COVID-19
Allergic disorders and susceptibility to and severity of COVID-19: A nationwide cohort study

https://doi.org/10.1016/j.jaci.2020.08.008Get rights and content

Background

There is inconclusive and controversial evidence of the association between allergic diseases and the risk of adverse clinical outcomes of coronavirus disease 2019 (COVID-19).

Objective

We sought to determine the association of allergic disorders with the likelihood of a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test result and with clinical outcomes of COVID-19 (admission to intensive care unit, administration of invasive ventilation, and death).

Methods

A propensity-score–matched nationwide cohort study was performed in South Korea. Data obtained from the Health Insurance Review & Assessment Service of Korea from all adult patients (age, >20 years) who were tested for SARS-CoV-2 in South Korea between January 1, 2020, and May 15, 2020, were analyzed. The association of SARS-CoV-2 test positivity and allergic diseases in the entire cohort (n = 219,959) and the difference in clinical outcomes of COVID-19 were evaluated in patients with allergic diseases and SARS-CoV-2 positivity (n = 7,340).

Results

In the entire cohort, patients who underwent SARS-CoV-2 testing were evaluated to ascertain whether asthma and allergic rhinitis were associated with an increased likelihood of SARS-CoV-2 test positivity. After propensity score matching, we found that asthma and allergic rhinitis were associated with worse clinical outcomes of COVID-19 in patients with SARS-CoV-2 test positivity. Patients with nonallergic asthma had a greater risk of SARS-CoV-2 test positivity and worse clinical outcomes of COVID-19 than patients with allergic asthma.

Conclusions

In a Korean nationwide cohort, allergic rhinitis and asthma, especially nonallergic asthma, confers a greater risk of susceptibility to SARS-CoV-2 infection and severe clinical outcomes of COVID-19.

Key words

COVID-19
asthma
allergic rhinitis
atopic dermatitis

Abbreviations used

aOR
Adjusted odds ratio
COPD
Chronic obstructive pulmonary disease
COVID-19
Coronavirus disease 2019
ICD-10
International Classification of Disease, Tenth revision
ICU
Intensive care unit
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
SMD
Standardized mean difference

Cited by (0)

This work was supported by the National Research Foundation of Korea grant funded by the Korean government (grant no. NRF2019R1G1A109977912). The funders had no role in study design, data collection, data analysis, data interpretation, or writing of the report.

Disclosure of potential conflict of interest: The authors declare that they have no relevant conflicts of interest.

These authors contributed equally to this work.

Senior author.

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