Multiple manifestations of uncontrolled asthma increase the risk of severe COVID-19 - 08/07/23
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Abstract |
Objective |
Asthma control is of importance when assessing the risk of severe outcomes of COVID-19. The aim of this study was to explore associations of clinical characteristics and the effect of multiple manifestations of uncontrolled asthma with severe COVID-19.
Methods |
In 2014–2020, adult patients with uncontrolled asthma, defined as Asthma Control Test (ACT) ≤19 were identified in the Swedish National Airway Register (SNAR) (n = 24533). The SNAR database, including clinical data, was linked with national registers to identify patients with severe COVID-19 (n = 221). The effect of multiple manifestations of uncontrolled asthma was based on: 1) ACT ≤15, 2) frequent exacerbations and 3) previous asthma inpatient/secondary care and evaluated stepwise. Poisson regression analyses were conducted with severe COVID-19 as the dependent variable.
Results |
In this cohort with uncontrolled asthma, obesity was the strongest independent risk factor for severe COVID-19 in both sexes, but even greater in men. Multiple manifestations of uncontrolled asthma were more common among those with severe COVID-19 vs. without: one, 45.7 vs. 42.3%, two, 18.1 vs. 9.1% and three, 5.0 vs. 2.1%. The risk ratio (RR) of severe COVID-19 increased with an increasing number of manifestations of uncontrolled asthma: one, RR 1.49 (95% CI 1.09–2.02), two, RR 2.42 (95% CI 1.64–3.57) and three, RR 2.96 (95% CI 1.57–5.60), when adjusted for sex, age, and BMI.
Conclusions |
It is important to consider the effect of multiple manifestations of uncontrolled asthma and obesity when assessing patients with COVID-19, as this increases the risk of severe outcomes substantially.
Le texte complet de cet article est disponible en PDF.Highlights |
• | It is important to identify different manifestations of uncontrolled asthma. |
• | Obesity is the strongest risk factor for severe COVID-19 in uncontrolled asthma. |
• | Multiple manifestations of uncontrolled asthma are a risk factor of severe COVID-19. |
Keywords : Asthma, COVID-19, Asthma control test (ACT), Uncontrolled asthma, Exacerbation, Obesity, Quality register, Register studies
Plan
Vol 216
Article 107308- septembre 2023 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.