre prospective cohort study using the ISARIC WHO Clinical Characterisation Protocol UK. Lancet Respir Med. 2021;9(7):699-711.
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Source 3 Name: Shi T, Pan J, Vasileiou E, Robertson C, Sheikh A; Public Health Scotland and the EAVE II Collaborators. Risk of serious COVID-19 outcomes among adults with asthma in Scotland: a national incident cohort study. Lancet Respir Med. 2022 Jan 13:S2213-2600(21)00543-9. doi: 10.1016/S2213-2600(21)00543-9. (incl Suppl.)
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Source 4 Name: Dolby T, Nafilyan V, Morgan A, Kallis C, Sheikh A, Quint JK. Relationship between asthma and severe COVID-19: a national cohort study. Thorax. 2022 Mar 30:thoraxjnl-2021-218629. doi: 10.1136/thoraxjnl-2021-218629
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