COVID-19 Severity decreased among patients with asthma, eosinophilia and noneosinophilic asthma

Recent study published in The Journal of Allergy and Clinical Immunology finds how COVID-19 affects individuals with respiratory conditions, specifically asthma and chronic obstructive pulmonary disease (COPD). 

The retrospective cohort study, conducted on 8,395 COVID-19 patients admitted between March 2020 and April 2021, identified patients with asthma, COPD, and those without airway diseases using International Classification of Diseases, 10th Revision codes. The study focused on comparing mortality rates and Sequential Organ Failure Assessment (SOFA) scores among these groups and used logistic regression analysis to adjust for confounding clinical factors associated with mortality.

Patients without airway diseases had a median SOFA score of 0.32, with an 11% mortality rate. In contrast, asthma patients exhibited significantly lower SOFA scores (median 0.15) and a reduced mortality rate, even after accounting for age, diabetes, and other confounders. Patients with asthma showed a 35% lower risk of mortality.

However, for patients with COPD, the picture was quite different. They had higher SOFA scores (median 0.86) and a 40% increased adjusted risk of mortality. This suggests that individuals with COPD may be more susceptible to severe outcomes when infected with COVID-19.

Interestingly, blood eosinophil count, a marker of type 2 inflammation, was linked to lower mortality across all groups. This implies that certain immunological factors, such as type 2 inflammation, might influence COVID-19 severity in patients with airway diseases.

Moreover, the study found that patients with asthma still demonstrated improved outcomes even after accounting for eosinophilia, indicating that not only eosinophilic asthma but also non-eosinophilic asthma was associated with better protection against severe COVID-19.

These findings are significant in understanding the relationship between airway diseases and COVID-19 severity. While asthma appears to offer some level of protection, especially in cases without eosinophilia, COPD patients may be at higher risk. This research underscores the importance of considering underlying health conditions when assessing COVID-19 risks and could potentially guide more tailored treatment and care for patients with respiratory illnesses during the pandemic. 

Source: 

Liu, Y., Rajeevan, H., Simonov, M., Lee, S., Wilson, F. P., Desir, G. V., Vinetz, J. M., Yan, X., Wang, Z., Clark, B. J., Possick, J. D., Price, C., Zaeh, S., Gomez, J. V.-L., Cohn, L., Gautam, S., & Chupp, G. L. (2023). Differences in Mortality Among Patients With Asthma and COPD Hospitalized With COVID-19. In The Journal of Allergy and Clinical Immunology: In Practice. Elsevier BV. https://doi.org/10.1016/j.jaip.2023.07.006