Risk of serious COVID-19 outcomes among adults and children with moderate-to-severe asthma: a systematic review and meta-analysis

Bohee Lee; Grace Lewis; Eldad Agyei-Manu; Nadege Atkins; Urmila Bhattacharyya; Marshall Dozier; Jasmin Rostron; Aziz Sheikh; Ruth McQuillan; Evropi Theodoratou

doi:10.1183/16000617.0066-2022

Risk of serious COVID-19 outcomes among adults and children with moderate-to-severe asthma: a systematic review and meta-analysis

Bohee Lee
, Grace Lewis
, Eldad Agyei-Manu
, Nadege Atkins
, Urmila Bhattacharyya
, Marshall Dozier
, Jasmin Rostron
, Aziz Sheikh
, Ruth McQuillan
, Evropi Theodoratou

Research output: Contribution to journal › Article (Academic Journal) › peer-review

19 Citations (Scopus)

Abstract

Background
The Joint Committee on Vaccination and Immunisation in the United Kingdom requested an evidence synthesis to investigate the relationship between asthma and coronavirus disease 2019 (COVID-19) outcomes.

Objective
We conducted a systematic review and meta-analysis to summarise evidence on the risk of severe COVID-19 outcomes in people with uncontrolled asthma or markers of asthma severity.

Methods
High-dose inhaled corticosteroids (ICS) or oral corticosteroids (OCS) were used as markers of asthma severity, following international or national asthma guidelines. Risk of bias was assessed using Joanna Briggs Institute tools. Adjusted point estimates were extracted for random-effects meta-analyses and subgroup analyses.

Results
After screening, 12 studies (11 in adults and one in children) met the eligibility criteria. Adults using high-dose ICS or OCS had a pooled adjusted hazard ratio (aHR) of 1.33 (95% CI 1.06–1.67, I2=0%) for hospitalisation and an aHR of 1.22 (95% CI 0.90–1.65, I2=70%) for mortality for COVID-19. We found insufficient evidence for associations between markers on COVID-19 mortality in the subgroup analyses.

Conclusions
Adults with severe asthma are at increased risk of COVID-19 hospitalisation compared to nonusers. Our analysis highlighted the dearth of studies in children with asthma investigating serious COVID-19 outcomes.

Original language	English
Article number	220066
Number of pages	11
Journal	European Respiratory Review
Volume	31
Issue number	166
Early online date	2 Nov 2022
DOIs	https://doi.org/10.1183/16000617.0066-2022
Publication status	Published - 1 Dec 2022

Access to Document

10.1183/16000617.0066-2022Licence: CC BY-NC

Handle.net

Persistent link

Cite this

Lee, B., Lewis, G., Agyei-Manu, E., Atkins, N., Bhattacharyya, U., Dozier, M., Rostron, J., Sheikh, A., McQuillan, R., & Theodoratou, E. (2022). Risk of serious COVID-19 outcomes among adults and children with moderate-to-severe asthma: a systematic review and meta-analysis. European Respiratory Review, 31(166), Article 220066. https://doi.org/10.1183/16000617.0066-2022

@article{3a324ffe22a74664ba3f4413202ed12e,

title = "Risk of serious COVID-19 outcomes among adults and children with moderate-to-severe asthma: a systematic review and meta-analysis",

abstract = "Background The Joint Committee on Vaccination and Immunisation in the United Kingdom requested an evidence synthesis to investigate the relationship between asthma and coronavirus disease 2019 (COVID-19) outcomes. Objective We conducted a systematic review and meta-analysis to summarise evidence on the risk of severe COVID-19 outcomes in people with uncontrolled asthma or markers of asthma severity. Methods High-dose inhaled corticosteroids (ICS) or oral corticosteroids (OCS) were used as markers of asthma severity, following international or national asthma guidelines. Risk of bias was assessed using Joanna Briggs Institute tools. Adjusted point estimates were extracted for random-effects meta-analyses and subgroup analyses. Results After screening, 12 studies (11 in adults and one in children) met the eligibility criteria. Adults using high-dose ICS or OCS had a pooled adjusted hazard ratio (aHR) of 1.33 (95\% CI 1.06–1.67, I2=0\%) for hospitalisation and an aHR of 1.22 (95\% CI 0.90–1.65, I2=70\%) for mortality for COVID-19. We found insufficient evidence for associations between markers on COVID-19 mortality in the subgroup analyses. Conclusions Adults with severe asthma are at increased risk of COVID-19 hospitalisation compared to nonusers. Our analysis highlighted the dearth of studies in children with asthma investigating serious COVID-19 outcomes.",

author = "Bohee Lee and Grace Lewis and Eldad Agyei-Manu and Nadege Atkins and Urmila Bhattacharyya and Marshall Dozier and Jasmin Rostron and Aziz Sheikh and Ruth McQuillan and Evropi Theodoratou",

year = "2022",

month = dec,

day = "1",

doi = "10.1183/16000617.0066-2022",

language = "English",

volume = "31",

journal = "European Respiratory Review",

issn = "0905-9180",

publisher = "European Respiratory Society",

number = "166",

}

TY - JOUR

T1 - Risk of serious COVID-19 outcomes among adults and children with moderate-to-severe asthma

T2 - a systematic review and meta-analysis

AU - Lee, Bohee

AU - Lewis, Grace

AU - Agyei-Manu, Eldad

AU - Atkins, Nadege

AU - Bhattacharyya, Urmila

AU - Dozier, Marshall

AU - Rostron, Jasmin

AU - Sheikh, Aziz

AU - McQuillan, Ruth

AU - Theodoratou, Evropi

PY - 2022/12/1

Y1 - 2022/12/1

N2 - Background The Joint Committee on Vaccination and Immunisation in the United Kingdom requested an evidence synthesis to investigate the relationship between asthma and coronavirus disease 2019 (COVID-19) outcomes. Objective We conducted a systematic review and meta-analysis to summarise evidence on the risk of severe COVID-19 outcomes in people with uncontrolled asthma or markers of asthma severity. Methods High-dose inhaled corticosteroids (ICS) or oral corticosteroids (OCS) were used as markers of asthma severity, following international or national asthma guidelines. Risk of bias was assessed using Joanna Briggs Institute tools. Adjusted point estimates were extracted for random-effects meta-analyses and subgroup analyses. Results After screening, 12 studies (11 in adults and one in children) met the eligibility criteria. Adults using high-dose ICS or OCS had a pooled adjusted hazard ratio (aHR) of 1.33 (95% CI 1.06–1.67, I2=0%) for hospitalisation and an aHR of 1.22 (95% CI 0.90–1.65, I2=70%) for mortality for COVID-19. We found insufficient evidence for associations between markers on COVID-19 mortality in the subgroup analyses. Conclusions Adults with severe asthma are at increased risk of COVID-19 hospitalisation compared to nonusers. Our analysis highlighted the dearth of studies in children with asthma investigating serious COVID-19 outcomes.

AB - Background The Joint Committee on Vaccination and Immunisation in the United Kingdom requested an evidence synthesis to investigate the relationship between asthma and coronavirus disease 2019 (COVID-19) outcomes. Objective We conducted a systematic review and meta-analysis to summarise evidence on the risk of severe COVID-19 outcomes in people with uncontrolled asthma or markers of asthma severity. Methods High-dose inhaled corticosteroids (ICS) or oral corticosteroids (OCS) were used as markers of asthma severity, following international or national asthma guidelines. Risk of bias was assessed using Joanna Briggs Institute tools. Adjusted point estimates were extracted for random-effects meta-analyses and subgroup analyses. Results After screening, 12 studies (11 in adults and one in children) met the eligibility criteria. Adults using high-dose ICS or OCS had a pooled adjusted hazard ratio (aHR) of 1.33 (95% CI 1.06–1.67, I2=0%) for hospitalisation and an aHR of 1.22 (95% CI 0.90–1.65, I2=70%) for mortality for COVID-19. We found insufficient evidence for associations between markers on COVID-19 mortality in the subgroup analyses. Conclusions Adults with severe asthma are at increased risk of COVID-19 hospitalisation compared to nonusers. Our analysis highlighted the dearth of studies in children with asthma investigating serious COVID-19 outcomes.

U2 - 10.1183/16000617.0066-2022

DO - 10.1183/16000617.0066-2022

M3 - Article (Academic Journal)

C2 - 36323417

SN - 0905-9180

VL - 31

JO - European Respiratory Review

JF - European Respiratory Review

IS - 166

M1 - 220066

ER -

Risk of serious COVID-19 outcomes among adults and children with moderate-to-severe asthma: a systematic review and meta-analysis

Abstract

Access to Document

Handle.net

Fingerprint

Cite this