Prevalence of Comorbid Asthma and Related Outcomes in COVID-19: A Systematic Review and Meta-Analysis

Shuang Liu; Yang Cao; Tian Du; Yuxiang Zhi

doi:10.1016/j.jaip.2020.11.054

Prevalence of Comorbid Asthma and Related Outcomes in COVID-19: A Systematic Review and Meta-Analysis

J Allergy Clin Immunol Pract. 2021 Feb;9(2):693-701. doi: 10.1016/j.jaip.2020.11.054. Epub 2020 Dec 9.

Authors

Shuang Liu¹, Yang Cao¹, Tian Du², Yuxiang Zhi³

Affiliations

¹ Department of Allergy & Clinical Immunology, National Clinical Research Center for Immunologic Diseases, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China; School of Clinical Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
² State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Breast Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
³ Department of Allergy & Clinical Immunology, National Clinical Research Center for Immunologic Diseases, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China. Electronic address: yuxiang_zhi@126.com.

Abstract

Background: The impact of asthma on coronavirus disease 2019 (COVID-19) remains largely unknown.

Objective: To investigate the asthma prevalence among patients with COVID-19 and compare outcomes between patients with and without asthma.

Methods: In this systematic review and meta-analysis, we searched PubMed, Embase, Web of Science, bioRxiv, and medRxiv for studies reporting asthma prevalence in general patients with COVID-19 or comparing outcomes between patients with and without asthma, and excluded duplicate publications, reviews, editorials, comments, single case reports, or small case series (<10 cases). We determined the pooled estimates of effect using random-effect model.

Results: On the basis of 131 studies (410,382 patients), we found great variability in the prevalence of comorbid asthma among patients with COVID-19 in different countries or regions ranging from 1.1% to 16.9%. No significant difference in asthma prevalence was found between hospitalized and nonhospitalized (risk ratio [RR], 1.15; 95% CI, 0.92-1.43), severe and nonsevere (RR, 1.21; 95% CI, 0.92-1.57), intensive care unit and non-intensive care unit (RR, 1.19; 95% CI, 0.92-1.54), dead and survived (RR, 0.90; 95% CI, 0.73-1.11), intubated/mechanically ventilated and nonintubated/mechanically ventilated (RR, 0.91; 95% CI, 0.71-1.17) patients with COVID-19. Patients with asthma have a lower risk of death compared with patients without asthma (RR, 0.65; 95% CI, 0.43-0.98). Asthma is not associated with a higher risk of intubation or mechanical ventilation (RR, 1.03; 95% CI, 0.72-1.46).

Conclusions: There is great variability in asthma prevalence among patients with COVID-19 in different countries or regions. Asthma is not associated with higher COVID-19 severity or worse prognosis, and patients with asthma are found to have a lower risk of death compared with patients without asthma.

Keywords: Asthma; COVID-19; Prevalence; Prognosis; Severity.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Asthma / epidemiology*
COVID-19 / epidemiology*
Comorbidity
Humans
Prevalence
SARS-CoV-2*