Rojas GA, Ost FN, Stirbulov R, Simões O. In-hospital severe COVID-19 in a philanthropic tertiary hospital setting: is asthma a concern? A retrospective study.
SAO PAULO MED J 2022;
140:651-657. [PMID:
35920529 PMCID:
PMC9514860 DOI:
10.1590/1516-3180.2021.0403.r2.15122021]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 12/15/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND
The frequency of coronavirus disease 2019 (COVID-19) cases among asthmatics has been reported to be reduced. However, the findings regarding the association between asthma and the risk of severe COVID-19 have been divergent.
OBJECTIVE
To investigate whether asthma is associated with a reduced risk of development of severe COVID-19.
DESIGN AND SETTING
Retrospective analysis on COVID-19 surveillance databases at two tertiary-level hospitals in São Paulo, Brazil.
METHODS
The medical records of patients hospitalized due to COVID-19 between March and August 2020 were reviewed in accordance with the clinical, laboratorial, radiological and epidemiological criteria for COVID-19, and for comorbidities.
RESULTS
Among the adult patients included (> 18 years of age) there were 52 asthmatics and 1,318 non-asthmatics. Their median ages and interquartile ranges (IQR) were, respectively, 54 (41-69) and 60 (44-72) years. At least one comorbidity was seen in 73% of asthmatics and 56% of the non-asthmatics. Among the asthmatics, most presented mild asthma (92%) and the prevalence of chronic obstructive pulmonary disease (COPD) was high (27%). The asthmatics presented an unadjusted odds ratio (OR) for severe COVID-19 of 0.89 (95% confidence interval, CI 0.5-1.56); and OR 0.88 (95% CI 0.5 -1.68) after multivariable adjustment. Age > 60 years, male sex, hypertension, diabetes, cancer and homelessness were covariates associated with increased odds for severe COVID-19. Kaplan-Meier estimated survival over hospitalization of up to 30 days did not differ between the groups (log-rank P = 0.09).
CONCLUSIONS
The association between asthma and decreased risk of severe COVID-19 or increased survival was statistically non-significant.
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