支气管哮喘的新冠肺炎易感性
2020/12/17
摘要
背景：支气管哮喘在新冠肺炎（COVID-19）中尚未得到充分评估。呼吸道过敏与ACE2受体表达的显著降低有关，ACE2受体是COVID-19的进入受体。
目的：为了观察COVID-19在支气管哮喘中的易感性，我们分析了大量连续性门诊受试者哮喘的患病率，这些受试者均采用RT-PCR检测COVID-19。
方法：这是一项基于人群的回顾性横断面研究，使用了来自以色列的一个大型全国性医疗保健组织（HMO）的数据。包括所有自2020年2月至6月期间接受COVID-19检测的HMO注册人员。分析了COVID-19 RT-PCR检测阴性和阳性受试者之间以及COVID-19 RT-PCR检测阳性伴有和不伴有哮喘的受试者之间的人口学和临床特征差异。
结果：总共37469名受试者进行了COVID-19 RT-PCR检测，其中2266人(6.05 %)呈阳性。在COVID-19阴性组中观察到的吸烟者比例明显高于COVID-19阳性组(4734(13.45 %)vs103(4.55%)；p<0.001)。153名(6.75 %) COVID-19阳性受试者和3388名(9.62 %) COVID-19阴性受试者出现哮喘(p<0.001)。抗白三烯类药物、吸入皮质类固醇和长效β受体阻滞剂的使用对COVID-19阳性比例没有显著影响。经性别、年龄、吸烟和共患病校正后的多元逻辑回归分析显示，哮喘与COVID-19阳性的可能性呈负相关(OR 0.71 (95%置信区间，0.58-0.87)；p=0.001)。
结论：我们观察到先前患有哮喘的患者新冠肺炎易感性较低。
COVID-19 susceptibility in bronchial asthma
Ilan Green, Eugene Merzon, Shlomo Vinker, Avivit Golan-Cohen, Eli Magen.
Abstract
BACKGROUND:Bronchial asthma has not been adequately assessed in the coronavirus disease 2019 (COVID-19). Respiratory allergy is associated with significant reductions in ACE2 receptors expression, which is the entry receptor for COVID-19.
OBJECTIVE:To observe COVID-19 susceptibility in patients with bronchial asthma, we have analyzed the prevalence of asthma in a large cohort of consecutive outpatient subjects who tested in the RT-PCR assay for COVID-19.
METHODS:This was a retrospective population-based cross-sectional study utilizing data from a large nation-wide health maintenance organization (HMO) in Israel. All HMO enrollees who had been tested for COVID-19 from February to June 2020 were included. Differences in demographic and clinical characteristics between the subjects with negative and positive COVID-19 RT-PCR tests and between COVID-19 RT-PCR positive subjects with and without asthma were analyzed.
RESULTS:A total of 37,469 subjects were tested for COVID-19 RT-PCR and 2,266 (6.05 %) of them were positive. A significantly higher proportion of smokers was observed in the COVID-19 negative group, than in the COVID-19 positive group (4,734 (13.45 %) vs 103 (4.55 %); p<0.001). Asthma was found in 153 (6.75 %) subjects of COVID-19 positive and in 3,388 (9.62 %) subjects of COVID-19 negative group (p<0.001). No significant impact of antileukotrienes, inhaled corticosteroids and long-acting beta-blockers use was revealed on COVID-19 positivity proportions. Multiple logistic regression analysis adjusted for sex, age, smoking, and comorbidity revealed a negative association of asthma with the likelihood of being positive for COVID-19 (OR 0.71 (95% confidence interval, 0.58-0.87); p=0.001).
CONCLUSION:we observed lower COVID-19 susceptibility in patients with pre-existing asthma.
背景：支气管哮喘在新冠肺炎（COVID-19）中尚未得到充分评估。呼吸道过敏与ACE2受体表达的显著降低有关，ACE2受体是COVID-19的进入受体。
目的：为了观察COVID-19在支气管哮喘中的易感性，我们分析了大量连续性门诊受试者哮喘的患病率，这些受试者均采用RT-PCR检测COVID-19。
方法：这是一项基于人群的回顾性横断面研究，使用了来自以色列的一个大型全国性医疗保健组织（HMO）的数据。包括所有自2020年2月至6月期间接受COVID-19检测的HMO注册人员。分析了COVID-19 RT-PCR检测阴性和阳性受试者之间以及COVID-19 RT-PCR检测阳性伴有和不伴有哮喘的受试者之间的人口学和临床特征差异。
结果：总共37469名受试者进行了COVID-19 RT-PCR检测，其中2266人(6.05 %)呈阳性。在COVID-19阴性组中观察到的吸烟者比例明显高于COVID-19阳性组(4734(13.45 %)vs103(4.55%)；p<0.001)。153名(6.75 %) COVID-19阳性受试者和3388名(9.62 %) COVID-19阴性受试者出现哮喘(p<0.001)。抗白三烯类药物、吸入皮质类固醇和长效β受体阻滞剂的使用对COVID-19阳性比例没有显著影响。经性别、年龄、吸烟和共患病校正后的多元逻辑回归分析显示，哮喘与COVID-19阳性的可能性呈负相关(OR 0.71 (95%置信区间，0.58-0.87)；p=0.001)。
结论：我们观察到先前患有哮喘的患者新冠肺炎易感性较低。
(中日友好医院呼吸与危重症医学科 王静茹 摘译 林江涛 审校 )
(J Allergy Clin Immunol Pract. 2020 Nov 23; S2213-2198(20)31240-X. doi: 10.1016/j.jaip.2020.11.020.)
(J Allergy Clin Immunol Pract. 2020 Nov 23; S2213-2198(20)31240-X. doi: 10.1016/j.jaip.2020.11.020.)
COVID-19 susceptibility in bronchial asthma
Ilan Green, Eugene Merzon, Shlomo Vinker, Avivit Golan-Cohen, Eli Magen.
Abstract
BACKGROUND:Bronchial asthma has not been adequately assessed in the coronavirus disease 2019 (COVID-19). Respiratory allergy is associated with significant reductions in ACE2 receptors expression, which is the entry receptor for COVID-19.
OBJECTIVE:To observe COVID-19 susceptibility in patients with bronchial asthma, we have analyzed the prevalence of asthma in a large cohort of consecutive outpatient subjects who tested in the RT-PCR assay for COVID-19.
METHODS:This was a retrospective population-based cross-sectional study utilizing data from a large nation-wide health maintenance organization (HMO) in Israel. All HMO enrollees who had been tested for COVID-19 from February to June 2020 were included. Differences in demographic and clinical characteristics between the subjects with negative and positive COVID-19 RT-PCR tests and between COVID-19 RT-PCR positive subjects with and without asthma were analyzed.
RESULTS:A total of 37,469 subjects were tested for COVID-19 RT-PCR and 2,266 (6.05 %) of them were positive. A significantly higher proportion of smokers was observed in the COVID-19 negative group, than in the COVID-19 positive group (4,734 (13.45 %) vs 103 (4.55 %); p<0.001). Asthma was found in 153 (6.75 %) subjects of COVID-19 positive and in 3,388 (9.62 %) subjects of COVID-19 negative group (p<0.001). No significant impact of antileukotrienes, inhaled corticosteroids and long-acting beta-blockers use was revealed on COVID-19 positivity proportions. Multiple logistic regression analysis adjusted for sex, age, smoking, and comorbidity revealed a negative association of asthma with the likelihood of being positive for COVID-19 (OR 0.71 (95% confidence interval, 0.58-0.87); p=0.001).
CONCLUSION:we observed lower COVID-19 susceptibility in patients with pre-existing asthma.
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儿童和青春期严重哮喘：一项纵向研究
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30年以上队列成人哮喘的缓解和严重程度变化
