COVID-19患者合并哮喘的风险和结局:一项荟萃分析

IF 0.3 Q4 ALLERGY

Astim Allerji Immunoloji Pub Date : 2020-12-21 DOI:10.21911/aai.590

Sharmi Biswas, Z. Sarfraz, A. Sarfraz, F. Malanyaon, R. Vijayan, I. Gupta, Uroosa Arif, Muzna Sarfraz, G. Yatzkan, M. Sanchez-Gonzalez

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引用次数: 3

摘要

目的:2019年爆发的新冠肺炎疫情(COVID-19)最终在全球范围内传播，并于2020年3月11日被世界卫生组织定义为大流行。与COVID-19相关的呼吸系统疾病可以无症状，也可以表现为破坏性的ARDS和死亡。老年人和有合并症和免疫功能低下状态的个体风险更高。哮喘是一种肺泡水平ACE2过表达的气道炎症痉挛。ACE2和TMPRSS2表达介导SARS-CoV-2宿主肺细胞感染，从而可能增加哮喘患者的疾病易感性。材料与方法:检索Pubmed、WHO、clinicaltrials.gov和谷歌Scholar数据库，检索关键词-COVID-19、SARS-CoV-2、冠状病毒、哮喘及其组合，时间为2019年12月至2020年8月10日。我们纳入了诊断为COVID-19的哮喘患者，同时排除了非COVID-19患者、孕妇患者和其他疾病或合并症患者。主要结局包括两组患者的死亡率和ICU入院率。基于现有资料，采用RevMan 5.4软件，采用随机效应模型和95%置信区间进行meta分析。结果:哮喘患者和非哮喘患者的死亡率风险结果进行了比较。在755例合并哮喘的COVID-19患者和4969例非哮喘的COVID-19患者中，我们发现哮喘组的死亡风险会增加9% (RR=1.09, CI= 0.58 ~ 2.03, I2=72%)。哮喘组ICU住院比例增加(RR=1.39, CI = 0.80 ~ 2.42)。研究之间存在高度异质性(I²= 79%)。皮质类固醇等药物可提高死亡率和ICU住院率。结论:我们的研究结果表明，哮喘患者的COVID-19病例数已低于非哮喘组。由于潜在因素或易感性，COVID-19哮喘患者的死亡率和ICU入院风险增加。最后，皮质类固醇被认为是安全的，可以预防COVID-19感染的严重程度。

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Risk and Outcomes of COVID-19 Patients with Asthma: A Meta-Analysis

Objective: The outbreak of SARS-CoV-2 disease (COVID-19) emerged in 2019, and ultimately spread worldwide, being defined as a pandemic by the World Health Organization on March 11, 2020. The respiratory disease related to COVID-19 can range from being asymptomatic to presenting as devastating ARDS and death. The elderly and individuals with comorbidities and immunocompromised states are at a higher risk. Asthma is an inflammatory spasm of the airways with ACE2 overexpression at the alveolar level. ACE2 and TMPRSS2 expression mediate SARS-CoV-2 infection of host lung cells and hence might increase disease susceptibility in asthmatics. Materials and Methods: A literature review was done by searching the databases of Pubmed, WHO, clinicaltrials.gov, and Google Scholar, using the keywords of -COVID-19, SARS-CoV-2, coronavirus, asthma, and their combinations, following the timeline of December 2019 to August 10, 2020. We included patients with asthma diagnosed with COVID-19 while excluding non-COVID-19 patients, pregnant patients, and patients with other diseases or comorbidities. Primary outcomes included mortality and ICU admissions of both groups. Based on the available data, we conducted a meta-analysis via RevMan 5.4 using a random-effects model and 95% confidence intervals. Results: Patients with and without asthma were compared for risk outcomes of mortality. For the 755 COVID-19 patients with asthma and 4969 non-asthmatic COVID-19 patients, we found that the risk of mortality would increase by 9% in the asthmatic group (RR=1.09, CI= 0.58 to 2.03, I2=72%). There was an increased proportion of ICU admissions among the asthmatic group (RR=1.39, CI = 0.80 to 2.42). There was high heterogeneity among the studies (I² = 79%). Medications such as corticosteroids improve the mortality and ICU admission rates. Conclusion: Our results indicate that the number of COVID-19 cases in patients with asthma has been lower than those of the nonasthmatic group. COVID-19 patients with asthma were at increased risk of mortality and ICU admission due to underlying factors or predisposition. Finally, corticosteroids are considered safe and may confer protection against the severity of COVID-19 infection.

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来源期刊

Astim Allerji Immunoloji ALLERGY-

CiteScore

0.80

自引率

0.00%

发文量

期刊介绍： Asthma Allergy Immunology has been published three times a year in April, August and December as the official and periodical journal of the Turkish National Society of Allergy and Clinical Immunology since 2003. All articles published in the journal have been available online since 2003. A peer reviewed system is used in evaluation of the manuscripts submitted to Asthma Allergy Immunology. The official language of the journal is English. The aim of the journal is to present advances in the field of allergic diseases and clinical immunology to the readers. In accordance with this goal, manuscripts in the format of original research, review, case report, articles about clinical and practical applications and editorials, short report and letters to the editor about allergic diseases and clinical immunology are published in the journal. The target reader population of the Asthma Allergy Immunology includes specialists and residents of allergy and clinical immunology, pulmonology, internal medicine, pediatrics, dermatology and otolaryngology as well as physicians working in other fields of medicine interested in allergy and immunological diseases.