哮喘及哮喘药物治疗对COVID-19患者预后的影响
2020/10/14
摘要
背景：新冠病毒（COVID-19）在世界范围内迅速蔓延。然而，哮喘、哮喘药物和哮喘严重程度对COVID-19临床转归的影响尚未确定。
方法：该研究包括7590名患者，这些患者截止至2020年5月15日进行了严重急性呼吸综合征冠状病毒-2 RNA聚合酶链反应检测，被证实患有COVID-19；并且我们还使用了健康保险审查和评估服务处提供的相关医疗数据。哮喘和哮喘严重程度（GINA建议等级）由诊断代码和哮喘药物使用史来定义。
结果：7590例COVID-19患者中，218例（2.9%）有哮喘。COVID-19潜在哮喘患者相关的总医疗费用明显高于其他患者。COVID-19哮喘患者的死亡率（7.8%）明显高于其他患者（2.8%；p<0.001）。然而，哮喘并不是COVID-19治疗后临床转归的独立危险因素。哮喘药物的使用和哮喘的严重程度也不影响COVID-19的临床结果。然而，口服短效β2激动剂（SABA）是增加总医疗费用负担的独立因素。在单因素和多因素分析中，第5步哮喘患者的住院时间明显长于第1步哮喘患者。
结论：哮喘可导致COVID-19的不良预后；然而，一般来说，哮喘、哮喘药物的使用和哮喘的严重程度不是COVID-19不良临床结果的独立因素。
Effect of Asthma and Asthma Medication on the Prognosis of Patients with COVID-19
Yong Jun Choi, Ju-Young Park, Hye Sun Lee, Jin Suh, Jeung Yoon Song, Min Kwang Byun, Jae Hwa Cho, Hyung Jung Kim, Jae-Hyun Lee, Jung-Won Park, Hye Jung Park
Abstract
Background: Coronavirus disease (COVID-19) has rapidly spread worldwide. However, the effects of asthma, asthma medication, and asthma severity on the clinical outcomes of COVID-19 have not yet been established.
Methods: The study included 7590 de-identified patients, who were confirmed to have COVID-19 using the severe acute respiratory syndrome-coronavirus-2 RNA-polymerase chain reaction tests conducted up to 15th May 2020; and we used the linked-medical claims data provided by the Health Insurance Review and Assessment Service. Asthma and asthma severity (step suggested by GINA) was defined using the diagnostic code and history of asthma medication usage.
Results: Among 7590 COVID-19 patients, 218 (2.9%) had underlying asthma. The total medical cost associated with COVID-19 patients with underlying asthma was significantly higher than that of other patients. Mortality rate for COVID-19 patients with underlying asthma (7.8%) was significantly higher than that of other patients (2.8%; p<0.001). However, asthma was not an independent risk factor for the clinical outcomes of COVID-19 after adjustment. Asthma medication use and asthma severity also did not affect the clinical outcomes of COVID-19. However, use of oral short-acting β2-agonists (SABA) was an independent factor to increase the total medical cost burden. Patients with step 5 asthma showed significant prolonged admission duration than those with step 1 asthma in both univariate and multivariate analysis.
Conclusions: Asthma led to poor outcomes of COVID-19; however, underlying asthma, use of asthma medication, and asthma severity were not independent factors for poor clinical outcomes of COVID-19, generally.
背景：新冠病毒（COVID-19）在世界范围内迅速蔓延。然而，哮喘、哮喘药物和哮喘严重程度对COVID-19临床转归的影响尚未确定。
方法：该研究包括7590名患者，这些患者截止至2020年5月15日进行了严重急性呼吸综合征冠状病毒-2 RNA聚合酶链反应检测，被证实患有COVID-19；并且我们还使用了健康保险审查和评估服务处提供的相关医疗数据。哮喘和哮喘严重程度（GINA建议等级）由诊断代码和哮喘药物使用史来定义。
结果：7590例COVID-19患者中，218例（2.9%）有哮喘。COVID-19潜在哮喘患者相关的总医疗费用明显高于其他患者。COVID-19哮喘患者的死亡率（7.8%）明显高于其他患者（2.8%；p<0.001）。然而，哮喘并不是COVID-19治疗后临床转归的独立危险因素。哮喘药物的使用和哮喘的严重程度也不影响COVID-19的临床结果。然而，口服短效β2激动剂（SABA）是增加总医疗费用负担的独立因素。在单因素和多因素分析中，第5步哮喘患者的住院时间明显长于第1步哮喘患者。
结论：哮喘可导致COVID-19的不良预后；然而，一般来说，哮喘、哮喘药物的使用和哮喘的严重程度不是COVID-19不良临床结果的独立因素。
(中日友好医院呼吸与危重症医学科 李红雯 摘译 林江涛 审校)
(Eur Respir J. 2020 Sep 25;2002226.)
(Eur Respir J. 2020 Sep 25;2002226.)
Effect of Asthma and Asthma Medication on the Prognosis of Patients with COVID-19
Yong Jun Choi, Ju-Young Park, Hye Sun Lee, Jin Suh, Jeung Yoon Song, Min Kwang Byun, Jae Hwa Cho, Hyung Jung Kim, Jae-Hyun Lee, Jung-Won Park, Hye Jung Park
Abstract
Background: Coronavirus disease (COVID-19) has rapidly spread worldwide. However, the effects of asthma, asthma medication, and asthma severity on the clinical outcomes of COVID-19 have not yet been established.
Methods: The study included 7590 de-identified patients, who were confirmed to have COVID-19 using the severe acute respiratory syndrome-coronavirus-2 RNA-polymerase chain reaction tests conducted up to 15th May 2020; and we used the linked-medical claims data provided by the Health Insurance Review and Assessment Service. Asthma and asthma severity (step suggested by GINA) was defined using the diagnostic code and history of asthma medication usage.
Results: Among 7590 COVID-19 patients, 218 (2.9%) had underlying asthma. The total medical cost associated with COVID-19 patients with underlying asthma was significantly higher than that of other patients. Mortality rate for COVID-19 patients with underlying asthma (7.8%) was significantly higher than that of other patients (2.8%; p<0.001). However, asthma was not an independent risk factor for the clinical outcomes of COVID-19 after adjustment. Asthma medication use and asthma severity also did not affect the clinical outcomes of COVID-19. However, use of oral short-acting β2-agonists (SABA) was an independent factor to increase the total medical cost burden. Patients with step 5 asthma showed significant prolonged admission duration than those with step 1 asthma in both univariate and multivariate analysis.
Conclusions: Asthma led to poor outcomes of COVID-19; however, underlying asthma, use of asthma medication, and asthma severity were not independent factors for poor clinical outcomes of COVID-19, generally.
上一篇：
T2型哮喘与特定的室内真菌菌落和微生物群有关
下一篇：
应用糖皮质激素毒性指数量化严重哮喘患者的糖皮质激素相关并发症率
