September 4, 2020

There have been many studies looking at the relationship between COVID-19 and asthma. Thus far the vast majority of these studies have found no increased risk of COVID-19 disease severity in those with asthma. Further, there appears to be no indication that asthma is a risk factor for developing COVID-19 disease. However, a few studies have suggested that non-allergic asthma may be associated with more severe COVID-19 disease, although it is not clear in these studies that subjects did not have COPD, which is a well-established risk for severe COVID-19. A few studies have also suggested a higher rate of intubation in asthma patients hospitalized with COVID-19, but other studies have not replicated these findings. Finally, early data from New York State had suggested a reduced death rate in asthma patients hospitalized with COVID-19, but this has not been reproduced in other studies.

Taken together, it appears that there is either no risk or at most a very slight risk for more severe COVID-19 disease in non-allergic asthma patients. This is in contrast to other risk factors like COPD, obesity, etc., that have consistently been linked to more severe COVID-19 disease.

References

Ssentongo P, Ssentongo AE, Heilbrunn ES, Ba DM, Chinchilli VM. Association of cardiovascular disease and 10 other pre-existing comorbidities with COVID-19 mortality: A systematic review and meta-analysis. PLoS One. 2020;15(8):e0238215. Published 2020 Aug 26. doi:10.1371/journal.pone.0238215

Broadhurst R, Peterson R, Wisnivesky JP, et al. Asthma in COVID-19 Hospitalizations: An Overestimated Risk Factor? [published online ahead of print, 2020 Aug 31]. Ann Am Thorac Soc. 2020;10.1513/AnnalsATS.202006-613RL. doi:10.1513/AnnalsATS.202006-613RL

Yang JM, Koh HY, Moon SY, et al. Allergic disorders and susceptibility to and severity of COVID-19: A nationwide cohort study [published online ahead of print, 2020 Aug 15]. J Allergy Clin Immunol. 2020;S0091-6749(20)31136-2. doi:10.1016/j.jaci.2020.08.008

Antonicelli L, Tontini C, Manzotti G, et al. “Severe asthma in adults does not significantly affect the outcome of COVID-19 disease: results from the Italian Severe Asthma Registry” [published online ahead of print, 2020 Aug 14]. Allergy. 2020;10.1111/all.14558. doi:10.1111/all.14558

Lovinsky-Desir S, Deshpande DR, De A, et al. Asthma among hospitalized patients with COVID-19 and related outcomes [published online ahead of print, 2020 Aug 6]. J Allergy Clin Immunol. 2020;S0091-6749(20)31100-3. doi:10.1016/j.jaci.2020.07.026

Lombardi C, Roca E, Bigni B, Cottini M, Passalacqua G. Clinical course and outcomes of patients with asthma hospitalized for severe acute respiratory syndrome coronavirus 2pneumonia: A single-center, retrospective study [published online ahead of print, 2020 Aug 1]. Ann Allergy Asthma Immunol. 2020;S1081-1206(20)30520-2. doi:10.1016/j.anai.2020.07.029

Heffler E, Detoraki A, Contoli M, et al. COVID-19 in Severe Asthma Network in Italy (SANI) patients: Clinical features, impact of comorbidities and treatments [published online ahead of print, 2020 Aug 1]. Allergy. 2020;10.1111/all.14532. doi:10.1111/all.14532

Wang L, Foer D, Bates DW, Boyce JA, Zhou L. Risk factors for hospitalization, intensive care, and mortality among patients with asthma and COVID-19 [published online ahead of print, 2020 Jul 29]. J Allergy Clin Immunol. 2020;S0091-6749(20)31039-3. doi:10.1016/j.jaci.2020.07.018

Song J, Zeng M, Wang H, et al. Distinct effects of asthma and COPD comorbidity on disease expression and outcome in patients with COVID-19 [published online ahead of print, 2020 Jul 27]. Allergy. 2020;10.1111/all.14517. doi:10.1111/all.14517

Keswani A, Dhana K, Rosenthal JA, Moore D, Mahdavinia M. Atopy is predictive of a decreased need for hospitalization for coronavirus disease 2019 [published online ahead of print, 2020 Jul 18]. Ann Allergy Asthma Immunol. 2020;S1081-1206(20)30489-0. doi:10.1016/j.anai.2020.07.012

Gupta S, Hayek SS, Wang W, et al. Factors Associated With Death in Critically Ill Patients With Coronavirus Disease 2019 in the US [published online ahead of print, 2020 Jul 15]. JAMA Intern Med. 2020;e203596. doi:10.1001/jamainternmed.2020.3596

Garcia-Pachon E, Zamora-Molina L, Soler-Sempere MJ, et al. Asthma prevalence in patients with SARS-CoV-2 infection detected by RT-PCR not requiring hospitalization [published online ahead of print, 2020 Jul 4]. Respir Med. 2020;171:106084. doi:10.1016/j.rmed.2020.106084

Williamson EJ, Walker AJ, Bhaskaran K, et al. Factors associated with COVID-19-related death using OpenSAFELY. Nature. 2020;584(7821):430-436. doi:10.1038/s41586-020-2521-4

Haroun-Díaz E, Vázquez de la Torre M, Ruano FJ, et al. Severe asthma during the COVID-19 pandemic: Clinical observations [published online ahead of print, 2020 Jun 27]. J Allergy Clin Immunol Pract. 2020;S2213-2198(20)30668-1. doi:10.1016/j.jaip.2020.06.033