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. 2021 May;126(5):524-534.
doi: 10.1016/j.anai.2021.02.013. Epub 2021 Feb 18.

Asthma in patients with coronavirus disease 2019: A systematic review and meta-analysis

Li Shi  1 , Jie Xu  1 , Wenwei Xiao  1 , Ying Wang  1 , Yuefei Jin  1 , Shuaiyin Chen  1 , Guangcai Duan  1 , Haiyan Yang  2 , Yadong Wang  3
Affiliations

Asthma in patients with coronavirus disease 2019: A systematic review and meta-analysis

Li Shi et al. Ann Allergy Asthma Immunol. 2021 May.

Abstract

Background: It is unclear whether asthma has an influence on contracting coronavirus disease 2019 (COVID-19) or having worse outcomes from COVID-19 disease.

Objective: To explore the prevalence of asthma in patients with COVID-19 and the relationship between asthma and patients with COVID-19 with poor outcomes.

Methods: The pooled prevalence of asthma in patients with COVID-19 and corresponding 95% confidence interval (CI) were estimated. The pooled effect size (ES) was used to evaluate the association between asthma and patients with COVID-19 with poor outcomes.

Results: The pooled prevalence of asthma in patients with COVID-19 worldwide was 8.3% (95% CI, 7.6-9.0) based on 116 articles (119 studies) with 403,392 cases. The pooled ES based on unadjusted effect estimates revealed that asthma was not associated with reduced risk of poor outcomes in patients with COVID-19 (ES, 0.91; 95% CI, 0.78-1.06). Similarly, the pooled ES based on unadjusted effect estimates revealed that asthma was not associated with the reduced risk of mortality in patients with COVID-19 (ES, 0.88; 95% CI, 0.73-1.05). However, the pooled ES based on adjusted effect estimates indicated that asthma was significantly associated with reduced risk of mortality in patients with COVID-19 (ES 0.80, 95% CI 0.74-0.86).

Conclusion: The pooled prevalence of asthma in patients with COVID-19 was similar to that in the general population, and asthma might be an independent protective factor for the death of patients with COVID-19, which suggests that we should pay high attention to patients co-infected asthma and COVID-19 and take locally tailored interventions and treatment. Further well-designed studies with large sample sizes are required to verify our findings.

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Figures

Figure 1
Figure 1
Study selection. COVID-19, coronavirus disease 2019.
Figure 2
Figure 2
Forest plot of the pooled prevalence of asthma in patients with COVID-19 on a basis of 119 studies. CI, confidence interval; COVID-19, coronavirus disease 2019.
Figure 3
Figure 3
Forest plot of unadjusted ES for the association between asthma and the poor outcomes of patients with COVID-19 on a basis of 40 studies. CI, confidence interval; COVID-19, coronavirus disease 2019; ES, effect size; ID, identification.
Figure 4
Figure 4
Forest plots of the pooled ES for the relationship between asthma and the risk of mortality in patients with COVID-19. A, The unadjusted ES on a basis of 24 studies. B, The adjusted ES on a basis of 12 studies. CI, confidence interval; COVID-19, coronavirus disease 2019; ES, effect size; ID, identification.
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