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Meta-Analysis
. 2022 May;59(5):866-879.
doi: 10.1080/02770903.2021.1888116. Epub 2021 Apr 1.

Asthma and risk of infection, hospitalization, ICU admission and mortality from COVID-19: Systematic review and meta-analysis

Anthony P Sunjaya  1   2 , Sabine M Allida  2   3 , Gian Luca Di Tanna  2   4 , Christine Jenkins  1   2   5
Affiliations
Meta-Analysis

Asthma and risk of infection, hospitalization, ICU admission and mortality from COVID-19: Systematic review and meta-analysis

Anthony P Sunjaya et al. J Asthma. 2022 May.

Abstract

Objective: As COVID-19 spreads across the world, there are concerns that people with asthma are at a higher risk of acquiring the disease, or of poorer outcomes. This systematic review aimed to summarize evidence on the risk of infection, severe illness and death from COVID-19 in people with asthma.

Data sources and study selection: A comprehensive search of electronic databases including preprint repositories and WHO COVID-19 database was conducted (until 26 May 2020). Studies reporting COVID-19 in people with asthma were included. For binary outcomes, we performed Sidik-Jonkman random effects meta-analysis. We explored quantitative heterogeneity by subgroup analyses, meta regression and evaluating the I2 statistic.

Results: Fifty-seven studies with an overall sample size of 587 280 were included. The prevalence of asthma among those infected with COVID-19 was 7.46% (95% CI = 6.25-8.67). Non-severe asthma was more common than severe asthma (9.61% vs. 4.13%). Pooled analysis showed a 14% risk ratio reduction in acquiring COVID-19 (95% CI = 0.80-0.94; p < 0.0001) and 13% reduction in hospitalization with COVID-19 (95% CI = 0.77-0.99, p = 0.03) for people with asthma compared with those without. There was no significant difference in the combined risk of requiring admission to ICU and/or receiving mechanical ventilation for people with asthma (RR = 0.87 95% CI = 0.94-1.37; p = 0.19) and risk of death from COVID-19 (RR = 0.87; 95% CI = 0.68-1.10; p = 0.25).

Conclusion: The findings from this study suggest that the prevalence of people with asthma among COVID-19 patients is similar to the global prevalence of asthma. The overall findings suggest that people with asthma have a lower risk than those without asthma for acquiring COVID-19 and have similar clinical outcomes.

Keywords: Severe acute respiratory syndrome coronavirus 2; coronavirus; critical care medicine; meta-analysis; novel coronavirus 2019; respiratory infections; ventilator support.

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Conflict of interest statement

The authors report no conflict of interest. AS is in receipt of a UNSW Scientia PhD scholarship.

Figures

Figure 1.
Figure 1.
PRISMA study selection flow chart.
Figure 2.
Figure 2.
Quality of studies assessment.
Figure 3.
Figure 3.
Risk of acquiring COVID-19 in people with asthma compared to no asthma.
Figure 4.
Figure 4.
Risk of severe illness from COVID-19 among those with asthma compared to no asthma.
Figure 5.
Figure 5.
Risk of death against recovered from COVID-19 among those with asthma compared to no asthma.
See this image and copyright information in PMC

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