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Allergic disorders and susceptibility to and severity of COVID-19: A nationwide cohort study - 05/10/20

Doi : 10.1016/j.jaci.2020.08.008 
Jee Myung Yang, MD, PhD a, , Hyun Yong Koh, MD, PhD b, , Sung Yong Moon, BS c, , In Kyung Yoo, MD, PhD d, Eun Kyo Ha, MD e, Seulgi You, MD f, So Young Kim, MD, PhD g, Dong Keon Yon, MD h, i, , , Seung Won Lee, MD, PhD c,
a Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea 
b F.M. Kirby Neurobiology Center, Boston Children’s Hospital, Harvard Medical School, Boston, Mass 
c Department of Data Science, Sejong University College of Software Convergence, Seoul, Korea 
d Department of Gastroenterology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea 
e Department of Pediatrics, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea 
f Department of Radiology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea 
g Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea 
h Armed Force Medical Command, Republic of Korea Armed Forces, Seongnam, Korea 
i Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea 

Corresponding author: Dong Keon Yon, MD, Armed Force Medical Command, Republic of Korea Armed Forces, 81 Saemaeul-ro 177, Seongnam, Gyeonggi-do 463-040, Korea.Armed Force Medical CommandRepublic of Korea Armed Forces81 Saemaeul-ro 177Seongnam, Gyeonggi-doKorea463-040∗∗Seung Won Lee, MD, PhD, Department of Data Science, Sejong University College of Software Convergence, 209 Neungdong-ro, Gwangjin-gu, Seoul 05006, Korea.Department of Data ScienceSejong University College of Software Convergence209 Neungdong-roGwangjin-guSeoulKorea05006

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Abstract

Background

There is inconclusive and controversial evidence of the association between allergic diseases and the risk of adverse clinical outcomes of coronavirus disease 2019 (COVID-19).

Objective

We sought to determine the association of allergic disorders with the likelihood of a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test result and with clinical outcomes of COVID-19 (admission to intensive care unit, administration of invasive ventilation, and death).

Methods

A propensity-score–matched nationwide cohort study was performed in South Korea. Data obtained from the Health Insurance Review & Assessment Service of Korea from all adult patients (age, >20 years) who were tested for SARS-CoV-2 in South Korea between January 1, 2020, and May 15, 2020, were analyzed. The association of SARS-CoV-2 test positivity and allergic diseases in the entire cohort (n = 219,959) and the difference in clinical outcomes of COVID-19 were evaluated in patients with allergic diseases and SARS-CoV-2 positivity (n = 7,340).

Results

In the entire cohort, patients who underwent SARS-CoV-2 testing were evaluated to ascertain whether asthma and allergic rhinitis were associated with an increased likelihood of SARS-CoV-2 test positivity. After propensity score matching, we found that asthma and allergic rhinitis were associated with worse clinical outcomes of COVID-19 in patients with SARS-CoV-2 test positivity. Patients with nonallergic asthma had a greater risk of SARS-CoV-2 test positivity and worse clinical outcomes of COVID-19 than patients with allergic asthma.

Conclusions

In a Korean nationwide cohort, allergic rhinitis and asthma, especially nonallergic asthma, confers a greater risk of susceptibility to SARS-CoV-2 infection and severe clinical outcomes of COVID-19.

El texto completo de este artículo está disponible en PDF.

Key words : COVID-19, asthma, allergic rhinitis, atopic dermatitis

Abbreviations used : aOR, COPD, COVID-19, ICD-10, ICU, SARS-CoV-2, SMD


Esquema


 This work was supported by the National Research Foundation of Korea grant funded by the Korean government (grant no. NRF2019R1G1A109977912). The funders had no role in study design, data collection, data analysis, data interpretation, or writing of the report.
 Disclosure of potential conflict of interest: The authors declare that they have no relevant conflicts of interest.


© 2020  American Academy of Allergy, Asthma & Immunology. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 146 - N° 4

P. 790-798 - octobre 2020 Regresar al número
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