What is the introduction?
Managing and preventing respiratory illnesses like the SARS-CoV-2 pandemic is crucial for those with predisposing respiratory conditions, such as asthma.
Materials and Methods
Loma Linda University Health Institutional Review Board approved the retrospective study, which was conducted in accordance with the Declaration of Helsinki. The study included data from a single academic center in the United States from January 2020 to March 2021, including COVID-19 diagnosis, admission to an emergency room, and use of biologics. No exclusion criteria were used for this study. Severe asthmatics were compared to less severe asthmatic individuals.
The analysis of data was carried out in SPSS 28.0.0, with categorical variables containing percentages and continuous variables including means or medians (range) to summarize patients’ characteristics. The normality of variables was assessed using the Shapiro test and box plots. To examine the association between hospitalization and use of biologics/no, 2 analysis was used. Set at p -0.05.
What are the consequences?
Of the 189 patients who met the inclusion criteria, 28.8% were on biologics and 72% were not. The ER visit sample included 75 females with 75 males, while 54% took the ICU trip.
The comparison of COVID-19 hospital infections among asthmatics and severe asthmatic patients is presented in Table 1.
Hospitalization rates for severe asthmatics are shown in Table 2.
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The analysis of chart data indicated that severe asthmatics had a lower risk of hospitalization due to COVID-19 and less likely to develop severe illness. This could be attributed to the depressed immunoresponse associated with biologic therapy and cytokine-release storm, which was also observed in Italy in 2020. Prior studies have suggested that dupilumab can reduce IL4 and ILD13 levels, leading to less severe COV-19 reactions and improved survival rates among those on this treatment.7,8 As
During our study period, 13.2% of severe asthmatics who were admitted to the hospital did not seek medical attention. Of those admitted on mepolizumab and reslizumabe, only one (one from each group) required mechanical ventilation for an average of 10.2 days. Additionally, patients receiving omalizumeb were hospitalized in general wards for 4.13 days due to their use of these biologics.
Several limitations of this research need to be assessed in future studies including the lack of analysis of vaccination status and comorbidities, which may have caused differences in hospitalization rates among severe asthmatics.
Our study found that severe asthmatics had a lower risk of being hospitalized due to COVID-19 infections compared to those who did not require biologics. We believe that enhanced preventive measures and immunosuppression may have contributed to the lower incidence of serious COV-19 cases in this cohort. However, multicenter studies are necessary to better reflect differences among patient populations across different geographic areas and hospital settings. Further investigations are needed to factor in sex and comorbidity differences.