Asthma may not be significant risk factor for severe COVID-19

Asthma may not be a significant risk factor for developing the novel coronavirus (COVID-19) that is severe enough to warrant hospitalization and intubation, according to a new research letter published in the Annals of the American Thoracic Society.

According to the Centers for Disease Control and Prevention, individuals with asthma are at higher risk for hospitalization and other severe effects from COVID-19, similar to the elevated risk from such health conditions as obesity, hypertension, and diabetes.

In the paper, researchers led by Fernando Holguin, MD, MPH, compared the prevalence of asthma among patients hospitalized for COVID-19, as reported in 15 peer-reviewed studies, with that of the corresponding population's asthma prevalence. They also correlated the study's asthma prevalence with the four-year average asthma prevalence in influenza hospitalizations in the United States.

In addition, the researchers analyzed the medical records of 436 COVID-19 patients admitted to the University of Colorado Hospital to evaluate the likelihood that patients with asthma would be intubated more often than patients without asthma, once they considered patients' age, gender, and body mass index (BMI).

The researchers found that, among COVID-19 patients, those with asthma, which had a 12 percent prevalence rate, did not seem to be more likely to be intubated than non-asthmatics. In the paper, the researchers said this may be because the corticosteroid inhalers many people with asthma use make it more difficult for coronaviruses to enter their airways.

Specifically, these individuals may have lower levels of expression of ACE2, a protein that binds to SARS-CoV-2, the virus caused by COVID-19. People with asthma that is related to allergies may also have lower expression of ACE2, whether they use corticosteroids

“The contribution of ACE2 receptor expression levels to COVID-19 susceptibility is still unclear, however, it should certainly be further investigated," said Holguin, adding that the asthma-COVID-intubation risk relationship should be studied further.

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