The association of preexisting severe asthma with COVID-19 outcomes

Curr Opin Pulm Med. 2023 May 1;29(3):215-222. doi: 10.1097/MCP.0000000000000954. Epub 2023 Mar 17.

Abstract

Purpose of review: Three years after the emergence of coronavirus disease 2019 (COVID-19), many studies have examined the association between asthma and COVID-related morbidity and mortality, with most showing that asthma does not increase risk. However, the U.S. Centers for Disease Control (CDC) currently suggests that patients with severe asthma may, nonetheless, be particularly vulnerable to COVID-19-related morbidity.

Recent findings: With respect to poor COVID-19 outcomes, our search yielded nine studies that quantified associations with severe asthma, seven that considered use of monoclonal antibodies (mAB), and 14 that considered inhaled corticosteroids (ICS) use. mAb and ICS use have been used as measures of severe asthma in several studies. Severe asthma was significantly associated with poor COVID-19 outcomes. The results for mAb and ICS were mixed.

Summary: An increased risk of poor COVID-19 outcomes in patients with severe asthma is possible. However, these studies remain sparse and suffer from several methodological limitations that hinder their interpretation. Additional evidence is needed to provide clear, cogent guidance for health agencies seeking to inform patients with asthma about potential risks due to COVID-19.

Publication types

  • Review

MeSH terms

  • Administration, Inhalation
  • Anti-Asthmatic Agents* / therapeutic use
  • Antibodies, Monoclonal / therapeutic use
  • Asthma* / complications
  • Asthma* / drug therapy
  • Asthma* / epidemiology
  • COVID-19* / complications
  • COVID-19* / epidemiology
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / therapeutic use
  • Humans
  • Outcome Assessment, Health Care
  • Patient Acuity
  • Risk Factors

Substances

  • Anti-Asthmatic Agents
  • Glucocorticoids
  • Antibodies, Monoclonal