(46) Characteristics of Asthma Patients with COVID-19 by Disease Severity and Across Age Groups - a Swedish Population-Based Analysis Within The SCIFI-PEARL Project

Friday, August 26, 2022

8:00 AM – 6:00 PM CEST

Location: Hall C

Publication Number: 377

Presenting Author(s)

Brian K. Kirui, MMedSc
– Doctoral student, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, University of Gothenburg, Gothenburg, Vastra Gotaland, Sweden

Co-Author(s)

Ailiana Santosa
– School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, Sweden
Lowie Vanfleteren
– Senior Lecturer, Specialized Physician, COPD Center, Department of Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden, Sweden
Caroline Stridsman
– Department of Public Health and Clinical Medicine, Division of Medicine/The OLIN-unit, Umeå University, Umeå, Sweden., Sweden
Fredrik Nyberg, MD, PhD, FISPE
– Prof. of Register Epidemiology, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, M�lndal, V�stra G�talands l�n, Sweden

Background: As a complex and heterogenous chronic airway disease that affects people across the whole age spectrum, asthma might complicate susceptibility to COVID-19 infection and severity. However, characteristics of population-based and age-specific data on prevalence of key potential risk factors for COVID-19 outcomes in asthma is scarce.

Objectives: To characterize, compare and contrast sociodemographic, comorbidity, asthma medication and clinical measurements of asthma patients with and without COVID-19 outcomes of different severity across age groups.

Methods: We included asthma patients from the Swedish National Airways Register (SNAR), identified four COVID-19 outcome groups (diagnosis, hospitalization, intensive care, and death) and a general population group among them, and linked to data from several national health registers. The study period was Jan 2020 - Feb 2021. Subjects were grouped into adolescents (12-17 years) and adults (age groups 18-39, 40-64 and 65+). We report frequencies of characteristics related to sociodemography, comorbidities, asthma medications and clinical factors.

Results: We identified 241,066 asthma patients, of whom 19,137 (7.9 %) had COVID-19 diagnosis. Of these, 2,189 (0.91 %) were hospitalized, 255 (0.10%) were admitted to the Intensive Care Unit (ICU) and 336 (0.13%) died due to COVID-19. The mean age across the studied age groups gradually increased from milder to worse COVID-19 outcomes and was higher than the population. In all age groups, females were in majority (53-65%), except in adolescents, where males predominated in both the population (53.6%) and COVID-19 diagnosis group (52.3%). Adolescents with asthma and COVID-19 had more allergy and autoimmune disease than their non-COVID-19 peers (73-80% vs 72% and 1-13% vs 0.8%, respectively). The prevalence of comorbidities in COVID-19 positive adults ≥ 40 years was higher than in the corresponding asthma population - especially cardiovascular disease (29-70% vs 15-47%), diabetes (10-30% vs 4-11%) and psychiatric disorders (10-25% vs 3-6%) - most notably for COVID-19 hospitalizations and deaths. Elevated use of bronchodilators, inhaled corticosteroids, and poor asthma control was more prominent in asthma patients with severe COVID-19 outcomes and older age groups than in the asthma population. Body mass index was particularly elevated in age group 40-64 years with asthma and COVID-19 (29-33Kg/M2), and current smoking especially prevalent (5-14%) among age group 18-39 years with COVID-19.

Conclusions: We observe that characteristics are very specific for different age groups of asthma, which may translate to variability in COVID-19 risk. This information is critical for assessing the relationship between asthma and COVID-19 and for tailored patient care.