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Epidemiology, Healthcare Resource Utilization, and Mortality of Asthma and COPD in COVID-19: A Systematic Literature Review and Meta-Analyses.
Halpin, David M G; Rabe, Adrian Paul; Loke, Wei Jie; Grieve, Stacy; Daniele, Patrick; Hwang, Sanghee; Forsythe, Anna.
  • Halpin DMG; Respiratory Medicine, University of Exeter Medical School, College of Medicine and Health, University of Exeter, Exeter, Devon, UK.
  • Rabe AP; Primary Care and Public Health, Imperial College London, London, UK.
  • Loke WJ; Global Medical Affairs, AstraZeneca, Cambridge, UK.
  • Grieve S; Lister Hospital, Stevenage, East and North Hertfordshire NHS Trust, Stevenage, UK.
  • Daniele P; Ways Group, London, UK.
  • Hwang S; North America Real World Advanced Analytics, Cytel, Inc., Waltham, MA, USA.
  • Forsythe A; North America Real World Advanced Analytics, Cytel, Inc., Waltham, MA, USA.
J Asthma Allergy ; 15: 811-825, 2022.
Article in English | MEDLINE | ID: covidwho-1997372
ABSTRACT

Purpose:

There has been concern that asthma and chronic obstructive pulmonary disease [COPD] increase the risk of developing and exacerbating COVID-19. The effect of medications such as inhaled corticosteroids (ICS) and biologics on COVID-19 is unclear. This systematic literature review analyzed the published evidence on epidemiology and the burden of illness of asthma and COPD, and the use of baseline medicines among COVID-19 populations. Patients and

Methods:

Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, Embase®, MEDLINE® and Cochrane were searched (January 2019-August 2021). The prevalence of asthma or COPD among COVID-19 populations was compared to the country-specific populations. Odds ratios (ORs) were estimated to compare healthcare resource utilization (HCRU) rates, and meta-analyses of outcomes were estimated from age-adjusted ORs (aORs) or hazard ratios (aHRs). Meta-analyses of COVID-19 outcomes were conducted using random effects models for binary outcomes.

Results:

Given the number and heterogeneity of studies, only 183 high-quality studies were analyzed, which reported hospitalization, intensive care unit (ICU) admissions, ventilation/intubation, or mortality. Asthma patients were not at increased risk for COVID-19-related hospitalization (OR = 1.05, 95% CI 0.92 to 1.20), ICU admission (OR = 1.21, 95% CI 0.99 to 1.1.48), ventilation/intubation (OR = 1.24, 95% CI 0.95 to 1.62), or mortality (OR = 0.85, 95% CI 0.75 to 0.96). Accounting for confounding variables, COPD patients were at higher risk of hospitalization (aOR = 1.45, 95% CI 1.30 to 1.61), ICU admission (aOR = 1.28, 95% CI 1.08 to 1.51), and mortality (aOR = 1.41, 95% CI 1.37 to 1.65). Sixty-five studies reported outcomes associated with ICS or biologic use. There was limited evidence that ICS or biologics significantly impacted the risk of SARS-CoV-2 infection, HCRU, or mortality in asthma or COPD patients.

Conclusion:

In high-quality studies included, patients with asthma were not at significantly higher odds for adverse COVID-19-related outcomes, while patients with COPD were at higher odds. There was no clear evidence that baseline medication affected outcomes. Registration PROSPERO (CRD42021233963).
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Language: English Journal: J Asthma Allergy Year: 2022 Document Type: Article Affiliation country: JAA.S360985

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Language: English Journal: J Asthma Allergy Year: 2022 Document Type: Article Affiliation country: JAA.S360985