Imperial College London
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DrChloeBloom

Faculty of Medicine, National Heart & Lung Institute

Clinical Senior Lecturer in Respiratory Epidemiology
 
 
 
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Contact

 

chloe.bloom06

 
 
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Location

 

Emmanuel Kaye BuildingRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{Bloom:2021:10.1164/rccm.202107-1704oc,
author = {Bloom, CI and Cullinan, P and Wedzicha, JA},
doi = {10.1164/rccm.202107-1704oc},
journal = {American Journal of Respiratory and Critical Care Medicine},
pages = {36--45},
title = {Asthma phenotypes and COVID-19 risk: a population-based observational study},
url = {http://dx.doi.org/10.1164/rccm.202107-1704oc},
volume = {205},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Rationale: Studies have suggested some asthma patients are at risk of severe COVID-19, but they have had limited data on asthma phenotype and have not considered if risks are specific to COVID-19. Objectives: Determine the effect of asthma phenotype on three levels of COVID-19 outcomes. Compare hospitalisation rates to influenza and pneumonia. Methods: Electronic medical records were used to identify asthma patients and match them to the general population. Patient-level data were linked to Public Health England SARS-CoV-2 test data, hospital, and mortality data. Asthma was phenotyped by medication, exacerbation history, and type-2 inflammation. The risk of each outcome, adjusted for major risk factors, was measured using Cox regression. Measurements and Main Results: 434,348 asthma and 748,327 matched patients were included. All asthma patients had a significantly increased risk of a GP-diagnosis of COVID-19. Asthma with regular inhaled corticosteroid (ICS) use (HR=1.27, 95%CI=1.01-1.61), intermittent ICS + add-on asthma medication use (HR=2.00, 95%CI=1.43-2.79), regular ICS + add-on use (HR=1.63, 95 CI=1.37-1.94), or with frequent exacerbations (HR=1.82, 95% CI=1.34-2.47) was significantly associated with hospitalisation. These phenotypes were significantly associated with influenza and pneumonia hospitalisations. Only patients with regular ICS + add-on asthma therapy (HR=1.70, 95%CI=1.27-2.26) or frequent exacerbations (HR=1.66, 95%CI=1.03-2.68) had a significantly higher risk of ICU admission or death. Atopy and blood eosinophil count were not associated with severe COVID-19 outcomes. Conclusions: More severe asthma was associated with more severe COVID-19 outcomes, but type-2 inflammation was not. The risk of COVID-19 hospitalisation appeared to be similar to the risk with influenza or pneumonia.
AU  - Bloom,CI
AU  - Cullinan,P
AU  - Wedzicha,JA
DO  - 10.1164/rccm.202107-1704oc
EP  - 45
PY  - 2021///
SN  - 1073-449X
SP  - 36
TI  - Asthma phenotypes and COVID-19 risk: a population-based observational study
T2  - American Journal of Respiratory and Critical Care Medicine
UR  - http://dx.doi.org/10.1164/rccm.202107-1704oc
UR  - https://www.atsjournals.org/doi/10.1164/rccm.202107-1704OC
UR  - http://hdl.handle.net/10044/1/92227
VL  - 205
ER  -
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