Pre-COVID-19 obesity-related asthma phenotypes and risk of COVID-19 infection

ABSTRACT

Background: Incidence and clinical outcomes of COVID-19 appear to differ between allergic and non- allergic asthma, but evidence for other asthma phenotypes, such as obesity-related asthma, is scarce. We sought to determine whether pre-COVID-19 obesityrelated asthma phenotypes are associated with risk of COVID-19 incidence in a Swedish populationrepresentative adult cohort. Method: Clinical examination data from 2,006 subjects aged 16-75 years collected during 2009-2012 were linked to register data of COVID-19 diagnosis, based on real-time polymerase chain reaction or ICD-10 codes set by clinicians. Obese asthma was defined as current asthma and body mass index ≥30 kg/m2. Allergic obese asthma was further based on sensitization to any aeroallergen measured by specific immunoglobulin E. Results: In total, 344 (17.1%) of the subjects had COVID-19. After adjustment for gender, age, allergy history, farm childhood, urbanization, dust exposure, smoking, education, and occupation, there was no association between having allergic obese asthma (adjusted risk ratio (aRR) 0.92, 95% CI 0.63-1.34), non-allergic obese asthma (aRR 0.94, 95% CI 0.68-1.29), or any obese asthma (aRR 0.93, 95% CI 0.72-1.19), and getting COVID-19. Stratifying by gender and age produced similar results. Conclusion: We found no association between pre- COVID-19 obesity-related asthma phenotypes and being diagnosed with COVID-19. Further analyses are needed regarding long-term outcomes and disease severity of COVID-19 in relation to obesity-related asthma phenotypes.