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      Asthma and COVID-19: a dangerous liaison?

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          Abstract

          The coronavirus disease 2019 (COVID-19) pandemic, caused by the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), provoked the most striking international public health crisis of our time. COVID-19 can cause a range of breathing problems, from mild to critical, with potential evolution to respiratory failure and acute respiratory distress syndrome. Elderly adults and those affected with chronic cardiovascular, metabolic, and respiratory conditions carry a higher risk of severe COVID-19. Given the global burden of asthma, there are well-founded concerns that the relationship between COVID-19 and asthma could represent a “dangerous liaison”.

          Here we aim to review the latest evidence on the links between asthma and COVID-19 and provide reasoned answers to current concerns, such as the risk of developing SARS-CoV-2 infection and/or severe COVID-19 stratified by asthmatic patients, the contribution of type-2 vs. non-type-2 asthma and asthma-COPD overlap to the risk of COVID-19 development. We also address the potential role of both standard anti-inflammatory asthma therapies and new biological agents for severe asthma, such as mepolizumab, reslizumab, and benralizumab, on the susceptibility to SARS-CoV-2 infection and severe COVID-19 outcomes.

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          Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

          Fei Zhou, Ting Yu, Ronghui Du … (2020)
          Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p<0·0001), and d-dimer greater than 1 μg/mL (18·42, 2·64–128·55; p=0·0033) on admission. Median duration of viral shedding was 20·0 days (IQR 17·0–24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days. Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.
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            Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study

            Nanshan Chen, Min Zhou, Xuan Dong … (2022)
            Summary Background In December, 2019, a pneumonia associated with the 2019 novel coronavirus (2019-nCoV) emerged in Wuhan, China. We aimed to further clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia. Methods In this retrospective, single-centre study, we included all confirmed cases of 2019-nCoV in Wuhan Jinyintan Hospital from Jan 1 to Jan 20, 2020. Cases were confirmed by real-time RT-PCR and were analysed for epidemiological, demographic, clinical, and radiological features and laboratory data. Outcomes were followed up until Jan 25, 2020. Findings Of the 99 patients with 2019-nCoV pneumonia, 49 (49%) had a history of exposure to the Huanan seafood market. The average age of the patients was 55·5 years (SD 13·1), including 67 men and 32 women. 2019-nCoV was detected in all patients by real-time RT-PCR. 50 (51%) patients had chronic diseases. Patients had clinical manifestations of fever (82 [83%] patients), cough (81 [82%] patients), shortness of breath (31 [31%] patients), muscle ache (11 [11%] patients), confusion (nine [9%] patients), headache (eight [8%] patients), sore throat (five [5%] patients), rhinorrhoea (four [4%] patients), chest pain (two [2%] patients), diarrhoea (two [2%] patients), and nausea and vomiting (one [1%] patient). According to imaging examination, 74 (75%) patients showed bilateral pneumonia, 14 (14%) patients showed multiple mottling and ground-glass opacity, and one (1%) patient had pneumothorax. 17 (17%) patients developed acute respiratory distress syndrome and, among them, 11 (11%) patients worsened in a short period of time and died of multiple organ failure. Interpretation The 2019-nCoV infection was of clustering onset, is more likely to affect older males with comorbidities, and can result in severe and even fatal respiratory diseases such as acute respiratory distress syndrome. In general, characteristics of patients who died were in line with the MuLBSTA score, an early warning model for predicting mortality in viral pneumonia. Further investigation is needed to explore the applicability of the MuLBSTA score in predicting the risk of mortality in 2019-nCoV infection. Funding National Key R&D Program of China.
            Article 0 comments Cited 9339 times – based on 0 reviews     Review now
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              Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention

              Zunyou Wu, Jennifer M. McGoogan (2020)
              Article 0 comments Cited 8367 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Carlo Lombardi: carlo.lombardi@poliambulanza.it
                Journal
                Journal ID (nlm-ta): Asthma Res Pract
                Journal ID (iso-abbrev): Asthma Res Pract
                Title: Asthma Research and Practice
                Publisher: BioMed Central (London )
                ISSN (Electronic): 2054-7064
                Publication date (Electronic): 15 July 2021
                Publication date PMC-release: 15 July 2021
                Publication date Collection: 2021
                Volume: 7
                Electronic Location Identifier: 9
                Affiliations
                [1 ]GRID grid.415090.9, ISNI 0000 0004 1763 5424, Departmental Unit of Allergology, Immunology & Pulmonary Diseases, Fondazione Poliambulanza, ; Brescia, Italy
                [2 ]GRID grid.415090.9, ISNI 0000 0004 1763 5424, Departmental Unit of Pneumology & Allergology, Fondazione Poliambulanza Istituto Ospedaliero, ; Via Bissolati, 57, 25100 Brescia, Italy
                [3 ]Allergy Outpatients Clinic, Turin, Italy
                [4 ]GRID grid.11696.39, ISNI 0000 0004 1937 0351, Ospedale Santa Chiara and Department of Cellular, Computational and Integrative Biology (CIBIO), , University of Trento, ; Trento, Italy
                [5 ]GRID grid.66875.3a, ISNI 0000 0004 0459 167X, Thoracic Disease Research Unit, Mayo Clinic, ; Rochester, MN USA
                [6 ]GRID grid.5395.a, ISNI 0000 0004 1757 3729, Department of Clinical and Experimental Medicine, Section of Pediatrics, , University of Pisa, ; Pisa, Italy
                [7 ]GRID grid.448878.f, ISNI 0000 0001 2288 8774, Department of Clinical Immunology and Allergology, , I.M. Sechenov First Moscow State Medical University, ; Moscow, Russia
                [8 ]Allergy and Pneumology Outpatient Clinic, Bergamo, Italy
                Author information
                http://orcid.org/0000-0002-7831-921X
                Article
                Publisher ID: 75
                DOI: 10.1186/s40733-021-00075-z
                PMC ID: 8279806
                PubMed ID: 34261543
                SO-VID: 2b9ea4fd-43ee-411a-bbe3-730edc635075
                Copyright © © The Author(s) 2021
                License:

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                Date received : 29 March 2021
                Date accepted : 29 June 2021
                Categories
                Subject: Review
                Custom metadata
                issue-copyright-statement © The Author(s) 2021

                Keywords: sars-cov-2,covid-19,asthma,phenotypes,therapy,biological agents,biologics,immunotherapy
                Data availability:
                Keywords: sars-cov-2, covid-19, asthma, phenotypes, therapy, biological agents, biologics, immunotherapy

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