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Eosinophilia in Asthma Patients Is Protective Against Severe COVID-19 Illness.
Ferastraoaru, Denisa; Hudes, Golda; Jerschow, Elina; Jariwala, Sunit; Karagic, Merhunisa; de Vos, Gabriele; Rosenstreich, David; Ramesh, Manish.
Afiliación
  • Ferastraoaru D; Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY. Electronic address: dferastr@montefiore.org.
  • Hudes G; Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY.
  • Jerschow E; Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY.
  • Jariwala S; Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY.
  • Karagic M; Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY.
  • de Vos G; Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY.
  • Rosenstreich D; Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY.
  • Ramesh M; Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY.
J Allergy Clin Immunol Pract ; 9(3): 1152-1162.e3, 2021 03.
Article en En | MEDLINE | ID: mdl-33495097
BACKGROUND: There is a paucity of information on coronavirus disease 2019 (COVID-19) outcomes in asthmatics. OBJECTIVE: To identify risk factors associated with admission and subsequent mortality among COVID-19-infected asthmatics. METHODS: Adults at our institution with a positive polymerase chain reaction for COVID-19 between March 14 and April 27, 2020, were retrospectively identified. Comorbidities, laboratory results, and mortality rates during hospitalization were recorded. RESULTS: In total, 737 of 951 (77.5%) asthma patients with COVID-19 were seen in the emergency department (ED), and 78.8% of these ED patients (581 of 737) were admitted. Individuals with previously measured mean absolute eosinophil counts (AEC) ≥150 cells/µL were less likely to be admitted (odds ratio [OR] = 0.46, 95% confidence interval [CI]: 0.21-0.98, P = .04), whereas concomitant heart failure (CHF), chronic kidney disease (CKD), and chronic obstructive pulmonary disease (COPD) were risk factors for admission. Hospitalized patients with asthma with peak hospital-measured AEC ≥150 cells/µL (n = 104) were less likely to die compared with those whose AEC remained <150 cells/µL (n = 213) (mortality rate 9.6% vs 25.8%; OR = 0.006, 95% CI: 0.0001-0.64, P = .03). This group had also higher preadmission mean AEC (237 ± 181 vs 163 ± 147 cells/µL, P = .001, OR = 2012, 95% CI: 27.3-14,816). The mortality rate in patients with asthma alone (no associated CHF, CKD, COPD, diabetes, or hypertension) was similar to that of patients without asthma or any of these comorbidities. CONCLUSIONS: In asthmatics, pre-existing eosinophilia (AEC ≥150 cells/µL) was protective from COVID-19-associated admission, and development of eosinophilia (AEC ≥150 cells/µL) during hospitalization was associated with decreased mortality. Preadmission AEC influenced the AEC trend during hospitalization. Having a Th2-asthma phenotype might be an important predictor for reduced COVID-19 morbidity and mortality that should be further explored in prospective and mechanistic studies.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Asma / Eosinofilia / COVID-19 / Hospitalización Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Allergy Clin Immunol Pract Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Asma / Eosinofilia / COVID-19 / Hospitalización Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Allergy Clin Immunol Pract Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos