AAAAI 2021 Research Suggests No Raised Risk of COVID-19 Severity with Asthma

A collection of articles published at the American Academy of Allergy, Asthma & Immunology (AAAAI) 2021 Virtual Sessions this week would indicate that patients with asthma may not actually faced heightened risk of COVID-19 severity, hospitalization, or even death.

In fact, the broad interpretation of asthma as a chronic respiratory disease may not be suitable in interpreting an individual’s risk with COVID-19 infection.

In an interview with HCPLive®, Lakiea Wright, MD, of Brigham and Women’s Hospital and Thermo Fisher Scientific, discussed key findings from a trio of AAAAI 2021 studies on the matter of asthma-associated COVID-19 risk.

Wright also shared her takeaways from each of the trials, and what encompassing outcomes can be construed from the collection of data—more specifically, on matters of what asthma subtypes and treatment may actually be linked to COVID-19 severity.

Associations of Asthma, COPD and Medication History with the Risk of Severe COVID-19

Outcomes: Patients with both asthma and chronic obstructive pulmonary disease (COPD) were observed in a retrospective cohort from March – August 2020 to have a significantly greater risk of COVID-19 hospitalization. Additionally, such patients recently requiring medical treatment were more likely to develop severe illness than those with well-controlled disease.

Wright’s perspective: “It was really non-allergic asthma in this cohort that was associated with hospitalization for COVID…and in these patients, they were using bronchodilators and corticosteroids in the past 6 months. In this cohort, asthma and COPD were risk factors for severe COVID, but it was really about the disease severity of the asthma and COPD that correlated, rather than corticosteroid use.”

COVID-19 severity in asthma patients: A multi-center matched cohort study

Outcomes: The cohort assessment from the Massachusetts General Brigham Health Care System showed a comparable risk between asthma and COVID-19 hospitalization and mechanical ventilation in patients—as well as a lower risk of mortality.

Wright’s perspective: “For each asthma (COVID-19) patient, they had up to 5 non-asthma comparators, who were matched based on age, sex, and the date of their COVID-19 test.”

Outcomes among Patients with COVID-19 and Asthma: A Systematic Review and Meta-analysis

Outcomes: The review and analysis including data from 16 relevant trials showed the presence of asthma in COVID-19 patients was not linked to significantly greater hospitalization risk, length of hospital stay, admission to the intensive care unit (ICU), nor risk of death.

Wright’s perspective: “A really rigorous review…The authors suggested we need to further investigate the role of type 2 inflammation and the role inhaled corticosteroid use, and the reason that’s so important is because there was one paper published (in April 2020) that suggested that perhaps allergic asthma with type 2 inflammation, since it’s associated with lower ACE2 gene expression, it may have sort of a protective role.”