Risks of infection, hospital and ICU admission, and death from COVID-19 in people with asthma: systematic review and meta-analyses.
BMJ Evid Based Med
; 27(5): 263-273, 2022 10.
Article
in English
| MEDLINE | ID: covidwho-1583131
ABSTRACT
OBJECTIVES:
To determine if and to what degree asthma may predispose to worse COVID-19 outcomes in order to inform treatment and prevention decisions, including shielding and vaccine prioritisation.DESIGN:
Systematic review and meta-analysis.SETTING:
Electronic databases were searched (October 2020) for clinical studies reporting at least one of the following stratified by asthma status risk of infection with SARS-CoV-2; hospitalisation, intensive care unit (ICU) admission or mortality with COVID-19.PARTICIPANTS:
Adults and children who tested positive for or were suspected to have COVID-19. MAIN OUTCOMEMEASURES:
Main outcome measures were the following stratified by asthma status risk of infection with SARS-CoV-2; hospitalisation, ICU admission or mortality with COVID-19. We pooled odds ratios (ORs) and presented these with 95% confidence intervals (CI). Certainty was assessed using GRADE (Grading of Recommendations, Assessment, Development and Evaluations).RESULTS:
30 (n=112 420) studies were included (12 judged high quality, 15 medium, 3 low). Few provided indication of asthma severity. Point estimates indicated reduced risks in people with asthma for all outcomes, but in all cases the evidence was judged to be of very low certainty and 95% CIs all included no difference and the possibility of increased risk (death OR 0.90, 95% CI 0.72 to 1.13, I2=58%; hospitalisation OR 0.95, 95% CI 0.71 to 1.26; ICU admission OR 0.96, 95% CI 0.75 to 1.24). Findings on hospitalisation are also limited by substantial unexplained statistical heterogeneity. Within people with asthma, allergic asthma was associated with less COVID-19 risk and concurrent chronic obstructive pulmonary disease was associated with increased risk. In some studies, corticosteroids were associated with increased risk, but this may reflect increased risk in people with more severe asthma.CONCLUSIONS:
Though absence of evidence of a clear association between asthma and worse outcomes from COVID-19 should not be interpreted as evidence of absence, the data reviewed indicate that risks from COVID-19 in people with asthma, as a whole, may be less than originally anticipated.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Asthma
/
Cross Infection
/
COVID-19
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
/
Reviews
/
Systematic review/Meta Analysis
Topics:
Long Covid
/
Vaccines
Limits:
Adult
/
Child
/
Humans
Language:
English
Journal:
BMJ Evid Based Med
Year:
2022
Document Type:
Article
Affiliation country:
Bmjebm-2021-111788
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