Original Article
Asthma and COPD Are Not Risk Factors for ICU Stay and Death in Case of SARS-CoV2 Infection

https://doi.org/10.1016/j.jaip.2020.09.044Get rights and content
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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.

Key words

Asthma
COPD
Risk factors
ICU
Death
COVID19
SARS-CoV2
Viral infection
Severe asthma

Abbreviations used

ACE2
Angiotensin converting enzyme 2
CI
Confidence interval
CK
Creatinine kinase
COPD
Chronic obstructive pulmonary disease
COVID19
Disease due to the novel coronavirus discovered in late 2019 in Wuhan, China, later renamed SARS-CoV2
CRP
C-reactive protein
CT
Computed tomography
FEV1
Forced expiratory volume in 1 second
ICS
Inhaled corticosteroid
ICU
Intensive care unit
LDH
Lactate dehydrogenase
OCS
Oral corticosteroid
OR
Odds ratio
ORF
Open reading frame
PCR
Polymerase chain reaction
SARS-CoV2
Severe acute respiratory syndrome coronavirus 2

Cited by (0)

This study was supported by the Fondation Leon Fredericq, ULiege.

Conflicts of interest: A. Sibille received personal fees from BMS, MSD, AstraZeneca, Boehringer Ingelheim, Roche, and Takeda. R. Louis received grants from GSK, AstraZeneca, Novartis, and Chiesi; and personal fees from GSK, AstraZeneca, and Novartis. F. Schleich received grants from GSK and AstraZeneca; and personal fees from GSK and Chiesi. The rest of the authors declare that they have no relevant conflicts of interest.