Severity of COVID-19 in hospitalized patients with and without atopic disease

• Main Authors: Dylan T. Timberlake, Deepika Narayanan, Princess U. Ogbogu, Rekha Raveendran, Kyle Porter, Rebecca Scherzer, Benjamin Prince, Mitchell H. Grayson
• Format: Article
• Language: English
• Published: Elsevier 2021-02-01
• Series: World Allergy Organization Journal
• Subjects: COVID-19; Atopy; Asthma; SARS-CoV-2; Hospitalization; Severity
• Online Access: http://www.sciencedirect.com/science/article/pii/S1939455121000028

Background: Data from the 2009 influenza pandemic suggested asthma might protect from severe disease in hospitalized patients. Asthma does not appear to increase risk for hospitalization or mortality with COVID-19. Objective: This study was undertaken to see if atopy actually protected those hospitalized with COVID-19. Methods: Retrospective chart review on all patients testing positive for SARS-CoV-2 over 2 months at a major adult and pediatric tertiary referral center hospital. Charts were evaluated for history of atopic disease, as were the need for ICU admission, requirement for supplemental oxygen and/or intubation, and in hospital mortality. Results: No significant differences in outcomes for patients (n = 275) based on atopic disease were noted: ICU admission, 43% versus 44.7% (atopic versus no atopic disease, respectively; p = 0.84); supplemental oxygen use, 79.1% versus 73.6% (p = 0.36); intubation rate, 35.8% versus 36.5% (p = 0.92); and mortality rate, 13.4% versus 20.7% (p = 0.19). More patients with atopic disease had COPD listed as a diagnosis in their chart (38.8% versus 17.3%, p < 0.001). COPD was associated with an increased rate of ICU admission (aOR = 2.22 (1.15, 4.30) p = 0.02) and intubation (aOR = 2.05 (1.07, 3.92) p = 0.03). After adjusting for COPD, patients with atopic disease had a trend for reduced mortality (aOR 0.55 (0.23, 1.28), p = 0.16), but those with asthma did not (p > 0.2). Conclusion: Severity of COVID-19 in hospitalized patients does not differ based on atopic status. However, adjusting for presence of COPD led to a suggestion of possible reduced severity in patients with atopy but not asthma.