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The impact of COVID-19 on patients with asthma

José Luis Izquierdo, Carlos Almonacid, Yolanda González, Carlos Del Rio-Bermudez, Julio Ancochea, Remedios Cárdenas, Sara Lumbreras, Joan B. Soriano
European Respiratory Journal 2021 57: 2003142; DOI: 10.1183/13993003.03142-2020
José Luis Izquierdo
1Respiratory Medicine, University Hospital of Guadalajara, Guadalajara, Spain
2Dept of Medicine and Medical Specialties, University of Alcalá, Madrid, Spain
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Carlos Almonacid
2Dept of Medicine and Medical Specialties, University of Alcalá, Madrid, Spain
3Respiratory Medicine, University Hospital Ramón y Cajal, Madrid, Spain
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Yolanda González
4Savana Medica, Madrid, Spain
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Carlos Del Rio-Bermudez
4Savana Medica, Madrid, Spain
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Julio Ancochea
5Respiratory Medicine, Hospital Universitario de La Princesa, Madrid, Spain
6Universidad Autónoma de Madrid, Madrid, Spain
7Centro de Investigatión en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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Remedios Cárdenas
8Allergy, University Hospital of Guadalajara, Guadalajara, Spain
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Sara Lumbreras
4Savana Medica, Madrid, Spain
9Universidad Pontificia Comillas, Madrid, Spain
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Joan B. Soriano
5Respiratory Medicine, Hospital Universitario de La Princesa, Madrid, Spain
6Universidad Autónoma de Madrid, Madrid, Spain
7Centro de Investigatión en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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  • ORCID record for Joan B. Soriano
  • For correspondence: jbsoriano2@gmail.com
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    FIGURE 1

    Flowchart depicting the total number of patients with available electronic health records (EHRs), the number of patients with asthma, the number of patients diagnosed with coronavirus disease 2019 (COVID-19), and of those, the number of hospitalisations after diagnosis during the study period (January 1 to May 10, 2020). All percentage values are computed in relation to the level immediately above.

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  • TABLE 1

    Demographic and clinical characteristics of patients with asthma with/without coronavirus disease 2019 (COVID-19)

    AsthmaAsthma without COVID-19Asthma with COVID-19OR (95% CI)p-value#
    Patients n71 18270 1761006
    Age years42±2441±2455±20<0.001
    Female5959661.34 (1.18–1.54)<0.001
    Tobacco use109111.25 (1.03–1.53)00.02
    Comorbidities
     Arterial hypertension2424392.02 (1.78–2.30)<0.001
     Dyslipidaemia1717261.72 (1.49–1.98)<0.001
     Diabetes mellitus1110161.72 (1.45–2.03)<0.001
     Obesity1010131.35 (1.12–1.62)<0.001
     Rhinitis3333170.42 (0.35–0.49)<0.001
     Eczema7710.50 (0.40–0.76)<0.001

    Data are presented as mean±sd or %, unless otherwise stated. #: patients with asthma with COVID-19 versus patients with asthma without COVID-19.

    • TABLE 2

      Demographic and clinical characteristics of patients with asthma and coronavirus disease 2019 (COVID-19) who required hospital admission

      Asthma+COVID-19Asthma+COVID-19
      non-hospitalised
      Asthma+COVID-19
      hospitalised
      OR (95% CI)p-value#
      Patients n1006743263
      Age years55±2052±2063±18<0.001
      Female6667610.76 (0.57–1.02)0.07
      Tobacco use7760.69 (0.37–1.29)0.29
      Comorbidities
       Arterial hypertension3934542.27 (1.71–3.03)<0.001
       Dyslipidaemia2721382.31 (1.70–3.13)<0.001
       Diabetes mellitus1513211.76 (1.22–2.54)0.002
       Obesity1312181.60 (1.09–2.35)0.02

      Data are presented as mean±sd or %, unless otherwise stated. #: non-hospitalised patients versus hospitalised patients.

      • TABLE 3

        Treatment of patients with asthma and coronavirus disease 2019 (COVID-19): inhaled corticosteroids (ICS) and biologics in hospitalised versus non-hospitalised patients between January 1 and May 10, 2020

        PatientsAsthma+COVID-19Asthma+COVID-19
        hospitalised
        p-value
        Patients with asthma71 1821006263
        Asthma + ≤1 ICS42 171 (59.23% of asthmatic patients)619127<0.001
        Asthma + ≤1 biologic#865 (1.21% of asthmatic patients)182
         Omalizumab64190
         Mepolizumab30872
         Benralizumab9820
         Reslizumab2610

        Data are presented as n, unless otherwise stated. #: 54% of the patients treated with mepolizumab had been treated previously with omalizumab; 65% of patients treated with benralizumab had been treated previously with omalizumab and 35% with mepolizumab. Most of the patients treated with reslizumab had been treated previously with omalizumab and mepolizumab.

        • TABLE 4

          In-hospital mortality in asthmatic patients with/without coronavirus disease 2019 (COVID-19)

          Asthma with COVID-19Asthma without COVID-19OR (95% CI)p-value
          Age years78±1776±17<0.001
          Female61710.64 (0.56–0.73)
          Mortality2.290.542.29 (4.35–6.66)

          Data are presented as mean±sd or %, unless otherwise stated.

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            Supplementary material ERJ-03142-2020.SUPPLEMENT

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          The impact of COVID-19 on patients with asthma
          José Luis Izquierdo, Carlos Almonacid, Yolanda González, Carlos Del Rio-Bermudez, Julio Ancochea, Remedios Cárdenas, Sara Lumbreras, Joan B. Soriano
          European Respiratory Journal Mar 2021, 57 (3) 2003142; DOI: 10.1183/13993003.03142-2020

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          The impact of COVID-19 on patients with asthma
          José Luis Izquierdo, Carlos Almonacid, Yolanda González, Carlos Del Rio-Bermudez, Julio Ancochea, Remedios Cárdenas, Sara Lumbreras, Joan B. Soriano
          European Respiratory Journal Mar 2021, 57 (3) 2003142; DOI: 10.1183/13993003.03142-2020
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