Clinical features in patients with COVID-19 treated with biologics for severe asthma

Abstract

BackgroundFew studies have reported the clinical features of patients with coronavirus disease 2019 (COVID-19) who were treated with biologics for severe asthma (SA). ObjectiveTo elucidate the clinical features and mutual interaction between COVID-19 and SA in terms of disease severity during the Omicron epidemic. MethodsA retrospective study among patients with SA who received any biologic therapy from January 2022 to February 2023 at Jikei University Hospital (Tokyo, Japan) was performed. ResultsAmong 99 patients with SA, 22 women and 6 men suffered from COVID-19, and one woman was reinfected. The severity of COVID-19 was mild in 26 cases and moderate in 3. The number of vaccinations among patients with mild COVID-19 was significantly higher than that among patients with moderate COVID-19 (3.0 ± 1.4 vs. 1.0 ± 1.0, P = 0.03). Asthmatic exacerbations (AExs) were mild in 9 and moderate in 7 cases. The severity of AExs was significantly associated with the Asthma Control Test (ACT) score at baseline (no/mild/moderate exacerbation = 23.0 ± 2.3/18.1 ± 5.3/15.0 ± 4.3, respectively, P = 0.004, Kruskal‒Wallis test). By means of a multivariate logistic regression analysis, a lower number of vaccinations was a significant risk factor for COVID-19 progression [odds ratio 0.64 (0.46-0.91), P=0.006]. ConclusionDuring the Omicron epidemic, the onset and severity of COVID-19 were related to the number of vaccinations, and the severity of AExs caused by COVID-19 was associated with the ACT score at baseline and the number of vaccinations but not with the use of biologics.