COVID-19 in severe asthma treated with omalizumab: The Maltese perspective

Abstract

INTRODUCTION SARS-CoV-2 was identified as the causative agent of the COVID-19 pandemic, which has been the focus of extensive research for over a year. Asthmatics were listed as a high-risk group for susceptibility to SARSCoV-2. Several hypotheses have been proposed regarding protective factors in asthmatics, amongst which were the role of biological agents. One such agent is omalizumab, an IgE inhibitor, which is currently the only biological agent available in Malta for the treatment of severe asthma. METHODS This study aims to evaluate the symptomatology and disease course of SARS-CoV-2 in our cohort of severe asthmatic patients on omalizumab that contracted COVID-19. Molecular diagnostic tests (SARSCoV-2 PCR tests taken, if any, and the PCR result) since March 2020 of all adult patients receiving omalizumab for severe allergic asthma in January 2021, were reviewed from I-soft Clinical Manager (R). Demographic data were collected for those patients who were found to be positive. RESULTS Our cohort included 58 patients, of whom 43 had PCR tests. Of these, 7 patients (12%) tested positive during the study period. Results show a male predominance in the cohort, with fever being the commonest symptom, and a mortality of only 1 patient out of 7. CONCLUSIONS From the small number of our severe asthmatic patients infected with SARS-CoV-2 whilst receiving omalizumab, the majority had only mild symptoms, with minimal effect on asthma-related symptoms and hospitalizations, apart from mortality in one patient.