COVID hospitalisation among people with asthma, multiple sources

HOSPITALISATION:
– Adult patients with a history of asthma attack requiring oral corticosteroids (OCS) or hospitalisation are at increased risk of COVID hospitalisation, compared to patients without asthma. (1) Specifically:
– patients with a history of one or more asthma attacks in the last 2 years, defined as receiving one or more course of oral corticosteroids, had an adjusted HR between 1.30 (one course) and 1.54 (3 or more courses). (1)
– patients hospitalised for asthma in the last 2 years were about 3 times more likelly to be hospitalised for COVID than patients without asthma (adjusted HR 3.01), although this was calculated based on a small group of patients (201 patients with asthma hospitalisation). (1)

– in a Scottish study, children aged 5-17 years with uncontrolled asthma (defined as hospital admission or oral corticosteroids prescription in the last 2 years) had at increased risk of hospital admission for COVID, with a risk increased by at least 6-fold for those with a history of asthma hospitalisation, and at leat 3-fold for those with a history of at least 2 courses of OCS in the last 2 years. The rate of hospitalisation was higher in children with poorly controlled asthma compared to those with well-controled asthma or no asthma.(2)

– in a large national cohort study in England in adults and children aged 12-17 years old:(3)
– adults with asthma prescribed medium and high ICS had an elevated risk of COVID hospitalisation (fully adjusted HRs 1.53 and 1.52 respectively) compared to people without asthma.
– adults with asthma had a significantly higher risk of COVID hospitalisation, with those prescribed 2 or more courses of OCS in the year prior to the pandemic having an adjusted HR of COVID-19 hospitalisation of 1.94 compared to adults without asthma. => Nearly twice as likelly to be hospitalised for COVID
– children (12-17 yo) with asthma had a greater risk of hospitalisation compared to children without asthma, and was the greatest for children prescribed 1 (HR 2.58) or 2 or more (HR 3.80) courses of OCS in the year prior to the pandemic. => children prescribed OCS were more than twice as likelly to be hospitalised than children without asthma (nearly four times for children prescribed 2 or more courses).
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 hospitalisation (particularly those that required 2 or more courses of OCS).(3)