Sharmi Biswas, Z. Sarfraz, A. Sarfraz, F. Malanyaon, R. Vijayan, I. Gupta, Uroosa Arif, Muzna Sarfraz, G. Yatzkan, M. Sanchez-Gonzalez
{"title":"COVID-19患者合并哮喘的风险和结局:一项荟萃分析","authors":"Sharmi Biswas, Z. Sarfraz, A. Sarfraz, F. Malanyaon, R. Vijayan, I. Gupta, Uroosa Arif, Muzna Sarfraz, G. Yatzkan, M. Sanchez-Gonzalez","doi":"10.21911/aai.590","DOIUrl":null,"url":null,"abstract":"Objective: The outbreak of SARS-CoV-2 disease (COVID-19) emerged in 2019, and ultimately spread worldwide, being defined as a pandemic by the World Health Organization on March 11, 2020. The respiratory disease related to COVID-19 can range from being asymptomatic to presenting as devastating ARDS and death. The elderly and individuals with comorbidities and immunocompromised states are at a higher risk. Asthma is an inflammatory spasm of the airways with ACE2 overexpression at the alveolar level. ACE2 and TMPRSS2 expression mediate SARS-CoV-2 infection of host lung cells and hence might increase disease susceptibility in asthmatics. Materials and Methods: A literature review was done by searching the databases of Pubmed, WHO, clinicaltrials.gov, and Google Scholar, using the keywords of -COVID-19, SARS-CoV-2, coronavirus, asthma, and their combinations, following the timeline of December 2019 to August 10, 2020. We included patients with asthma diagnosed with COVID-19 while excluding non-COVID-19 patients, pregnant patients, and patients with other diseases or comorbidities. Primary outcomes included mortality and ICU admissions of both groups. Based on the available data, we conducted a meta-analysis via RevMan 5.4 using a random-effects model and 95% confidence intervals. Results: Patients with and without asthma were compared for risk outcomes of mortality. For the 755 COVID-19 patients with asthma and 4969 non-asthmatic COVID-19 patients, we found that the risk of mortality would increase by 9% in the asthmatic group (RR=1.09, CI= 0.58 to 2.03, I2=72%). There was an increased proportion of ICU admissions among the asthmatic group (RR=1.39, CI = 0.80 to 2.42). There was high heterogeneity among the studies (I² = 79%). Medications such as corticosteroids improve the mortality and ICU admission rates. Conclusion: Our results indicate that the number of COVID-19 cases in patients with asthma has been lower than those of the nonasthmatic group. COVID-19 patients with asthma were at increased risk of mortality and ICU admission due to underlying factors or predisposition. Finally, corticosteroids are considered safe and may confer protection against the severity of COVID-19 infection.","PeriodicalId":42004,"journal":{"name":"Astim Allerji Immunoloji","volume":null,"pages":null},"PeriodicalIF":0.3000,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"3","resultStr":"{\"title\":\"Risk and Outcomes of COVID-19 Patients with Asthma: A Meta-Analysis\",\"authors\":\"Sharmi Biswas, Z. Sarfraz, A. Sarfraz, F. Malanyaon, R. Vijayan, I. Gupta, Uroosa Arif, Muzna Sarfraz, G. Yatzkan, M. Sanchez-Gonzalez\",\"doi\":\"10.21911/aai.590\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objective: The outbreak of SARS-CoV-2 disease (COVID-19) emerged in 2019, and ultimately spread worldwide, being defined as a pandemic by the World Health Organization on March 11, 2020. The respiratory disease related to COVID-19 can range from being asymptomatic to presenting as devastating ARDS and death. The elderly and individuals with comorbidities and immunocompromised states are at a higher risk. Asthma is an inflammatory spasm of the airways with ACE2 overexpression at the alveolar level. ACE2 and TMPRSS2 expression mediate SARS-CoV-2 infection of host lung cells and hence might increase disease susceptibility in asthmatics. Materials and Methods: A literature review was done by searching the databases of Pubmed, WHO, clinicaltrials.gov, and Google Scholar, using the keywords of -COVID-19, SARS-CoV-2, coronavirus, asthma, and their combinations, following the timeline of December 2019 to August 10, 2020. We included patients with asthma diagnosed with COVID-19 while excluding non-COVID-19 patients, pregnant patients, and patients with other diseases or comorbidities. Primary outcomes included mortality and ICU admissions of both groups. Based on the available data, we conducted a meta-analysis via RevMan 5.4 using a random-effects model and 95% confidence intervals. Results: Patients with and without asthma were compared for risk outcomes of mortality. For the 755 COVID-19 patients with asthma and 4969 non-asthmatic COVID-19 patients, we found that the risk of mortality would increase by 9% in the asthmatic group (RR=1.09, CI= 0.58 to 2.03, I2=72%). There was an increased proportion of ICU admissions among the asthmatic group (RR=1.39, CI = 0.80 to 2.42). There was high heterogeneity among the studies (I² = 79%). Medications such as corticosteroids improve the mortality and ICU admission rates. Conclusion: Our results indicate that the number of COVID-19 cases in patients with asthma has been lower than those of the nonasthmatic group. COVID-19 patients with asthma were at increased risk of mortality and ICU admission due to underlying factors or predisposition. Finally, corticosteroids are considered safe and may confer protection against the severity of COVID-19 infection.\",\"PeriodicalId\":42004,\"journal\":{\"name\":\"Astim Allerji Immunoloji\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.3000,\"publicationDate\":\"2020-12-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"3\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Astim Allerji Immunoloji\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.21911/aai.590\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ALLERGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Astim Allerji Immunoloji","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.21911/aai.590","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ALLERGY","Score":null,"Total":0}
Risk and Outcomes of COVID-19 Patients with Asthma: A Meta-Analysis
Objective: The outbreak of SARS-CoV-2 disease (COVID-19) emerged in 2019, and ultimately spread worldwide, being defined as a pandemic by the World Health Organization on March 11, 2020. The respiratory disease related to COVID-19 can range from being asymptomatic to presenting as devastating ARDS and death. The elderly and individuals with comorbidities and immunocompromised states are at a higher risk. Asthma is an inflammatory spasm of the airways with ACE2 overexpression at the alveolar level. ACE2 and TMPRSS2 expression mediate SARS-CoV-2 infection of host lung cells and hence might increase disease susceptibility in asthmatics. Materials and Methods: A literature review was done by searching the databases of Pubmed, WHO, clinicaltrials.gov, and Google Scholar, using the keywords of -COVID-19, SARS-CoV-2, coronavirus, asthma, and their combinations, following the timeline of December 2019 to August 10, 2020. We included patients with asthma diagnosed with COVID-19 while excluding non-COVID-19 patients, pregnant patients, and patients with other diseases or comorbidities. Primary outcomes included mortality and ICU admissions of both groups. Based on the available data, we conducted a meta-analysis via RevMan 5.4 using a random-effects model and 95% confidence intervals. Results: Patients with and without asthma were compared for risk outcomes of mortality. For the 755 COVID-19 patients with asthma and 4969 non-asthmatic COVID-19 patients, we found that the risk of mortality would increase by 9% in the asthmatic group (RR=1.09, CI= 0.58 to 2.03, I2=72%). There was an increased proportion of ICU admissions among the asthmatic group (RR=1.39, CI = 0.80 to 2.42). There was high heterogeneity among the studies (I² = 79%). Medications such as corticosteroids improve the mortality and ICU admission rates. Conclusion: Our results indicate that the number of COVID-19 cases in patients with asthma has been lower than those of the nonasthmatic group. COVID-19 patients with asthma were at increased risk of mortality and ICU admission due to underlying factors or predisposition. Finally, corticosteroids are considered safe and may confer protection against the severity of COVID-19 infection.
期刊介绍:
Asthma Allergy Immunology has been published three times a year in April, August and December as the official and periodical journal of the Turkish National Society of Allergy and Clinical Immunology since 2003. All articles published in the journal have been available online since 2003. A peer reviewed system is used in evaluation of the manuscripts submitted to Asthma Allergy Immunology. The official language of the journal is English. The aim of the journal is to present advances in the field of allergic diseases and clinical immunology to the readers. In accordance with this goal, manuscripts in the format of original research, review, case report, articles about clinical and practical applications and editorials, short report and letters to the editor about allergic diseases and clinical immunology are published in the journal. The target reader population of the Asthma Allergy Immunology includes specialists and residents of allergy and clinical immunology, pulmonology, internal medicine, pediatrics, dermatology and otolaryngology as well as physicians working in other fields of medicine interested in allergy and immunological diseases.