Characteristics and outcomes of adult patients with asthma presenting with COVID-19: A comparative cohort study

Eman Alhmoud; Raja Barazi; Mohammed Saad; Dania Al Khiyami; Reem El Ajez; Dana Bakdach; Ali Omrani; Wanis Ibrahim; Rasha El Anany; Moza Al-Hail

doi:10.5339/qmj.2023.15

Characteristics and outcomes of adult patients with asthma presenting with COVID-19: A comparative cohort study

Qatar Med J. 2023 Aug 8;2023(3):15. doi: 10.5339/qmj.2023.15. eCollection 2023.

Authors

Eman Alhmoud¹, Raja Barazi¹, Mohammed Saad¹, Dania Al Khiyami¹, Reem El Ajez¹, Dana Bakdach¹, Ali Omrani^{2

3}, Wanis Ibrahim^{2

3

4}, Rasha El Anany¹, Moza Al-Hail¹

Affiliations

¹ Pharmacy Department, Hamad Medical Corporation, Doha, Qatar. E-mail: ealhamoud@hamad.qa ORCID: 0000-0002-3871-7088.
² Department of Medicine, Hamad Medical Corporation, Doha, Qatar.
³ College of Medicine, Qatar University, Doha, Qatar.
⁴ Weill Cornell Medicine - Qatar (WCM-Q), Qatar.

Abstract

Background: Bronchial asthma affects about 20% of Qatar's population. The impact of asthma on COVID-19 outcomes is controversial. The aim of this study was to explore the impact of asthma on COVID-19 outcomes and the predictors of COVID-19-related morbidity and mortality in a cohort of asthma patients infected by COVID-19.

Methods: This is a retrospective cohort study of adult patients with asthma infected with COVID-19, who were recruited from Hamad Medical Corporation (HMC), the main healthcare system in Qatar. Patients were matched to a control group of non-asthmatic COVID-19 patients (1:2) based on sex, age, and other comorbidities.

Results: Between March and August 2020, 616 patients with asthma met the inclusion criteria. The need for hospitalization among patients with asthma was independently associated with older age (adjusted odds ratio [aOR] for 10 years, 1.32; 95% confidence interval [CI], 1.13-1.54; p = 0.001) and hypertension (aOR, 2.4; 95% CI, 1.43-3.93; p = 0.001) but not with the use of inhaled corticosteroids (ICS), long-acting beta2 agonists, montelukast, or tiotropium. Patients with asthma required less hospitalization for COVID-19 than non-asthmatic patients (28.2% vs. 37.3%, respectively; aOR, 0.59; 95% CI, 0.77-0.90; p < 0.001). However, admission to the intensive care unit (ICU) was comparable between both groups (3.3% vs. 2.2%; aOR, 1.64; 95% CI, 0.78-3.43; p = 0.193). No difference in mortality rate was observed between the two groups.

Conclusions: In Qatar, adult patients with asthma do not appear to be at higher risk of COVID-19-related hospitalization or ICU admission compared to the general adult COVID-19-infected population. Older age and hypertension were the only significant predictors of COVID-19-related hospitalization among patients with asthma. Further larger studies are required to confirm such an association.

Keywords: Asthma; COVID-19; morbidity; mortality.