Clinical outcomes among hospitalized US adults with asthma or chronic obstructive pulmonary disease, with or without COVID-19

• Type of Material: Article
• Authors: Cheryl R. Cornwell, Oak Ridge Institute for Science and Education; Joy Hus, Centers for Disease Control and Prevention; Lindsay K. Tompkins, Centers for Disease Control and Prevention; Audrey F. Pennington, Centers for Disease Control and Prevention; W Dana Flanders, Emory University; kanta Sircar, Centers for Disease Control and Prevention
• Language: English
• Date: 2021-12-29
• Publisher: Taylor & Francis
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: this work was authored as part of the Contributor’s official duties as an Employee of the united states Government and is therefore a work of the united states Government.In accordance with 17 usC. 105, no copyright protection is available for such works under us law.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): https://doi.org/10.1080/02770903.2021.2018703
• Title of Journal or Parent Work: Asthma Outcomes
• Volume: 59
• Issue: 12
• Start Page: 2509
• End Page: 2519
• Grant/Funding Information: The author(s) reported there is no funding associated with the work featured in this article.
• Keywords: COVID-19; asthma–COPD overlap; Asthma; chronic obstructive pulmonary disease
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Objective: This study assesses the risk of severe clinical outcomes during hospitalizations of adults with asthma and/or COPD plus COVID-19 and compares those risks with those during hospitalizations of adults with asthma and/or COPD without COVID-19. Methods: We used data from 877 U.S. hospitals from the Premier Healthcare Database during March 2020–March 2021. Hospitalizations (n = 311,215) among patients aged ≥18 years with an ICD-10-CM diagnosis involving asthma or COPD were classified into three groups: adults with asthma (but not COPD), adults with COPD (but not asthma), and adults with both asthma and COPD. We used multivariable Poisson regression to assess associations of severe clinical outcomes [intensive care unit (ICU) admission, use of invasive mechanical ventilation (IMV), and death] and COVID-19 status. Results: The percentage of hospitalizations among patients with asthma and COVID-19 resulting in ICU admission, IMV, and death were 46.9%, 14.0%, and 8.0%, respectively. These risks were higher than those among patients with asthma without COVID-19 (adjusted risk ratio [aRR], 1.17 [95% confidence interval (CI), 1.14–1.21], 1.61 [95% CI, 1.50–1.73], and 5.56 [95% CI, 4.89–6.32]), respectively. Risks of ICU admission, IMV, and death were also high among patients with COPD and COVID-19 and exceeded the corresponding risks among patients with COPD without COVID-19. Conclusion: Hospitalizations among patients with asthma and/or COPD with COVID-19 had a more severe clinical course than hospitalizations for asthma and/or COPD exacerbations without COVID-19.