Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Feb:177:106287.
doi: 10.1016/j.rmed.2020.106287. Epub 2020 Dec 24.

Poor outcome of SARS-CoV-2 infection in patients with severe asthma on biologic therapy

Katrien Eger  1 , Simone Hashimoto  2 , Gert Jan Braunstahl  3 , Anneke Ten Brinke  4 , Kornelis W Patberg  5 , Annelies Beukert  6 , Frank Smeenk  7 , Simone van der Sar-van der Brugge  8 , Els J M Weersink  9 , Elisabeth H Bel  10
Affiliations

Poor outcome of SARS-CoV-2 infection in patients with severe asthma on biologic therapy

Katrien Eger et al. Respir Med. 2021 Feb.

Abstract

Background: It is unclear whether asthma and asthma medications increase or decrease the risk of severe COVID-19, and this is particularly true for patients with severe asthma receiving biologics.

Objectives: The aim of this study was to assess incidence and disease course of COVID-19 in patients with severe asthma on biologic therapy (omalizumab, mepolizumab, reslizumab, benralizumab, dupilumab), as compared with COVID-19 data from the general Dutch population.

Methods: COVID-19 cases were identified through a prospective ongoing survey between March 17 and April 30, 2020 among all severe asthma specialists from 15 hospitals of the Dutch Severe Asthma Registry RAPSODI. From these cases, data was collected on patient characteristics, including co-morbidities, COVID-19 disease progression and asthma exacerbations. Findings were then compared with COVID-19 data from the general Dutch population.

Results: Of 634 severe asthma patients who received biologic therapy in RAPSODI, 9 (1.4%) were diagnosed with COVID-19. Seven patients (1.1%) required hospitalization for oxygen therapy, of which 5 were admitted to the intensive care for intubation and mechanical ventilation. One patient died (0.16%). All intubated patients had ≥1 co-morbidities. Odds (95%CI) for COVID-19 related hospitalization and intubations were 14 (6.6-29.5) and 41 (16.9-98.5) times higher, respectively, compared to the Dutch population. One patient presented with an asthma exacerbation.

Conclusion: Patients with severe asthma using biologic therapy showed to have a more severe course of COVID-19 compared to the general population. This may be due to co-morbidities, the severity of asthmatic airway inflammation, the use of biologics, or a combination of these.

Keywords: Biologics; COVID-19; SARS-CoV-2; Severe asthma.

PubMed Disclaimer

Conflict of interest statement

Katrien Eger: has nothing to declare.

Simone Hashimoto: has nothing to declare.

Gert Jan Braunstahl: reports grants and personal fees from AstraZeneca, GSK, Chiesi, Novartis, Boehringer Ingelheim, Sanofi/Regeneron, Teva, ALK Abello outside the submitted work.

Anneke ten Brinke: reports institutional grants from GSK, TEVA and Astra Zeneca outside the submitted work and participated in advisory boards for AstraZeneca, TEVA and Sanofi Regeneron.

Kornelis W. Patberg: reports personal fees from Novartis, personal fees from TEVA, personal fees from GSK, personal fees from Boehringer, outside the submitted work.

Annelies Beukert: reports personal fees from Sanofi, personal fees from Astra Zeneca, personal fees and non-financial support from Novartis, personal fees from TEVA, personal fees from Esculaap media, outside the submitted work.

Frank Smeenk: has nothing to disclose.

Simone van der Sar: reports personal fees from Astra Zeneca, Chiesi, ALK, Novartis and GSK, outside the submitted work.

Els Weersink: reports other from Astra Zeneca, other from GSK, other from Novartis, from Sanofi/Regeneron, outside the submitted work.

Elisabeth H. Bel: reports grants and personal fees from AstraZeneca, grants and personal fees from GSK, grants and personal fees from Novartis, personal fees from Sanofi/Regeneron, grants and personal fees from Teva, personal fees from Sterna, personal fees from Chiesi, outside the submitted work.

Comment in

References

    1. World Health Organization . 2019. Weekly Epidemiological Update on Coronavirus Disease.https://www.who.int/docs/default-source/coronaviruse/situation-reports/2...
    1. Wu Z., McGoogan J.M. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese center for disease control and prevention. JAMA, J. Am. Med. Assoc. 2020;323(13):1239–1242. doi: 10.1001/jama.2020.2648. - DOI - PubMed
    1. Richardson S., Hirsch J.S., Narasimhan M., et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York city area. JAMA, J. Am. Med. Assoc. 2020;323(20):2052–2059. doi: 10.1001/jama.2020.6775. - DOI - PMC - PubMed
    1. Li X., Xu S., Yu M., Wang K., Tao Y., Zhou Y. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J. Allergy Clin. Immunol. 2020;146(1):110–118. doi: 10.1016/j.jaci.2020.04.006. - DOI - PMC - PubMed
    1. Mughal M.S., Kaur I.P., Jaffery A.R., et al. COVID-19 patients in a tertiary US hospital: assessment of clinical course and predictors of the disease severity. Respir. Med. 2020;172(June):106130. doi: 10.1016/j.rmed.2020.106130. - DOI - PMC - PubMed