Characteristics and outcomes of COVID-19 patients with and without asthma from the United States, South Korea, and Europe

Daniel Morales (Lead / Corresponding author), Anna Ostropolets, Lana Lai, Anthony Sena, Scott DuVall, Marc Suchard, Katia Verhamme, Peter Rjinbeek, Joe Posada, Waheed Ahmed, Thamer Alshammary, Heba Alghoul, Osaid Asler, Carlos Areia, Clair Blacketer, Ed Burn, Paula Casajust, Seng You, Dalia Dawoud, Asieh GolozarMenchung Gong, Jitendra Jonnagaddala, Kristine Lynch, Michael E. Matheny, Evan Minty, Fredrik Nyberg, Albert Uribe, Martina Recalde, Christian Reich, Martijn Scheumie, Karishma Shah, Nigam Shah, Lisa Schilling, David Vizcaya, Lin Zhang, George Hripcsak, Patrick Ryan, Daniel Prieto-Alhambra, Duarte-Salles Talita, Kristin Kostka

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5 Citations (Scopus)
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Objective: Large international comparisons describing the clinical characteristics of patients with COVID-19 are limited. The aim of the study was to perform a large-scale descriptive characterization of COVID-19 patients with asthma.

Methods: We included nine databases contributing data from January to June 2020 from the US, South Korea (KR), Spain, UK and the Netherlands. We defined two cohorts of COVID-19 patients (‘diagnosed’ and ‘hospitalized’) based on COVID-19 disease codes. We followed patients from COVID-19 index date to 30 days or death. We performed descriptive analysis and reported the frequency of characteristics and outcomes in people with asthma defined by codes and prescriptions.

Results: The diagnosed and hospitalized cohorts contained 666,933 and 159,552 COVID-19 patients respectively. Exacerbation in people with asthma was recorded in 1.6–8.6% of patients at presentation. Asthma prevalence ranged from 6.2% (95% CI 5.7–6.8) to 18.5% (95% CI 18.2–18.8) in the diagnosed cohort and 5.2% (95% CI 4.0–6.8) to 20.5% (95% CI 18.6–22.6) in the hospitalized cohort. Asthma patients with COVID-19 had high prevalence of comorbidity including hypertension, heart disease, diabetes and obesity. Mortality ranged from 2.1% (95% CI 1.8–2.4) to 16.9% (95% CI 13.8–20.5) and similar or lower compared to COVID-19 patients without asthma. Acute respiratory distress syndrome occurred in 15–30% of hospitalized COVID-19 asthma patients.

Conclusion: The prevalence of asthma among COVID-19 patients varies internationally. Asthma patients with COVID-19 have high comorbidity. The prevalence of asthma exacerbation at presentation was low. Whilst mortality was similar among COVID-19 patients with and without asthma, this could be confounded by differences in clinical characteristics. Further research could help identify high-risk asthma patients. KEY MESSAGES Asthma prevalence in COVID-19 patients varied internationally (5.2–20.5%).The prevalence of asthma exacerbation at presentation with COVID-19 in diagnosed and hospitalized patients was low. Comorbidities were common in COVID-19 patients with asthma.

Original languageEnglish
Pages (from-to)76-86
Number of pages11
JournalJournal of Asthma
Issue number1
Early online date10 Jan 2022
Publication statusPublished - 2023


  • asthma
  • COVID-19
  • comorbidity
  • epidemiology
  • Asthma

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Pediatrics, Perinatology, and Child Health
  • Immunology and Allergy


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