Characteristics and outcomes of COVID-19 patients with and without asthma from the United States, South Korea, and Europe.
Morales D., Ostropolets A., Lai L., Sena A., Duvall S., Suchard M., Verhamme K., Rjinbeek P., Posada J., Ahmed W., Alshammary T., Alghoul H., Alser O., Areia C., Blacketer C., Burn E., Casajust P., You S., Dawoud D., Golozar A., Gong M., Jonnagaddala J., Lynch K., Matheny M., Minty E., Nyberg F., Uribe A., Recalde M., Reich C., Scheumie M., Shah K., Shah N., Schilling L., Vizcaya D., Zhang L., Hripcsak G., Ryan P., Prieto-Alhambra D., Durate-Salles T., Kostka K.
Objective: Large international comparisons describing the clinical characteristics of patients with COVID-19 are limited. The aim of the study was to perform a large-scale descriptive characterization of COVID-19 patients with asthma.Methods: We included nine databases contributing data from January-June 2020 from the US, South Korea (KR), Spain, UK and the Netherlands. We defined two cohorts of COVID-19 patients ('diagnosed' and 'hospitalized') based on COVID-19 disease codes. We followed patients from COVID-19 index date to 30 days or death. We performed descriptive analysis and reported the frequency of characteristics and outcomes in people with asthma defined by codes and prescriptions.Results: The diagnosed and hospitalized cohorts contained 666,933 and 159,552 COVID-19 patients respectively. Exacerbation in people with asthma was recorded in 1.6%-8.6% of patients at presentation. Asthma prevalence ranged from 6.2% (95%CI 5.7-6.8) to 18.5% (95%CI 18.2-18.8) in the diagnosed cohort and 5.2% (95%CI 4.0-6.8) to 20.5% (95%CI 18.6-22.6) in the hospitalized cohort. Asthma patients with COVID-19 had high prevalence of comorbidity including hypertension, heart disease, diabetes and obesity. Mortality ranged from 2.1% (95%CI 1.8-2.4) to 16.9% (95%CI 13.8-20.5) and similar or lower compared to COVID-19 patients without asthma. Acute respiratory distress syndrome occurred in 15%-30% of hospitalized COVID-19 asthma patients.Conclusion: The prevalence of asthma among COVID-19 patients varies internationally. Asthma patients with COVID-19 have high comorbidity. The prevalence of asthma exacerbation at presentation was low. Whilst mortality was similar among COVID-19 patients with and without asthma, this could be confounded by differences in clinical characteristics. Further research could help identify high-risk asthma patients.