Abstract
Background: There is controversial evidence of the associations of asthma and chronic obstructive pulmonary disease (COPD) with the risk and outcomes of Coronavirus Disease 2019 (COVID-19). We aimed to evaluate the effects of asthma and COPD on the susceptibility to and severity of COVID-19. Methods: Data from a nationwide COVID-19 cohort database by the Korea National Health Insurance Corporation were utilized. A total of 4066 COVID-19 patients (1 January 2020 through 4 June 2020) were 1:4 matched with 16,264 controls with regard to age, sex, and income. Asthma and COPD were defined as diagnostic codes (ICD-10) and medication claim codes. Conditional and unconditional multivariate logistic regression were applied to analyze the susceptibility to and severity of COVID-19 associated with asthma and COPD. Results: The prevalence of mild and severe asthma/COPD did not differ between the COVID-19 and control patients in the multivariate analyses. Among the total 4066 COVID-19 patients, 343 (8.4%) had severe COVID-19, of whom 132 (3.2% of the total COVID-19 patients) died. Regarding the outcomes of COVID-19, neither mild nor severe asthma were associated with the severity or mortality of COVID-19 after adjusting for other variables. However, severe COPD was a significant risk factor for severe COVID-19 (odds ratio (OR) = 2.23, 95% confidence intervals (CI): 1.08–4.60, p = 0.030) and the mortality of COVID-19 in the multivariate analyses (OR = 3.06, 95% CI: 1.14–8.2, p = 0.026). Conclusions: In a Korean nationwide cohort, neither asthma nor COPD were associated with COVID-19, but severe COPD was associated with the severity and mortality of COVID-19.
Highlights
The COVID-19 pandemic is ongoing worldwide with global vaccination efforts
NHID-COVID DB provided the data of individuals who underwent SARS-CoV-2 testing using real-time reverse transcriptase–PCR assay of nasal or pharyngeal swabs in accordance with the WHO guidelines, and control patients were proportionally sampled from the database of Korean
The baseline characteristics of the COVID-19 and control patients were well balanced according to age, sex, and income Non-smokers were more common in the control groups, but alcohol consumption was more frequent in the COVID-19 groups (p < 0.001)
Summary
The COVID-19 pandemic is ongoing worldwide with global vaccination efforts This pandemic is of particular concern for patients with chronic respiratory diseases because it is already known that respiratory virus infections are associated with more severe outcomes in these patients [1]. A severe form of COVID-19 invades the lungs, and COVID-19 could be deadly, especially in patients with compromised lung function Because of these concerns, several studies have tried to clarify the association between chronic lung disease and excess risk for contracting COVID-19 and severe outcomes due to COVID-19. Conditional and unconditional multivariate logistic regression were applied to analyze the susceptibility to and severity of COVID-19 associated with asthma and COPD. Results: The prevalence of mild and severe asthma/COPD did not differ between the COVID-19 and control patients in the multivariate analyses.
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