Are Asthma and COPD Risk Factors for Poor Outcomes in COVID-19? A Single-center Observational Study in the South of Iran
Abstract
Asthma and Chronic Obstructive Pulmonary Disease (COPD) are prevalent chronic respiratory conditions that may impact clinical outcomes in patients with COVID-19. This study aimed to evaluate the influence of asthma and COPD on the outcomes of hospitalized COVID-19 patients.
This retrospective observational study, conducted in 2021 at Shahid Mohammadi Hospital, Bandar Abbas, Iran, included 1777 COVID-19 patients. Data on demographics, comorbidities, and clinical parameters were retrieved from the hospital’s COVID-19 registry. Logistic regression analysis was used to evaluate the impact of asthma and COPD on clinical outcomes.
Asthma was diagnosed in 83 patients (4.7%) and COPD in 19 patients (1.0%), with a mean age of 50.5 ± 17.5 years. The mortality rate was highest in the COPD group (31.6%), followed by the asthma group (20.5%) and the group without obstructive diseases (13.5%). No significant differences were found in intensive care unit (ICU) admission, mechanical ventilation, or mortality associated with asthma or COPD. Age and comorbidities were significant factors influencing mortality.
This study found no significant impact of asthma or COPD on ICU admission, mechanical ventilation, or mortality rates among hospitalized COVID-19 patients.
2. Gerayeli FV, Milne S, Cheung C, Li X, Yang CWT, Tam A, et al. COPD and the risk of poor outcomes in COVID-19: A systematic review and meta-analysis. EClinicalMedicine. 2021;33:100789.
3. Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA. 2020;323(20):2052-9.
4. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239-42.
5. Castaldi PJ, San José Estépar R, Mendoza CS, Hersh CP, Laird N, Crapo JD, et al. Distinct quantitative computed tomography emphysema patterns are associated with physiology and function in smokers. Am J Respir Crit Care Med. 2013;188(9):1083-90.
6. Hersh CP, Washko GR, Estépar RS, Lutz S, Friedman PJ, Han MK, et al. Paired inspiratory-expiratory chest CT scans to assess for small airways disease in COPD. Respir Res. 2013;14(1):42.
7. Estépar RS, Kinney GL, Black-Shinn JL, Bowler RP, Kindlmann GL, Ross JC, et al. Computed tomographic measures of pulmonary vascular morphology in smokers and their clinical implications. Am J Respir Crit Care Med. 2013;188(2):231-9.
8. Cloutier MM, Baptist AP, Blake KV, Brooks EG, Bryant-Stephens T, DiMango E, et al. 2020 Focused Updates to the Asthma Management Guidelines: A Report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group. J Allergy Clin Immunol. 2020;146(6):1217-70.
9. Halpin DMG, Singh D, Hadfield RM. Inhaled corticosteroids and COVID-19: a systematic review and clinical perspective. Eur Respir J. 2020;55(5).
10. Leung JM, Yang CX, Tam A, Shaipanich T, Hackett TL, Singhera GK, et al. ACE-2 expression in the small airway epithelia of smokers and COPD patients: implications for COVID-19. Eur Respir J. 2020;55(5).
11. Hansen ES MA BV, Andersen MP, Kober L, Kragholm K, Torp-Pedersen C. Severe outcomes of COVID-19 among patients with COPD and asthma. ERJ Open Res. 2021;Jan.
12. Janjani H AM, Yunesian M. Risk factors affecting the mortality of COVID-19 patients: impacts of modifiable factors. Iranian Journal of Health and Environment. 2021;140.
13. Chen L YJ, He W, Chen L, Yuan G, Dong F, ., et al. Risk factors for death in 1859 subjects with COVID-19. Leukemia. 2020;340.
14. Leung JM YC, Tam A, Shaipanich T, Hackett TL, Singhera GK, ., et al. ACE-2 expression in the small airway epithelia of smokers and COPD patients: Implications for COVID-19. Europ Resp J. 2020;55.
15. Ikram AS, Pillay S. Admission vital signs as predictors of COVID-19 mortality: a retrospective cross-sectional study. BMC Emerg Med. 2022;22(1):68.
16. Udompongpaiboon P, Reangvilaikul T, Vattanavanit V. Predicting mortality among patients with severe COVID-19 pneumonia based on admission vital sign indices: a retrospective cohort study. BMC Pulm Med. 2023;23(1):342.
17. Calmes D GS MN, Frix AN, Thys M, Bonhomme O, Berg J, Debruche M, Gester F, Henket M, Paulus V. Asthma and COPD are not risk factors for ICU stay and death in case of SARS-CoV-2 infection. J Allergy Clin Immunol Pract. 2021;9(1):160-169.
18. Lacedonia D SG, Santomasi C, Fuso P, Carpagnano GE, Portacci A, et al. Impact of smoking, COPD and comorbidities on the mortality of COVID-19 patients. Sci Rep. 2021.
19. Wang L FD, Bates DW, Boyce JA, Zhou L. Risk factors for hospitalization, intensive care, and mortality among patients with asthma and COVID-19. J Allergy Clin Immunol. 2020.
20. Parohan M, Yaghoubi S, Seraji A, Javanbakht MH, Sarraf P, Djalali M. Risk factors for mortality in patients with Coronavirus disease 2019 (COVID-19) infection: a systematic review and meta-analysis of observational studies. Aging Male. 2020;23(5):1416-24.
21. Jawad Hashim M, Alsuwaidi AR, Khan G. Population risk factors for COVID-19 mortality in 93 countries. J Epidemiol Glob Health. 2020;10(3):204-8.
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Issue | Vol 24 No 2 (2025) | |
Section | Original Article(s) | |
Keywords | ||
Asthma Chronic obstructive pulmonary disease COVID-19 Mortality Risk factors |
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