[en] BACKGROUND: Asthmatics and patients with chronic obstructive pulmonary disease (COPD) have more severe outcomes with viral infections than people without obstructive disease. OBJECTIVE: To evaluate if obstructive diseases are risk factors for intensive care unit (ICU) stay and death due to coronavirus disease 2019 (COVID19). METHODS: We collected data from the electronic medical record from 596 adult patients hospitalized in University Hospital of Liege between March 18 and April 17, 2020, for severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection. We classified patients into 3 groups according to the underlying respiratory disease, present before the COVID19 pandemic. RESULTS: Among patients requiring hospitalization for COVID19, asthma and COPD accounted for 9.6% and 7.7%, respectively. The proportions of asthmatics, patients with COPD, and patients without obstructive airway disease hospitalized in the ICU were 17.5%, 19.6%, and 14%, respectively. One-third of patients with COPD died during hospitalization, whereas only 7.0% of asthmatics and 13.6% of patients without airway obstruction died due to SARS-CoV2. The multivariate analysis showed that asthma, COPD, inhaled corticosteroid treatment, and oral corticosteroid treatment were not independent risk factors for ICU admission or death. Male gender (odds ratio [OR]: 1.9; 95% confidence interval [CI]: 1.1-3.2) and obesity (OR: 8.5; 95% CI: 5.1-14.1) were predictors of ICU admission, whereas male gender (OR 1.9; 95% CI: 1.1-3.2), older age (OR: 1.9; 95% CI: 1.6-2.3), cardiopathy (OR: 1.8; 95% CI: 1.1-3.1), and immunosuppressive diseases (OR: 3.6; 95% CI: 1.5-8.4) were independent predictors of death. CONCLUSION: Asthma and COPD are not risk factors for ICU admission and death related to SARS-CoV2 infection.
Disciplines :
Public health, health care sciences & services Cardiovascular & respiratory systems
Author, co-author :
CALMES, Doriane ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de pneumologie - allergologie
Graff, Sophie ; Université de Liège - ULiège > I3-Pneumology
MAES, Nathalie ; Centre Hospitalier Universitaire de Liège - CHU > Département de gestion des systèmes d'informations (GSI) > Secteur d'appui à la recherche clinique et biostatistique
Frix, Anne-Noëlle ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de pneumologie - allergologie
THYS, Marie ; Centre Hospitalier Universitaire de Liège - CHU > Département de gestion des systèmes d'informations (GSI) > Secteur exploitation des données
BONHOMME, Olivier ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de pneumologie - allergologie
Berg, Julien ; Centre Hospitalier Universitaire de Liège - CHU > Autres Services Médicaux > Service des soins intensifs
DEBRUCHE, Mathieu ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de pneumologie - allergologie
GESTER, Fanny ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de pneumologie - allergologie
HENKET, Monique ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Clinique de l'asthme
PAULUS, Virginie ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Clinique de l'asthme
DUYSINX, Bernard ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Oncologie thoracique
HEINEN, Vincent ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de pneumologie - allergologie
NGUYEN DANG, Delphine ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Centre de revalidation pulmonaire
PAULUS, Astrid ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de pneumologie - allergologie
QUAEDVLIEG, Valérie ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de pneumologie - allergologie
VAILLANT, Frédérique ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de pneumologie - allergologie
VAN CAUWENBERGE, Hélène ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de pneumologie - allergologie
MALAISE, Michel ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de rhumatologie
GILBERT, Allison ; Centre Hospitalier Universitaire de Liège - CHU > Autres Services Médicaux > Service des urgences
GHUYSEN, Alexandre ; Centre Hospitalier Universitaire de Liège - CHU > Autres Services Médicaux > Service des urgences
GILLET, Pierre ; Centre Hospitalier Universitaire de Liège - CHU > Direction médicale > Direction médicale
MOUTSCHEN, Michel ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service des maladies infectieuses - médecine interne
Misset, Benoît ; Centre Hospitalier Universitaire de Liège - CHU > Autres Services Médicaux > Service des soins intensifs
SIBILLE, Anne ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de pneumologie - allergologie
GUIOT, Julien ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de pneumologie - allergologie
CORHAY, Jean-Louis ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de pneumologie - allergologie
LOUIS, Renaud ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de pneumologie - allergologie
SCHLEICH, FLorence ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de pneumologie - allergologie
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Bibliography
Hewitt, R., Farne, H., Ritchie, A., Luke, E., Johnston, S.L., Mallia, P., The role of viral infections in exacerbations of chronic obstructive pulmonary disease and asthma. Ther Adv Respir Dis 10 (2016), 158–174.
Zhang, J.J., Dong, X., Cao, Y.Y., Yuan, Y.D., Yang, Y.B., Yan, Y.Q., et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy 75 (2020), 1730–1741.
Peters, M.C., Sajuthi, S., Deford, P., Christenson, S., Rios, C.L., Montgomery, M.T., et al. COVID-19 related genes in sputum cells in asthma: relationship to demographic features and corticosteroids. Am J Respir Crit Care Med 202 (2020), 83–90.
Contoli, M., Ito, K., Padovani, A., Poletti, D., Marku, B., Edwards, M.R., et al. Th2 cytokines impair innate immune responses to rhinovirus in respiratory epithelial cells. Allergy 70 (2015), 910–920.
Jackson, D.J., Trujillo-Torralbo, M.B., Del-Rosario, J., Bartlett, N.W., Edwards, M.R., Mallia, P., et al. The influence of asthma control on the severity of virus-induced asthma exacerbations. J Allergy Clin Immunol 136 (2015), 497–500.
Boonnak, K., Vogel, L., Feldmann, F., Feldmann, H., Legge, K.L., Subbarao, K., Lymphopenia associated with highly virulent H5N1 virus infection due to plasmacytoid dendritic cell–mediated apoptosis of T cells. J Immunol 192 (2014), 5906–5912.
Global Initiative for Asthma. COVID-19. GINA answers to frequently asked questions on asthma management. 2020. Available from: https://ginasthma.org/covid-19-gina-answers-to-frequently-asked-questions-on-asthma-management/. (Accessed 29 June 2020)
British Thoracic Society. Advice for healthcare professionals treating people with asthma. 2020 Available from: https://www.brit-thoracic.org.uk/document-library/quality-improvement/covid-19/bts-advice-for-healthcare-professionals-treating-patients-with-asthma/. (Accessed 29 June 2020)
National Institute for Health and Care Excellence. COVID-19 rapid guideline: severe asthma. Available from: https://www.guidelines.co.uk/covid-19-rapid-guideline-severe-asthma/455275.article. (Accessed 3 April 2020)
National Institute for Health and Care Excellence. COVID-19 rapid guideline: community-based care of patients with chronic obstructive pulmonary disease. Available from: https://www.nice.org.uk/guidance/ng168, 2020. (Accessed 3 April 2020)
Dong, Y.H., Chang, C.H., Wu, F.L.L., Shen, L.J., Calverley, P.M.A., Löfdahl, C.G., et al. Use of inhaled corticosteroids in patients with COPD and the risk of TB and influenza: a systematic review and meta-analysis of randomized controlled trials. Chest 145 (2014), 1286–1297.
Hill, A.T., Sullivan, A.L., Chalmers, J.D., De Soyza, A., Stuart Elborn, J., Andres Floto, R., et al. British thoracic society guideline for bronchiectasis in adults. Thorax 74 (2019), 1–69.
Xie, M., Wang, W., Dou, S., Cui, L., Xiao, W., Quantitative computed tomography measurements of emphysema for diagnosing asthma-chronic obstructive pulmonary disease overlap syndrome. Int J Chron Obstruct Pulmon Dis 11 (2016), 953–961.
Schleich, F.N., Chevremont, A., Paulus, V., Henket, M., Manise, M., Seidel, L., et al. Importance of concomitant local and systemic eosinophilia in uncontrolled asthma. Eur Respir J 44 (2014), 97–108.
Schleich, F., Corhay, J.L., Louis, R., Blood eosinophil count to predict bronchial eosinophilic inflammation in COPD. Eur Respir J 47 (2016), 1562–1564.
Li, X., Xu, S., Yu, M., Wang, K., Tao, Y., Zhou, Y., et al. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol 146 (2020), 110–118.
Chow, N., Fleming-Dutra, K., Gierke, R., Hall, A., Hughes, M., Pilishvili, T., et al. Preliminary estimates of the prevalence of selected underlying health conditions among patients with coronavirus disease 2019—United States, February 12-March 28, 2020. MMWR Morb Mortal Wkly Rep 69 (2020), 382–386.
Richardson, S., Hirsch, J.S., Narasimhan, M., Crawford, J.M., McGinn, T., Davidson, K.W., et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City Area. JAMA 323 (2020), 2052–2059.
Kainu, A., Pallasaho, P., Piirilä, P., Lindqvist, A., Sovijärvi, A., Pietinalho, A., Increase in prevalence of physician-diagnosed asthma in Helsinki during the Finnish Asthma Programme: improved recognition of asthma in primary care? A cross-sectional cohort study. Prim Care Respir J 22 (2013), 64–71.
Ntritsos, G., Franek, J., Belbasis, L., Christou, M.A., Markozannes, G., Altman, P., et al. Gender-specific estimates of COPD prevalence: a systematic review and meta-analysis. Int J Chron Obstruct Pulmon Dis 13 (2018), 1507–1514.
Kaye, L., Theye, B., Smeenk, I., Gondalia, R., Barrett, M.A., Stempel, D.A., Changes in medication adherence among patients with asthma and COPD during the COVID-19 pandemic. J Allergy Clin Immunol Pract 8 (2020), 2384–2385.
Lippi, G., Henry, B.M., Chronic obstructive pulmonary disease is associated with severe coronavirus disease 2019 (COVID-19): COPD and COVID-19. Respir Med, 167, 2020, 105941.
Mehra, M.R., Desai, S.S., Ruschitzka, F., Patel, A.N., Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis. [published online ahead of print May 22, 2020] Lancet, 2020, 10.1016/S0140-6736(20)31180-6.
Mehra, M.R., Desai, S.S., Kuy, S., Henry, T.D., Patel, A.N., Cardiovascular disease, drug therapy, and mortality in Covid-19. N Engl J Med, 382, 2020, 2582.
Wichmann, D., Sperhake, J.-P., Lütgehetmann, M., Steurer, S., Edler, C., Heinemann, A., et al. Autopsy findings and venous thromboembolism in patients with COVID-19: a prospective cohort study. Ann Intern Med 173 (2020), 268–277.
Bettiol, J., Bartsch, P., Louis, R., De Groote, D., Gevaerts, Y., Louis, E., et al. Cytokine production from peripheral whole blood in atopic and nonatopic asthmatics: relationship with blood and sputum eosinophilia and serum IgE levels. Allergy 55 (2000), 1134–1141.
Bradding, P., Richardson, M., Hinks, T.S.C., Howarth, P.H., Choy, D.F., Arron, J.R., et al. ACE2, TMPRSS2, and furin gene expression in the airways of people with asthma—implications for COVID-19. J Allergy Clin Immunol 146 (2020), 208–211.
Mahdavinia, M., Foster, K.J., Jauregui, E., Moore, D., Adnan, D., Andy-Nweye, A.B., et al. Asthma prolongs intubation in COVID-19. J Allergy Clin Immunol Pract 8 (2020), 2388–2391.
Brake, S.J., Barnsley, K., Lu, W., McAlinden, K.D., Eapen, M.S., Sohal, S.S., Smoking upregulates angiotensin-converting enzyme-2 receptor: a potential adhesion site for novel coronavirus SARS-CoV-2 (Covid-19). J Clin Med, 9, 2020, 841.
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