Asthmatic Patients Experience Harsher Reaction to COVID-19

Findings from recent studies from Beni-Suef, Egypt called for a greater focus on developing rapid differential clinical diagnosis of COVID-19 among patients with respiratory diseases.

The team of investigators, led by Rania M. Sarhan, PhD, spoke of the prevalence of symptom screenings for patients, as COVID-19 and respiratory diseases often shared the same symptoms such as fever, pneumonia, lung infection and difficulty breathing.

Sarhan and colleagues collected data from 522 patients with either allergic rhinitis, asthma, chronic obstructive pulmonary disease (COPD), and/or COVID-19. Participants ranged from 18-60 years old, and roughly 60% (n = 312) patients were women.

The participants were divided into 4 groups: asthmatic patients, asthmatic patients with allergic rhinitis, COPD patients, and COVID-19 patients.

The participants were further divided into 3 subdivisions of COVID-19 patients only, COVID-19 patients with COPD, and COVID-19 patients with asthma.

The data were collected from Beni-Suef University Hospital and Hospital of Chest Diseases in Beni-Suef, and analyzed for demographic and clinical features.

The prevalence of asthma and COPD in COVID-19 patients were nearly equal, totaling 30.7% and 35.1% respectively. However, patients with COVID-19 showed significant scarification as opposed to patients without the disease.

According to the study, chest CT scans conducted on patients with COVID-19 showed bilateral ground-glass opacity (GGO) with abnormal findings.

Additionally, patients with COVID-19 experienced different and worse symptoms than other participants in the study, despite some similarities being noted earlier in the study.

Fever, dry cough, diarrhea, loss of smell and taste senses, shortness of breath, and blue lips were significantly more prevalent symptoms in all COVID-19 patients. Despite this, no significant effects observed when controlled for age, gender or comorbidities.

The findings in Sarhan and colleagues’ study echo recent research into correlations between respiratory disease and COVID-19 risk. A collection of articles published at the American Academy of Allergy, Asthma and Immunology (AAAAI) 2021 Virtual Sessions indicated that asthmatic patients may not face a heightened risk of COVID-19 severity, hospitalization, or death.

Lakiea Wright, MD, of Brigham and Women’s Hospital and Thermo Fisher Scientific offered her perspective on the AAAAI findings in an interview with HCPLive.

The review and analysis showed the presence of asthma in COVID-19 patients did not result in greater hospitalization risk, length of hospital stay, admission to the intensive care unit, or death.

“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,” Wright said. “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.”

Both the Egypt and AAAAI findings showed a greater need for clarification of ailments in asthmatic patients, especially those suffering from COVID-19.

While mortality rates do not differ between participant groups in either studies, Wright and the investigators from the Egypt studies came to the same conclusion.

Sarhan and colleagues suggested COVID-19 diagnosis in patients should be confirmed by ground-glass opacity and abnormal findings on chest CT, while Wright spoke on the ever-changing landscape that COVID-19 presented.

“I would say that there’s a lot of information out there, we’re still understanding it, and the pace at which we’re trying to understand SARS-CoV-2 and COVID-19 is just so rapid,” Wright said. “A really good take-home is that we have that meta-analysis suggesting asthma in general is not a risk factor for COVID-19, but we want to make sure that patients with asthma have their asthma controlled during the pandemic.”

The study, “Differential Clinical Diagnosis and Prevalence Rate of Allergic Rhinitis, Asthma, and Chronic Obstructive Pulmonary Disease among COVID-19 Patients,” was published online in The International Journal of Clinical Practice.