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. 2020 Sep;8(8):2600-2607.
doi: 10.1016/j.jaip.2020.06.032. Epub 2020 Jun 27.

SARS-CoV-2 Pneumonia in Hospitalized Asthmatic Patients Did Not Induce Severe Exacerbation

Manon Grandbastien  1 , Anays Piotin  1 , Julien Godet  2 , Ines Abessolo-Amougou  1 , Carole Ederlé  3 , Irina Enache  1 , Philippe Fraisse  1 , Thi Cam Tu Hoang  1 , Loic Kassegne  1 , Aissam Labani  4 , Pierre Leyendecker  4 , Louise Manien  1 , Christophe Marcot  1 , Guillaume Pamart  1 , Benjamin Renaud-Picard  1 , Marianne Riou  3 , Virginie Doyen  5 , Romain Kessler  6 , Samira Fafi-Kremer  7 , Carine Metz-Favre  1 , Naji Khayath  3 , Frédéric de Blay  8
Affiliations

SARS-CoV-2 Pneumonia in Hospitalized Asthmatic Patients Did Not Induce Severe Exacerbation

Manon Grandbastien et al. J Allergy Clin Immunol Pract. 2020 Sep.

Abstract

Background: Viral infections are known to exacerbate asthma in adults. Previous studies have found few patients with asthma among severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia cases. However, the relationship between SARS-CoV-2 infection and severe asthma exacerbation is not known.

Objective: To assess the frequency of asthma exacerbation in patients with asthma hospitalized for SARS-CoV-2 pneumonia and compare symptoms and laboratory and radiological findings in patients with and without asthma with SARS-CoV-2 pneumonia.

Methods: We included 106 patients between March 4 and April 6, 2020, who were hospitalized in the Chest Diseases Department of Strasbourg University Hospital; 23 had asthma. To assess the patients' asthma status, 3 periods were defined: the last month before the onset of COVID-19 symptoms (p1), prehospitalization (p2), and during hospitalization (p3). Severe asthma exacerbations were defined according to Global INitiative for Asthma guidelines during p1 and p2. During p3, we defined severe asthma deterioration as the onset of breathlessness and wheezing requiring systemic corticosteroids and inhaled β2 agonist.

Results: We found no significant difference between patients with and without asthma in terms of severity (length of stay, maximal oxygen flow needed, noninvasive ventilation requirement, and intensive care unit transfer); 52.2% of the patients with asthma had Global INitiative for Asthma step 1 asthma. One patient had a severe exacerbation during p1, 2 patients during p2, and 5 patients were treated with systemic corticosteroids and inhaled β2 agonist during p3.

Conclusions: Our results demonstrate that patients with asthma appeared not to be at risk for severe SARS-CoV-2 pneumonia. Moreover, SARS-CoV-2 pneumonia did not induce severe asthma exacerbation.

Keywords: Asthma; COVID-19; Coronavirus; Europe; Exacerbation; France; SARS-CoV-2; SARS-CoV-2 pneumonia.

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Figures

Figure 1
Figure 1
Flowchart of patient inclusion.
Figure 2
Figure 2
Number of patients treated or not with oral corticosteroids during the 3 periods (dark gray) p1 and p2: Number of patients with a severe asthma exacerbation; p3: Number of patients treated with oral corticosteroids and β2 agonist; (light gray) no treatment with oral corticosteroids, and β2 agonist during p1, p2, and p3. No time period effect (P = .09).
See this image and copyright information in PMC

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