Meta-Analysis the Effect of Asthma Comorbidity on the Mortality of COVID-19 Patients
Abstract
Background: COVID-19 is an infectious disease that spread throughout the world in December 2019. The risk factors for mortality of COVID-19 patients depend on comorbid diseases. Most of the comorbid diseases associated with COVID-19 deaths consist of hypertension, diabetes, obesity, cardiovascular disease, chronic obstructive pulmonary disease, chronic kidney disease, and asthma. This study aims to analyze the effect of comorbid asthma on mortality in COVID-19 patients.
Subjects and Method: This research is a meta-analysis study using PRISMA flowchart guidelines. The article search process was carried out between 2020-2021 using databases from PubMed, Google Scholar, and Scopus. Based on the database, there were 15 articles that met the inclusion criteria. The analysis was carried out using the RevMan 5.3 software.
Results: The 15 articles reviewed in the meta-analysis showed that comorbid asthma increased the mortality risk of COVID-19 patients and was statistically significant (aOR = 1.18; 95% CI = 1.02 to 1.36; p = 0.030).
Conclusion: Asthma comorbidities increase the mortality of COVID-19 patients.
Keywords: Asthma, mortality, COVID-19, SARS-CoV 2
Correspondence:
References
Abrams EM, Szefler SJ (2020). Managing asthma during COVID-19: an example for other chronic conditions in children and adolescents. J Pediatr. 222: 221-226. DOI: https://doi.org/10.1016/j.jpeds.2020.04.049
Almazeedi S, Al-Youha S, Jamal MH, Al-Haddad M, Al-Muhaini A, Al-Ghimlas F, Al-Sabah S (2020). Characteristics, risk factors and outcomes among the first consecutive 1096 patients diagnosed with COVID-19 in Kuwait. EclinicalMedicine. 24 (2020): 100448. DOI: 10.1016/j.eclinm.2020.100448.
Almirall A, Kostov B, Mas-Heredia M, Vilanova-Rotllan S, Sequeira-Aymar E, Sans-Corrales M, Sant-Arderiu E, et al. (2020). Prognostic factors in Spanish COVID-19 patients: A case series from Barcelona. PLoS One. 15(8): e0237960. DOI: 10.1371/journal.pone.0237960.
Arshad S, Kilgore P, Chaudhry ZS, Jacobsen G, Wang DD, Huitsing K, Brar I, et al (2020). Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19. Int J Infect Dis. 97: 396-403. DOI: 10.1016/j.ijid.2020.06.099.
Atkins JL, Masoli JAH, Delgado J, Pilling LC, Kuo CL, Kuchel GA, Melzer D (2020). Preexisting Comorbidities Predicting COVID-19 and Mortality in the UK Biobank Community Cohort. J Gerontol A Biol Sci Med Sci. 75(11): 2224-2230. DOI: 10.1093/gerona/glaa183.
Beltramo G, Cottenet J, Mariet AS, Georges M, Piroth L, Tubert-Bitter P, Bonniaud P, et al. (2021). Chronic respiratory diseases are predictors of severe outcome in COVID-19 hospitalised patients: a nationwide study. Eur Respir J. 2004474. DOI: 10.1183/13993003.04474-2020.
Bennett KE, Mullooly M, O'Loughlin M, Fitzgerald M, O'Donnell J, O'Connor L, Oza A, et al. (2021). Underlying conditions and risk of hospitalisation, ICU admission and mortality among those with COVID-19 in Ireland: a national surveillance study. Lancet Reg Health Eur. 100097. DOI: 10.10-16/j.lanepe.2021.100097.
Calmes D, Graff S, Maes N, Frix AN, Thys M, Bonhomme O, Berg J, et al. (2020) Asthma and copd are not risk factors for icu stay and death in case of sars-cov2 infection. J Allergy Clin Immunol Pract. 9(1): 160-169. DOI: 10.10-16/j.jaip.2020.09.044.
Carli G, Cecchi L, Stebbing J, Parronchi P, Farsi A (2021). Is asthma protective against COVID-19? Allergy. 2021(76): 866-936. DOI: 10.1111/all.14426.
Castro MC, Gurzenda S, Mac
Centers for Disease Control and Prevention (2020). Coronavirus disease 2019 (COVID-19). Retrieved from: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-higher-risk.html.
Charoenngam N, Alexanian SM, Apovian CM, Holick MF (2020). Association between hyperglycemia at hospital presentation and hospital outcomes in covid-19 patients with and without type 2 diabetes: a retrospective cohort study of hospitalized innercity
COVID-19 patients. Nutrients. 13(7): 2199. DOI: 10.3390/nu13072199.
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y et al. (2020). Epidemio-logical and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 395(10223): 507-513. DOI: 10.1016/S0140-6736(20)30211-7.
Choi YJ, Park JY, Lee HS, Suh J, Song JY, Byun MK, Cho JH, et al. (2020). Effect of asthma and asthma medication on the prognosis of patients with COVID-19. Eur Respir J. 57(3): 200-2226. DOI: 10.1183/13993003.0-2226-2020.
Corcoles A, Satue-Graciaa E, Vila-Rovirab A, Diego-Cabanesa C, Forcadell-Perisa MJ, Ochoa-Gondar O (2020). Development of a predictive prognostic rule for early assessment of COVID-19 patients in primary care settings. Atencion Primaria. 53 (2021): 102-118. DOI: https://doi.org/10.1016/j.aprim.2021.102118.
Cummins L, Ebyarimpa I, Cheetham N, Tzortziou Brown V, Brennan K, Panovska-Griffiths J (2021). Factors associated with COVID-19 related hospitalisation, critical care admission and mortality using linked primary and secondary care data. Influenza Other Respir Viruses. 15(5): 577-588. DOI: 10.1111/irv.12864.
Fang X, Li S, Yu H, Wang P, Zhang Y, Chen Z, Li Y, et al. (2020). Epidemiological, comorbidity factors with severity and prognosis of COVID-19: A syste-matic review and meta-analysis. Aging. 12(13): 12493
Fong WCG, Borca F, Phan H, Moyses HE, Dennison P, Kurukulaaratchy RJ, Haitchi HM (2021). Asthma did not increase in-hospital COVID-19-related mortality in a tertiary UK hospital. Clin Exp Allergy. 51(7): 939-941. DOI: 10.1111/cea.13855.
G, Greco M, Zanella A, Albano G, Antonelli M, Bellani G, Bonanomi E, et al. (2020). Risk factors associated with mortality among patients with covid-19 in intensive care units in Lombardy, Italy. JAMA Intern Med. 180(10): 1345-1355. DOI: 10.1001/jamainternmed.2020.3539.
Huang K, Yang T, Xu J, Yang L, Zhao J, Zhang X, Bai C, et al. (2019). Preva-lence, risk factors, and management of asthma in China: a national cross-sectional study. Lancet. 394(10196): 407-418. DOI: 10.1016/S01406736(19)31147-X.
Huang C, Wang Y, Li W, Ren L, Zhao J, Hu Y, Zang L, et al. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 395(10223): 497-506. DOI: 10.1016/S01406736(20)30183-5.
Izurieta HS, Graham DJ, Jiao Y, Hu M, Lu Y, Wu Y, Chillarige Y, Wernecke et al. (2021). Natural history of coronavirus disease 2019: risk factors for hospitalizations and deaths among 26 million us medicare beneficiaries. J Infect Dis. 223(6): 945-956. DOI: 10.1093/infdis/jiaa767.
Jackson DJ, Busse WW, Bacharier LB, Kattan M, O'Connor GT, Wood RA, Visness CM, et al. (2020). Association of respiratory allergy, asthma, and expression of the SARS-CoV-2 receptor ACE2. J Allergy Clin Immunol. 146(1): 203-206.e3. DOI: 10.1016/j.jaci.2020.04.009.
Kar S, Chawla R, Haranath SP, Ramasubban S, Ramakrishnan N, Vaishya R, Sibal A, et al. (2020). Multivariable mortality risk prediction using machine learning for COVID 19 patients at admission (AICOVID). Sci Rep. 11(12801). DOI: https://doi.org/10.1038/s41598-021-92146-7.
Kelly JD, Bravata DM, Bent S, Wray CM, Leonard SJ, Boscardin WJ, Myers LJ, et al. (2021). Association of social and behavioral risk factors with mortality among US veterans with COVID-19. JAMA network open. 4(6), e2113031. https://DOI.org/10.1001/jamanetworkopen.2021.13031
Ken-Dror G, Wade C, Sharma S, Law J, Russo C, Sharma A, Joy E, et al. (2020). COVID-19 outcomes in UK centre within highest health and wealth band: a prospective cohort study. BMJ Open. 10(11): e042090. DOI: 10.1136/bmjopen-2020-042090.
Kim D, Adeniji N, Latt N, Kumar S, Bloom PP, Aby ES, Perumalswami P (2021). Predictors of Outcomes of COVID-19 in Patients with Chronic Liver Disease: US Multicenter Study. Clin Gastroenterol Hepatol. 19(7): 1469
Kurniawati O, Prasetya H, Murti B (2021). Meta-analysis the effects of obesity and type 2 diabetes mellitus on COVID-19 mortality. J Epidemiol Public Health. 06(02): 177-191. DOI: https://doi.org/10.26911/jepublichealth.2021.06.02.05.
La-Pena JE, Rascon-Pacheco RA, Ascencio-Montiel IJ, Gonzalez-Figueroa E, Fernandez-Garate JE, Medina-Gomez OS, Borja-Bustamante P (2021). Hypertension, diabetes and obesity, major risk factors for death in patients with COVID-19 in Mexico. Arch Med Res. 52(4): 443-449. DOI: 10.1016/j.arcmed.2020.12.002.
Lee SC, Son KJ, Han CH, Jung JY, Park S (2020). Impact of comorbid asthma on severity of coronavirus disease (COVID-19). Sci Rep. 2020(10): 21-805. DOI: 10.1038/s41598-020-77791-8.
Lohia P, Sreeram K, Nguyen P, Choudhary A, Khicher S, Yarandi H, et al. (2021). Preexisting respiratory diseases and clinical outcomes in COVID-19: a multihospital cohort study on predominantly African American population. Respir Res. 2021(22): 37. DOI: 10.1186/s12931-021-01647-6.
Li X, Xu S, Yu M, Wang K, Tao Y, Zhou Y, Tao Y, et al. (2020). Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol. 110-118. DOI: https://doi.org/10.1016/j.jaci.2020.04.006.
Martos-Ben
Mato AR, Roeker LE, Lamanna N, Allan JN, Leslie L, Pagel JM, Patel K, et al. (2020). Outcomes of COVID-19 in patients with CLL: a multicenter international experience. Blood. 136-(10): 1134-1143. DOI: 10.1182/blood.2020006965.
Mulhem E, Oleszkowicz A, Lick D (2021). 3219 hospitalised patients with COVID-19 in Southeast Michigan: a retrospective case cohort study. BMJ Open 2021(11): e042042. DOI: 10.1136/bmjopen-2020-042042.
Osibogun A, Balogun M, Abayomi A, Idris J, Kuyinu Y, Odukoya O, et al. (2021). Outcomes of COVID-19 patients with comorbidities in southwest Nigeria. PLoS One 2021(16): e0248281. DOI: https://DOI.org/10.1371/journal.pone.0248281.
Park BE, Lee JH, Park HK, Kim HN, Jang SY, Bae MH, Yang DH, et al. (2021). Impact of cardiovascular risk factors and cardiovascular diseases on outco-mes in patients hospitalized with COVID-19 in Daegu Metropolitan City. J Korean Med Sci. 36(2): e15. DOI: 10.3346/jkms.2021.36.e15.
Parra-Bracamonte GM, Lopez-Villalobos N, Parra-Bracamonte FE (2020). Clinical characteristics and risk factors for mortality of patients with COVID-19 in a large data set from Mexico. Ann Epidemiol. 2020(52): 93-98.e2. DOI: 10.1016/j.annepidem.2020.08.005.
Perez-Guzman PNP, Daunt A, Mukherjee S, Crook P, Forlano R, Kont MD, et al. (2020). Clinical characteristics and predictors of outcomes of hospitalized patients with coronavirus disease 2019 in a multiethnic london national health service trust: a retrospective cohort study. Clin Infect Dis. 2020 (ciaa1091): 1-11. DOI: https://DOI.org/10.1093/cid/ciaa1091.
Peters MC, Sajuthi S, Deford P, Christenson S, Rios CL, Montgomery MT, Woodruff PG, et al. (2020). COVID-19-rela-ted Genes in Sputum Cells in Asthma. Relationship to Demographic Features and Corticosteroids. Am J Respir Crit Care Med. 202(1): 83-90. DOI: 10.1164/rccm.202003-0821OC.
Robles-P
Rosa FG, Palazzo A, Rosso T, Shbaklo N, Mussa M, Boglione L, et al. (2021). Risk factors for mortality in COVID-19 hospitalized patients in Piedmont, Italy: results from the multicenter, regional, CORACLE registry. J. Clin. Med. 10(9): 1951. DOI: https://DOI.org/10.3390/jcm10091951
Ruan Q, Yang K, Wang W, Jiang L, Song J (2020). Clinical predictors of morta-lity due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 46: 846
Shi S, Qin M, Shen B, Cai Y, Liu T, Yang, Gong W, et al. (2021). Association of cardiac injury with mortality in hospitalized patients with covid-19 in Wuhan, China. JAMA Cardiol. 5(7): 802-810. DOI:10.1001/jamacardio.2020.0950.
Shin EK, Choi HY, Hayes N (2021). The anatomy of COVID-19 comorbidity networks among hospitalized Korean patients. Epidemiol Health. 2021(43): e2021035. DOI: 10.4178/epih.e2021-035.
Song J, Park DW, Cha J, Seok H, Kim JY, Park J, Cho H (2020). Clinical course and risk factors of fatal adverse outcomes in COVID 19 patients in Korea: a nationwide retrospective cohort study. Sci Rep. 11(10066). DOI: 10.1038/s41598-021-89548-y.
Sticchi A, Cereda A, Toselli M, Esposito A, Palmisano A, Vignale D, Nicoletti V, et al. (2021). Diabetes and mortality in patients with COVID-19: Are we missing the link? Anatol J Cardiol. 25(6): 376-9 DOI:10.5152/Anatol-JCardiol.2021.29132.
Sun Y, Guan X, Jia L, Xing N, Cheng L, Liu B, Zhang S, et al. (2020). Independent and combined effects of hypertension and diabetes on clinical outcomes in patients with COVID-19: A retrospective cohort study of Huoshen Mountain Hospital and Guanggu Fangcang Shelter Hospital. J Clin Hypertens. 2021(23): 218
Sunjaya AP, Allida SM, Di Tanna GL, Jenkins C (2021). Asthma and risk of infection, hospitalization, ICU admission and mortality from COVID-19: Systematic review and meta-analysis. J Asthma. 1:1-14. DOI: 10.1080/0277-0903.2021.1888116.
Topless RK, Phipps-Green A, Leask M, Dalbeth N, Stamp LK, Robinson PC, Merriman TR (2021). Gout, rheumatoid arthritis, and the risk of death related to coronavirus disease 2019: an analysis of the UK Biobank. ACR Open Rheumatol. 3(5): 333-340. DOI: 10.1002/acr2.11252.
Trabulus S, Karaca C, Balkan II, Dincer MT, Murt A, Ozcan SG, Karaali R, et al. (2020). Kidney function on admission predicts in-hospital mortality in COVID-19. PLoS One. 15(9): e0238680. DOI: 10.1371/journal.pone.0238680.
Vaughn VM, Gandhi TN, Petty LA, Patel PK, Prescott HC, Malani AN, Ratz D, et al. (2021). Empiric antibacterial therapy and community-onset bacterial coinfection in patients hospitalized with coronavirus disease 2019 (COVID-19): a multi-hospital cohort study. Clin Infect Dis. 72(10): e533-e541. DOI: 10.1093/cid/ciaa1239.
WHO (2020a). COVID-19 Weekly Epidemiological Update 22. World Health Organization. 1
Williamson EJ, Walker AJ, Bhaskaran K, Bacon S, Bates S, Morton CE, Curtis HJ (2020). Factors associated with COVID-19-related death using Open-SAFELY. Nature. 584: 430
Xu X, Yu C, Qu J, Zhang L, Jiang S, Huang D, Chen B, et al. (2020). Imaging and clinical features of patients with 2019 novel coronavirus SARS-CoV-2. Eur J Nucl Med Mol Imaging. 47(5): 1275-1280. DOI: 10.1007/s00259-020-04-735-9.
Yehia BR, Winegar A, Fogel R, Fakih M, Ottenbacher A, Jesser C, Bufalini A, et al. (2020). Association of race with mortality among patients hospitalized with coronavirus disease 2019 (COVID-19) at 92 US Hospitals. JAMA Netw Open. 3(8): e2018039. DOI: 10.1001/jamanetworkopen.2020.18-039
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, et al. (2020). Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 395(10229): 1054-1062. DOI: 10.1016/S01406736(20)305663.
