Characteristics and outcomes of asthmatic patients with COVID-19 pneumonia who require hospitalisation

Beurnier, Antoine; Jutant, Etienne-Marie; Jevnikar, Mitja; Boucly, Athénaïs; Pichon, Jérémie; Preda, Mariana; Frank, Marie; Laurent, Jérémy; Richard, Christian; Monnet, Xavier; Duranteau, Jacques; Harrois, Anatole; Chaumais, Marie-Camille; Bellin, Marie-France; Noël, Nicolas; Bulifon, Sophie; Jaïs, Xavier; Parent, Florence; Seferian, Andrei; Savale, Laurent; Sitbon, Olivier; Montani, David; Humbert, Marc

BACKGROUND: Viral respiratory infections are the main causes of asthma exacerbation. The susceptibility of asthmatics to develop an exacerbation when they present with severe pneumonia due to SARS-CoV-2 infection is unknown. The objective of this study was to investigate the characteristics and outcomes of asthmatic patients with COVID-19 pneumonia who required hospitalisation during the spring 2020 outbreak in Paris, France. METHODS: A prospective cohort follow-up was carried out from March 15 to April 15, 2020 in Bicêtre Hospital, University Paris-Saclay, France. All hospitalised patients with a SARS-CoV-2 infection who reported a history of asthma were included. RESULTS: Among 768 hospitalised patients, 37 (4.8%) reported a history of asthma, which had been previously confirmed by a pulmonologist in 85% of cases. Patients were mainly female (70%), non-smokers (85%), with a median age of 54 years (interquartile range, IQR 42–67). None of them presented with an asthma exacerbation. Twenty-two (59%) had major comorbidities and 31 (84%) had a body mass index ≥25 kg·m(−2). The most common comorbidities were obesity (36%), hypertension (27%) and diabetes (19%). All patients had a confirmed diagnosis of COVID-19 pneumonia on computed tomography of the chest. Eosinopenia was a typical biologic feature with a median count of 0/mm3 (IQR 0–0). Eleven patients (30%) were admitted in intensive care unit with three death (8.1%) occurring in the context of comorbidities. CONCLUSION: Asthmatics were not overrepresented among patients with severe pneumonia due to SARS-CoV-2 infection who required hospitalisation. Worst outcomes were observed mainly in patients with major comorbidities.