Impact of Allergic Rhinitis and Asthma on COVID-19 Infection, Hospitalization, and Mortality

Jianjun Ren; Wendu Pang; Yaxin Luo; Danni Cheng; Ke Qiu; Yufang Rao; Yongbo Zheng; Yijun Dong; Jiajia Peng; Yao Hu; Zhiye Ying; Haopeng Yu; Xiaoxi Zeng; Zhiyong Zong; Geoffrey Liu; Deyun Wang; Gang Wang; Wei Zhang; Wei Xu; Yu Zhao

doi:10.1016/j.jaip.2021.10.049

Impact of Allergic Rhinitis and Asthma on COVID-19 Infection, Hospitalization, and Mortality

J Allergy Clin Immunol Pract. 2022 Jan;10(1):124-133. doi: 10.1016/j.jaip.2021.10.049. Epub 2021 Oct 30.

Authors

Jianjun Ren¹, Wendu Pang², Yaxin Luo³, Danni Cheng², Ke Qiu², Yufang Rao², Yongbo Zheng², Yijun Dong², Jiajia Peng², Yao Hu⁴, Zhiye Ying⁴, Haopeng Yu⁴, Xiaoxi Zeng⁴, Zhiyong Zong⁵, Geoffrey Liu⁶, Deyun Wang⁷, Gang Wang⁸, Wei Zhang⁹, Wei Xu¹⁰, Yu Zhao¹¹

Affiliations

¹ Department of Oto-Rhino-Laryngology, West China Hospital, Sichuan University, Chengdu, China; West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China; Department of Biostatistics, Princess Margaret Cancer Centre and Dalla Lana School of Public Health, Toronto, ON, Canada; Department of Oto-Rhino-Laryngology, Langzhong People's Hospital, Langzhong, China.
² Department of Oto-Rhino-Laryngology, West China Hospital, Sichuan University, Chengdu, China.
³ Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
⁴ West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China.
⁵ Department of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China.
⁶ Department of Medicine, Division of Medical Oncology and Hematology, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, ON, Canada.
⁷ Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore.
⁸ Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China.
⁹ West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China. Electronic address: weizhang27@163.com.
¹⁰ Department of Biostatistics, Princess Margaret Cancer Centre and Dalla Lana School of Public Health, Toronto, ON, Canada. Electronic address: Wei.Xu@uhnresearch.ca.
¹¹ Department of Oto-Rhino-Laryngology, West China Hospital, Sichuan University, Chengdu, China; West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China. Electronic address: yutzhao@VIP.163.com.

Abstract

Background: It remains unclear if patients with allergic rhinitis (AR) and/or asthma are susceptible to corona virus disease 2019 (COVID-19) infection, severity, and mortality.

Objective: To investigate the role of AR and/or asthma in COVID-19 infection, severity, and mortality, and assess whether long-term AR and/or asthma medications affected the outcomes of COVID-19.

Methods: Demographic and clinical data of 70,557 adult participants completed SARS-CoV-2 testing between March 16 and December 31, 2020, in the UK Biobank were analyzed. The rates of COVID-19 infection, hospitalization, and mortality in relation to pre-existing AR and/or asthma were assessed based on adjusted generalized linear models. We further analyzed the impact of long-term AR and/or asthma medications on the risk of COVID-19 hospitalization and mortality.

Results: Patients with AR of all ages had lower positive rates of SARS-CoV-2 tests (relative risk [RR]: 0.75, 95% confidence interval [CI]: 0.69-0.81, P < .001), with lower susceptibility in males (RR: 0.74, 95% CI: 0.65-0.85, P < .001) than females (RR: 0.8, 95% CI: 0.72-0.9, P < .001). However, similar effects of asthma against COVID-19 hospitalization were only major in participants aged <65 (RR: 0.93, 95% CI: 0.86-1, P = .044) instead of elderlies. In contrast, patients with asthma tested positively had higher risk of hospitalization (RR: 1.42, 95% CI: 1.32-1.54, P < .001). Neither AR nor asthma had an impact on COVID-19 mortality. None of conventional medications for AR or asthma, for example, antihistamines, corticosteroids, or β2 adrenoceptor agonists, showed association with COVID-19 infection or severity.

Conclusion: AR (all ages) and asthma (aged <65) act as protective factors against COVID-19 infection, whereas asthma increases risk for COVID-19 hospitalization. None of the long-term medications had a significant association with infection, severity, and mortality of COVID-19 among patients with AR and/or asthma.

Keywords: Allergic rhinitis; Asthma; COVID-19; Glucocorticoids; Long-term medications.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Asthma*
COVID-19 Testing
COVID-19*
Female
Hospitalization
Humans
Male
Rhinitis, Allergic*
SARS-CoV-2

Abstract

Publication types

MeSH terms

Grants and funding