The Impact of Asthma as an Underlying Disease for COVID-19 in ICU Admitted Patients
Abstract
Background: Asthma is one of the most common chronic diseases triggered by viral respiratory infections leading to severe exacerbations. This study was performed to compare asthma with other underlying systemic disorders in coronavirus patients of 2019 (COVID-19) to evaluate any significant difference between these two groups in terms of ICU admission.
Method: The study was a retrospective study using hospital records of patients’ from Intensive Care Units of Azad University hospitals in Tehran. Adult patients admitted to intensive care unit (ICU) due to COVID19 infection for a period of one year from March 2020 to February 2021, were enrolled in this cross-sectional study and their anonymized information was collected from an electronic system.
Results: This study evaluated a total of 160 COVID-19 patients, aged 29 to 92 years old (mean age: 63.03±15.67 years). 90 (56.3%) patients were males and 70 (43.7%) were females. Comparing the mortality rate of COVID-19 patients with underlying systemic disorders to those with asthma showed that there was no significant difference between them. However, the rate of ICU admission in COVID-19 patients with diabetes and hypertension were significant compared with asthma (P =0.03).
Conclusion: Asthma does not increase the risk of ICU admission in case of COVID-19 infection. Among the ICU admitted patients due to COVID-19 infection, the presence of asthma is not necessarily associated with a significant increase in poor outcomes.
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12. Tadesse DB, Negash M, Kiros KG, Ayele E, Hailay A, Haile TG, et al. Uncontrolled asthma in Ethiopia: a systematic review and meta-analysis. Adv Respir Med. 2020.
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14. Hassanzad M, Nadji SA, Darougar S, Tashayoie-Nejad S, Boloursaz MR, Mahdaviani SA, et al. Association of specific viral infections with childhood asthma exacerbations. Interv Med Appl Sci. 2019; 11(1):17-20.
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24. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395(10223):497-506.
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26. Guan WJ, Liang WH, Zhao Y, Liang HR, Chen ZS, Li YM, et al. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J. 2020; 55(5).
27. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020; 323(11):1061-9.
28. Croft JB, Wheaton AG, Liu Y, Xu F, Lu H, Matthews KA, et al. Urban-Rural County and State Differences in Chronic Obstructive Pulmonary Disease - United States, 2015. MMWR. 2018; 67(7):205-11.
29. Mazurek JM, Syamlal G. Prevalence of Asthma, Asthma Attacks, and Emergency Department Visits for Asthma Among Working Adults - National Health Interview Survey, 2011-2016. MMWR. 2018; 67(13):377-86.
30. Halpin D, Faner R, Sibila O, Badia J, Agusti A. Do chronic respiratory diseases or their treatment affect the risk of SARS-CoV-2 infection? Lancet Respir Med. 2020 Apr 3.
31. Caminati M, Vultaggio A, Matucci A, Senna G, Almerigogna F, Bagnasco D, et al. Asthma in a large COVID-19 cohort: Prevalence, features, and determinants of COVID-19 disease severity. Respir Med. 2021; 176:106261.
32. Gonzales‐van Horn SR, Farrar JD. Interferon at the crossroads of allergy and viral infections. J Leukoc Biol. 2015; 98(2):185-94.
33. Sykes A, Edwards MR, Macintyre J, Del Rosario A, Bakhsoliani E, Trujillo-Torralbo M-B, et al. Rhinovirus 16–induced IFN-α and IFN-β are deficient in bronchoalveolar lavage cells in asthmatic patients. J Allergy Clinical Immunol. 2012;129(6):1506-14. e6.
34. Contoli M, Message SD, Laza-Stanca V, Edwards MR, Wark PA, Bartlett NW, et al. Role of deficient type III interferon-λ production in asthma exacerbations. Nat Med. 2006; 12(9):1023-6.
35. Gill MA, Bajwa G, George TA, Dong CC, Dougherty II, Jiang N, et al. Counterregulation between the FcεRI pathway and antiviral responses in human plasmacytoid dendritic cells. J Immunol. 2010; 184(11):5999-6006.
36. Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of immune response in patients with coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020; 71(15):762-8.
37. Zhang JJ, Dong X, Cao YY, Yuan YD, Yang YB, Yan YQ, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. 2020; 75(7):1730-41.
38. Kimura H, Francisco D, Conway M, Martinez FD, Vercelli D, Polverino F, et al. Type 2 inflammation modulates ACE2 and TMPRSS2 in airway epithelial cells. J Allergy Clin Immunol. 2020; 146(1):80-8. e8.
39. Magalhães GS, Rodrigues-Machado MG, Motta-Santos D, Silva AR, Caliari MV, Prata LO, et al. Angiotensin-(1-7) attenuates airway remodelling and hyperresponsiveness in a model of chronic allergic lung inflammation.Br J Pharmacol. 2015; 172(9):2330-42.
40. Kaye L, Theye B, Smeenk I, Gondalia R, Barrett MA, Stempel DA. Changes in medication adherence among patients with asthma and COPD during the COVID-19 pandemic. J Allergy Clin Immunol Pract. 2020; 8(7):2384-5.
2. Liu S, Zhi Y, Ying S. COVID-19, and asthma: reflection during the pandemic. Clin Rev Allergy Immunol. 2020; 59:78-88.
3. Triggle CR, Bansal D, Ding H, Islam MM, Farag EABA, Hadi HA, et al. A comprehensive review of viral characteristics, transmission, pathophysiology, immune response, and management of SARS-CoV-2 and COVID-19 as a basis for controlling the pandemic. Front Immunol. 2021; 12:338.
4. Lauer SA, Grantz KH, Bi Q, Jones FK, Zheng Q, Meredith HR, et al. The incubation period of coronavirus disease 2019 (COVID-19) from publicly reported confirmed cases: estimation and application. Ann Intern Med. 2020; 172(9):577-82.
5. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020; 323(13):1239-42.
6. Guan W-j, Ni Z-y, Hu Y, Liang W-h, Ou C-q, He J-x, et al. Clinical characteristics of coronavirus disease 2019 in China. NEJM. 2020; 382(18):1708-20.
7. Xie J, Tong Z, Guan X, Du B, Qiu H. Clinical characteristics of patients who died of coronavirus disease 2019 in China. JAMA Netw Open. 2020; 3(4):e205619-e.
8. Sahraian MA, Azimi A, Navardi S, Ala S, Moghadasi AN. Evaluation of the rate of COVID-19 infection, hospitalization and death among Iranian patients with multiple sclerosis. Mult Scler Relat Disord. 2020; 46:102472.
9. Panettieri RA, Jr., Carson J, Horton D, Barrett E, Roy J, Radbel J. Asthma and COVID: What Are the Important Questions? J Allergy Clin Immunol Pract. 2020; 8(8):2487-8.
10. Asher MI, Ellwood P. The Global Asthma Report. 2014.
11. Soriano JB, Kendrick PJ, Paulson KR, Gupta V, Abrams EM, Adedoyin RA, et al. Prevalence and attributable health burden of chronic respiratory diseases, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Respir Med. 2020; 8(6):585-96.
12. Tadesse DB, Negash M, Kiros KG, Ayele E, Hailay A, Haile TG, et al. Uncontrolled asthma in Ethiopia: a systematic review and meta-analysis. Adv Respir Med. 2020.
13. Hosoki K, Chakraborty A, Sur S. Molecular mechanisms and epidemiology of COVID-19 from an allergist's perspective. J Allergy Clin Immunol. 2020;146 (2):285-99.
14. Hassanzad M, Nadji SA, Darougar S, Tashayoie-Nejad S, Boloursaz MR, Mahdaviani SA, et al. Association of specific viral infections with childhood asthma exacerbations. Interv Med Appl Sci. 2019; 11(1):17-20.
15. Wang Y, Chen J, Chen W, Liu L, Dong M, Ji J, et al. Does asthma increase the mortality of patients with COVID-19?: a systematic review and meta-analysis. Int Arch Allergy Immunol. 2021;182(1):76-82.
16. Holley AB. Does Asthma Lead to Worse COVID-19 Outcomes? – Medscape –Sep 18, 2020.
17. Goyal P, Choi JJ, Pinheiro LC, Schenck EJ, Chen R, Jabri A, et al. Clinical characteristics of Covid-19 in New York city. NEJM. 2020; 382(24):2372-4.
18. Johnston SL. Asthma and COVID-19: is asthma a risk factor for severe outcomes? Allergy.2020 Jul; 75(7):1543-1545.
19. Izquierdo JL, Almonacid C, González Y, Del Rio-Bermudez C, Ancochea J, Cárdenas R, et al. The impact of COVID-19 on patients with asthma. Eur Respir J. 2021;57(3).
20. Hatami H, Soleimantabar H, Ghasemian M, Delbari N, Aryannezhad S. Predictors of Intensive Care Unit Admission among Hospitalized COVID-19 Patients in a Large University Hospital in Tehran, Iran. J Res Health Sci. 2021; 21(1).
21. Kim L, Garg S, O'Halloran A, Whitaker M, Pham H, Anderson EJ, et al. Interim analysis of risk factors for severe outcomes among a cohort of hospitalized adults identified through the US Coronavirus disease 2019 (COVID-19)-Associated hospitalization surveillance network (COVID-NET). MedRxiv. 2020.
22. Guan W-j, Liang W-h, Zhao Y, Liang H-r, Chen Z-s, Li Y-m, et al. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J. 2020; 55(5).
23. Petrilli CM, Jones SA, Yang J, Rajagopalan H, O’Donnell L, Chernyak Y, et al. Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: prospective cohort study. BMJ. 2020; 369.
24. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395(10223):497-506.
25. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395(10229):1054-62.
26. Guan WJ, Liang WH, Zhao Y, Liang HR, Chen ZS, Li YM, et al. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J. 2020; 55(5).
27. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020; 323(11):1061-9.
28. Croft JB, Wheaton AG, Liu Y, Xu F, Lu H, Matthews KA, et al. Urban-Rural County and State Differences in Chronic Obstructive Pulmonary Disease - United States, 2015. MMWR. 2018; 67(7):205-11.
29. Mazurek JM, Syamlal G. Prevalence of Asthma, Asthma Attacks, and Emergency Department Visits for Asthma Among Working Adults - National Health Interview Survey, 2011-2016. MMWR. 2018; 67(13):377-86.
30. Halpin D, Faner R, Sibila O, Badia J, Agusti A. Do chronic respiratory diseases or their treatment affect the risk of SARS-CoV-2 infection? Lancet Respir Med. 2020 Apr 3.
31. Caminati M, Vultaggio A, Matucci A, Senna G, Almerigogna F, Bagnasco D, et al. Asthma in a large COVID-19 cohort: Prevalence, features, and determinants of COVID-19 disease severity. Respir Med. 2021; 176:106261.
32. Gonzales‐van Horn SR, Farrar JD. Interferon at the crossroads of allergy and viral infections. J Leukoc Biol. 2015; 98(2):185-94.
33. Sykes A, Edwards MR, Macintyre J, Del Rosario A, Bakhsoliani E, Trujillo-Torralbo M-B, et al. Rhinovirus 16–induced IFN-α and IFN-β are deficient in bronchoalveolar lavage cells in asthmatic patients. J Allergy Clinical Immunol. 2012;129(6):1506-14. e6.
34. Contoli M, Message SD, Laza-Stanca V, Edwards MR, Wark PA, Bartlett NW, et al. Role of deficient type III interferon-λ production in asthma exacerbations. Nat Med. 2006; 12(9):1023-6.
35. Gill MA, Bajwa G, George TA, Dong CC, Dougherty II, Jiang N, et al. Counterregulation between the FcεRI pathway and antiviral responses in human plasmacytoid dendritic cells. J Immunol. 2010; 184(11):5999-6006.
36. Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of immune response in patients with coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020; 71(15):762-8.
37. Zhang JJ, Dong X, Cao YY, Yuan YD, Yang YB, Yan YQ, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. 2020; 75(7):1730-41.
38. Kimura H, Francisco D, Conway M, Martinez FD, Vercelli D, Polverino F, et al. Type 2 inflammation modulates ACE2 and TMPRSS2 in airway epithelial cells. J Allergy Clin Immunol. 2020; 146(1):80-8. e8.
39. Magalhães GS, Rodrigues-Machado MG, Motta-Santos D, Silva AR, Caliari MV, Prata LO, et al. Angiotensin-(1-7) attenuates airway remodelling and hyperresponsiveness in a model of chronic allergic lung inflammation.Br J Pharmacol. 2015; 172(9):2330-42.
40. Kaye L, Theye B, Smeenk I, Gondalia R, Barrett MA, Stempel DA. Changes in medication adherence among patients with asthma and COPD during the COVID-19 pandemic. J Allergy Clin Immunol Pract. 2020; 8(7):2384-5.
| Files | ||
| Issue | Vol 4, No 2 (2021) | |
| Section | Original Article | |
| DOI | https://doi.org/10.18502/igj.v4i2.9986 | |
| Keywords | ||
| Asthma COVID-19 Intensive Care SARS-CoV-2 | ||
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How to Cite
1.
Ahmadi M, Mesgarian M, Hashemitari SK, Darougar S. The Impact of Asthma as an Underlying Disease for COVID-19 in ICU Admitted Patients. Immunol Genet J. 2021;4(2):101-108.
