Eosinophilia in Asthma Patients Is Protective Against Severe COVID-19 Illness.
J Allergy Clin Immunol Pract
; 9(3): 1152-1162.e3, 2021 03.
Article
in English
| MEDLINE | ID: covidwho-1046348
ABSTRACT
BACKGROUND:
There is a paucity of information on coronavirus disease 2019 (COVID-19) outcomes in asthmatics.OBJECTIVE:
To identify risk factors associated with admission and subsequent mortality among COVID-19-infected asthmatics.METHODS:
Adults at our institution with a positive polymerase chain reaction for COVID-19 between March 14 and April 27, 2020, were retrospectively identified. Comorbidities, laboratory results, and mortality rates during hospitalization were recorded.RESULTS:
In total, 737 of 951 (77.5%) asthma patients with COVID-19 were seen in the emergency department (ED), and 78.8% of these ED patients (581 of 737) were admitted. Individuals with previously measured mean absolute eosinophil counts (AEC) ≥150 cells/µL were less likely to be admitted (odds ratio [OR] = 0.46, 95% confidence interval [CI] 0.21-0.98, P = .04), whereas concomitant heart failure (CHF), chronic kidney disease (CKD), and chronic obstructive pulmonary disease (COPD) were risk factors for admission. Hospitalized patients with asthma with peak hospital-measured AEC ≥150 cells/µL (n = 104) were less likely to die compared with those whose AEC remained <150 cells/µL (n = 213) (mortality rate 9.6% vs 25.8%; OR = 0.006, 95% CI 0.0001-0.64, P = .03). This group had also higher preadmission mean AEC (237 ± 181 vs 163 ± 147 cells/µL, P = .001, OR = 2012, 95% CI 27.3-14,816). The mortality rate in patients with asthma alone (no associated CHF, CKD, COPD, diabetes, or hypertension) was similar to that of patients without asthma or any of these comorbidities.CONCLUSIONS:
In asthmatics, pre-existing eosinophilia (AEC ≥150 cells/µL) was protective from COVID-19-associated admission, and development of eosinophilia (AEC ≥150 cells/µL) during hospitalization was associated with decreased mortality. Preadmission AEC influenced the AEC trend during hospitalization. Having a Th2-asthma phenotype might be an important predictor for reduced COVID-19 morbidity and mortality that should be further explored in prospective and mechanistic studies.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Asthma
/
Eosinophilia
/
COVID-19
/
Hospitalization
Type of study:
Observational study
/
Prognostic study
Limits:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
/
Young adult
Language:
English
Journal:
J Allergy Clin Immunol Pract
Year:
2021
Document Type:
Article
Similar
MEDLINE
...
LILACS
LIS