Severity of COVID-19 in hospitalized patients with and without atopic disease☆

Abstract

\n Background\n Data from the 2009 influenza pandemic suggested asthma might protect from severe disease in hospitalized patients. Asthma does not appear to increase risk for hospitalization or mortality with COVID-19.\n \n Objective\n This study was undertaken to see if atopy actually protected those hospitalized with COVID-19.\n \n Methods\n Retrospective chart review on all patients testing positive for SARS-CoV-2 over 2\xa0months\xa0at a major adult and pediatric tertiary referral center hospital. Charts were evaluated for history of atopic disease, as were the need for ICU admission, requirement for supplemental oxygen and/or intubation, and in hospital mortality.\n \n Results\n No significant differences in outcomes for patients (n\xa0=\xa0275) based on atopic disease were noted: ICU admission, 43% versus 44.7% (atopic versus no atopic disease, respectively; p\xa0=\xa00.84); supplemental oxygen use, 79.1% versus 73.6% (p\xa0=\xa00.36); intubation rate, 35.8% versus 36.5% (p\xa0=\xa00.92); and mortality rate, 13.4% versus 20.7% (p\xa0=\xa00.19). More patients with atopic disease had COPD listed as a diagnosis in their chart (38.8% versus 17.3%, p\xa0<\xa00.001). COPD was associated with an increased rate of ICU admission (aOR\xa0=\xa02.22 (1.15, 4.30) p\xa0=\xa00.02) and intubation (aOR\xa0=\xa02.05 (1.07, 3.92) p\xa0=\xa00.03). After adjusting for COPD, patients with atopic disease had a trend for reduced mortality (aOR 0.55 (0.23, 1.28), p\xa0=\xa00.16), but those with asthma did not (p\xa0>\xa00.2).\n \n Conclusion\n Severity of COVID-19 in hospitalized patients does not differ based on atopic status. However, adjusting for presence of COPD led to a suggestion of possible reduced severity in patients with atopy but not asthma.\n