An Analysis of Demographics and Inhaled Corticosteroid Use on COVID-19 Outcomes Among Hospitalized Adult Asthmatics: An Early Experience at a NY Hospital System

Abstract

Purpose: It is unclear whether asthma is a risk factor for the development of COVID-19; however, severe asthma is a risk factor for morbidity and mortality. While systemic corticosteroids are beneficial during the inflammatory phase of COVID-19, the impact of inhaled corticosteroids (ICS) is unclear. We sought to characterize asthmatics admitted with COVID-19 early in the pandemic, determine if baseline factors are associated with more severe COVID-19 disease, and if the use of ICS may mitigate the severity of COVID-19. Patients and Methods: A retrospective chart review of hospitalized asthma patients >18 years testing positive for SARS-CoV2 from March to June 2020 was performed. Baseline demographic and asthma variables were collected. COVID-19 outcomes and laboratory values were extracted and compared between sex, race, ethnicity, and ICS use. Results: Of the 906 patient charts reviewed, 787 asthmatics were confirmed to be admitted for symptomatic COVID-19. Sex differences were found in hospitalization and intubation. Non-Hispanic patients had a significantly greater number of days on ventilator. Patients on ICS were 1.6 times more likely to be discharged on supplemental oxygen compared to patients not on ICS (p = 0.01). Conclusion: While our findings confirm trends observed by others with respect to risk factors among asthmatics with COVID-19, differences based on sex, ethnicity and ICS use in asthmatics were observed. Our finding that ICS use was associated with discharge with oxygen is novel. Future research is needed to study the trajectory of asthmatics from diagnosis to outcomes.