Prevalence and characterization of asthma in hospitalized and non-hospitalized patients with COVID-19

Chhiba, Krishan D.; Patel, Gayatri B.; Vu, Thanh Huyen T.; Chen, Michael M.; Guo, Amina; Kudlaty, Elizabeth; Mai, Quan; Yeh, Chen; Muhammad, Lutfiyya N.; Harris, Kathleen E.; Bochner, Bruce S.; Grammer, Leslie C.; Greenberger, Paul A.; Kalhan, Ravi; Kuang, Fei Li; Saltoun, Carol A.; Schleimer, Robert P.; Stevens, Whitney W.; Peters, Anju T.

Abstract: Background The Centers for Disease Control and Prevention advises that patients with moderate-to-severe asthma belong to a high-risk group that is susceptible to severe COVID-19. However, the association between asthma and COVID-19 has not been well-established. Objective The primary objective was to determine the prevalence of asthma among COVID-19 patients in a major U.S. health system. We assessed the clinical characteristics and comorbidities in asthmatic and non-asthmatic COVID-19 patients. We also determined the risk of hospitalization associated with asthma and/or inhaled corticosteroid use. Methods Medical records of patients with COVID-19 were searched by a computer algorithm (March 1–April 15, 2020), and chart review was used to validate the diagnosis of asthma and medications prescribed for asthma. All patients were PCR-confirmed COVID-19. Demographics and clinical features were characterized. Regression models were used to assess the associations between asthma and corticosteroid use and the risk of COVID-19-related hospitalization. Results Of 1,526 patients identified with COVID-19, 220 (14%) were classified as having asthma. Asthma was not associated with an increased risk of hospitalization (RR of 0.96 [95%CI: 0.77-1.19]) after adjusting for age, sex, gender, and comorbidities. The ongoing use of ICS did not increase the risk of hospitalization in a similar adjusted model (RR of 1.39 [95%CI: 0.90-2.15]). Conclusions Despite a substantial prevalence of asthma in our COVID-19 cohort, asthma was not associated with an increased risk of hospitalization. Similarly, the use of ICS with or without systemic corticosteroids was not associated with COVID-19-related hospitalization.