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COVID-19 Susceptibility in Bronchial Asthma

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DOI: 10.1016/j.jaip.2020.11.020

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Asthma; COVID-19; Susceptibility; Smoking

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The study on the prevalence and related factors of asthma in COVID-19 patients shows that patients with asthma have a lower susceptibility to COVID-19, and there is no significant correlation between asthma patients and the positivity rate of COVID-19.
BACKGROUND: Bronchial asthma has not been adequately assessed in coronavirus disease 2019 (COVID-19). Respiratory allergy is associated with significant reductions in the expression of angiotensin-converting enzyme 2 receptor, which is the entry receptor for COVID-19. OBJECTIVE: To observe COVID-19 susceptibility in patients with bronchial asthma, analyze the prevalence of asthma in a large cohort of consecutive outpatient subjects who were tested with the RT-PCR assay for COVID-19. METHODS: This was a retrospective population-based crosssectional study using data from a large nationwide health maintenance organization in Israel. All health maintenance organization enrollees who had been tested for COVID-19 from February to June 2020 were included. Differences in demographic and clinical characteristics between the subjects with negative and positive COVID-19 RT-PCR test results and between COVID-19 RT-PCR-positive subjects with and without asthma were analyzed. RESULTS: A total of 37,469 subjects were tested for COVID-19 RT-PCR, and results for 2,266 (6.05%) of them were positive. A significantly higher proportion of smokers was observed in the COVID-19-negative group than in the COVID-19-positive group (4734 [13.45%] vs 103 [4.55%]; P < .001). Asthma was found in 153 (6.75 %) subjects of the COVID-19-positive group and in 3388 (9.62%) subjects of the COVID-19-negative group (P < .001). No significant impact of antileukotrienes, inhaled corticosteroids, and long-acting beta-blockers use was revealed on COVID-19 positivity proportions. Multiple logistic regression analysis adjusted for sex, age, smoking, and comorbidity revealed a negative association of asthma with the likelihood of being positive for COVID-19 (odds ratio, 0.71; 95% CI, 0.58-0.87; P [ .001). CONCLUSIONS: We observed lower COVID-19 susceptibility in patients with preexisting asthma. (C) 2020 American Academy of Allergy, Asthma & Immunology (J Allergy Clin Immunol Pract 2021;9:684-92)

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