Study results show that patients with chronic obstructive pulmonary disease (COPD) and comorbid asthma may have a greater risk of hospitalization from COVID-19 if they use bronchodilators or steroids plus bronchodilators.
Study results shared in a poster presented at the American Academy of Allergy, Asthma & Immunology 2021 Annual Meetingpoint to a possible link between certain chronic obstructive pulmonary disease (COPD) and asthma medications and increased risk of hospitalization due to severe COVID-19.
The CDC has listed asthma and COPD as potential comorbidities that could cause more severe COVID-19 reactions, the authors noted. There has also been speculation on whether the anti-inflammatory effects associated with certain asthma and COPD medications, such as corticosteroids and bronchodilators, worsen COVID-19 severity. Previous studies, however, have produced inconsistent results on whether they pose additional risks.
The retrospective cohort study assessed 72,478 adult patients with COVID-19 diagnosed from March 1, 2020, to August 21, 2020. The mean patient age was 43 years, 54% were women, and 66% were Hispanic. Of the patients, 10.7% had asthma only, 8.8% has COPD only, 4.2% had a diagnosis for asthma and COPD, and 76.3% had neither condition.
Overall, 9.6% (n = 6989) were hospitalized during the study period. In addition, hospitalization as a result of severe COVID-19 was needed for 17.8% of patients with COPD and asthma, 15.1% for patients with COPD only, 9.2% for patients with asthma only, and 8.6% of patients who did not have COPD or asthma. Compared with this last group of patients, participants who had asthma (odds ratio [OR], 1.06; 95% CI, 0.97-1.16), COPD (OR, 1.16; 95% CI, 1.06-1.26), or both (OR, 1.22; 95% CI, 1.09-1.37) had an increased risk of hospitalization.
Of the patients with asthma only, 44.8% had used a corticosteroid or bronchodilator in the past 12 months vs 31.4% of patients with COPD only and 66.8% of patients with asthma and COPD.
Use of corticosteroids slightly increased hospitalization risk (OR, 1.01; 95% CI, 0.84-1.21). However, the risks were greater for patients who used bronchodilators (OR, 1.11; 95% CI, 0.95-1.29) or steroids and bronchodilators (OR, 1.36; 95% CI, 0.21-1.53).
Additionally, obesity and age 34 to 64 years were noted to be high-risk subgroups for patients with asthma only, COPD only, and asthma and COPD. The 34-to-64 age group was the sole age group to show an increased hospitalization risk for patients with COPD only (OR, 1.18; 95% CI, 1.05-1.32), asthma only (OR, 1.17; 95% CI, 1.03-1.32), and COPD and asthma (OR, 1.33; 95% CI, 1.14-1.55).
The ORs for hospitalization in patients who were obese were 1.15 (95% CI, 1.03-1.29) for patients with asthma only, 1.21 (95% CI, 1.09-1.36) for patients with COPD only, and 1.24 (95% CI, 1.07-1.43) for patients with COPD and asthma.
These results show that having a comorbidity, such as asthma and COPD, may not be the only factor influencing COVID-19 susceptibility and that medications and other risk factors could play larger roles.
Huang BZ, Chen Z, Sidell MA, et al. Associations of asthma, COPD and medication history with the risk of severe COVID-19. Presented at: the American Academy of Allergy, Asthma & Immunology 2021 Annual Meeting; February 26-March 1, 2021; Accessed March 4, 2021. https://bit.ly/3kTvYNC