Association between asthma and COVID-19 severity during Omicron epidemic: a retrospective cohort study using real-world data

BMC Infect Dis. 2024 Jul 4;24(1):667. doi: 10.1186/s12879-024-09520-9.

Abstract

Background: The available evidence presented inconsistencies and inconclusive findings regarding the associations between co-existing asthma and mortality among COVID-19 patients. The objective of the current study is to investigate the relationship between asthma and severe outcomes after SARS-CoV-2 Omicron infection in an infection-naïve population.

Methods: A retrospective cohort study using propensity score matching was conducted. The COVID-19 patients requiring hospitalisation in Hong Kong from January 1, 2022, to November 13, 2022, an Omicron-predominated period, were identified. Severe clinical outcomes were defined as ICU admission and inpatient death after the first positive PCR results as well as a composite outcome of both.

Results: Of the 74,396 hospitalised COVID-19 patients admitted, 1,290 asthma patients and 18,641 non-asthma patients were included in the matched cohort. The rates of death and the composite outcome were 15·3% and 17·2%, respectively, among the non-asthma patients,12·2% and 13·6%, respectively, among the asthma patients, with adjusted hazard ratios equal to 0·775 (95% CI: 0·660-0·909) and 0·770 (95% CI: 0·662-0·895), respectively. The negative association was more apparent in the elderly and female groups. Asthma remained a factor that lowered the risk of disease severity even though the patients were not fully vaccinated with at least two doses.

Conclusions: We used real-world data to demonstrate that asthma was not a risk factor for COVID-19 severity of the infections of Omicron variant, even though the patients were not fully vaccinated.

Keywords: Asthma; COVID-19 severity; Inhaled corticosteroids; Omicron.

MeSH terms

  • Adult
  • Aged
  • Asthma* / complications
  • Asthma* / epidemiology
  • COVID-19* / complications
  • COVID-19* / epidemiology
  • COVID-19* / mortality
  • Female
  • Hong Kong / epidemiology
  • Hospitalization* / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Propensity Score
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2*
  • Severity of Illness Index*

Supplementary concepts

  • SARS-CoV-2 variants