Asthma and COPD Are Not Risk Factors for ICU Stay and Death in Case of SARS-CoV2 Infection

J Allergy Clin Immunol Pract. 2021 Jan;9(1):160-169. doi: 10.1016/j.jaip.2020.09.044. Epub 2020 Oct 7.

Abstract

Background: Asthmatics and patients with chronic obstructive pulmonary disease (COPD) have more severe outcomes with viral infections than people without obstructive disease.

Objective: To evaluate if obstructive diseases are risk factors for intensive care unit (ICU) stay and death due to coronavirus disease 2019 (COVID19).

Methods: We collected data from the electronic medical record from 596 adult patients hospitalized in University Hospital of Liege between March 18 and April 17, 2020, for severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection. We classified patients into 3 groups according to the underlying respiratory disease, present before the COVID19 pandemic.

Results: Among patients requiring hospitalization for COVID19, asthma and COPD accounted for 9.6% and 7.7%, respectively. The proportions of asthmatics, patients with COPD, and patients without obstructive airway disease hospitalized in the ICU were 17.5%, 19.6%, and 14%, respectively. One-third of patients with COPD died during hospitalization, whereas only 7.0% of asthmatics and 13.6% of patients without airway obstruction died due to SARS-CoV2. The multivariate analysis showed that asthma, COPD, inhaled corticosteroid treatment, and oral corticosteroid treatment were not independent risk factors for ICU admission or death. Male gender (odds ratio [OR]: 1.9; 95% confidence interval [CI]: 1.1-3.2) and obesity (OR: 8.5; 95% CI: 5.1-14.1) were predictors of ICU admission, whereas male gender (OR 1.9; 95% CI: 1.1-3.2), older age (OR: 1.9; 95% CI: 1.6-2.3), cardiopathy (OR: 1.8; 95% CI: 1.1-3.1), and immunosuppressive diseases (OR: 3.6; 95% CI: 1.5-8.4) were independent predictors of death.

Conclusion: Asthma and COPD are not risk factors for ICU admission and death related to SARS-CoV2 infection.

Keywords: Asthma; COPD; COVID19; Death; ICU; Risk factors; SARS-CoV2; Severe asthma; Viral infection.

MeSH terms

  • Asthma / epidemiology*
  • Belgium / epidemiology
  • COVID-19 / mortality*
  • Comorbidity
  • Critical Illness
  • Female
  • Humans
  • Intensive Care Units / statistics & numerical data*
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Pulmonary Disease, Chronic Obstructive / epidemiology*
  • Risk Factors
  • SARS-CoV-2