过敏性鼻炎和哮喘对COVID-19感染、住院和死亡率的影响
2021/11/24
摘要
背景：目前尚不清楚变应性鼻炎(AR)和/或哮喘患者是否易受2019年冠状病毒病(COVID-19)感染、严重程度和死亡率的影响。
目的：探讨AR和/或哮喘在COVID-19感染、严重程度和死亡率中的作用，并评估长期服用AR和/或哮喘药物是否影响COVID-19的预后。
方法：分析2020年3月16日至12月31日期间在英国生物银行完成SARS-CoV-2检测的70557名成人参与者的人口统计学和临床数据。基于调整后的广义线性模型评估新冠肺炎感染率、住院率和死亡率与既往AR和/或哮喘的关系。
对2020年3月16日至12月31日期间在英国生物银行完成SARS-CoV-2检测的70557名成人参与者的人口统计学和临床数据进行了分析。2019冠状病毒疾病的感染率、住院率和死亡率与预先存在的AR和/或哮喘有关，基于调整的广义线性模型进行评估。我们进一步分析了长期服用 AR 和/或哮喘药物对 COVID-19 住院和死亡风险的影响。
结果：各年龄段AR患者SARS-CoV-2检测阳性率明显较低（相对危险度[RR]：0.75，95%可信区间[CI]：0.69-0.81，P<0.001），男性患者的易感性（RR:0.74，95%可信区间：0.65-0.85，P<0.001）低于女性（RR:0.8，95%可信区间：0.72-0.9，P<0.001）。然而，哮喘对COVID-19住院治疗的类似影响主要发生在65岁以下的参与者中 (RR：0.93，95%CI：0.86-1，P=0.044)，而非老年人。相反，哮喘患者COVID-19检测阳性的住院风险较高(RR：1.42，95%CI：1.32-1.54，P<0.001)。AR和哮喘对COVID-19死亡率均无影响。AR或哮喘的常规药物，如抗组胺药、糖皮质激素、β-2肾上腺素受体激动剂等均未发现与COVID-19感染或严重程度相关。
结论：AR(各年龄段)和哮喘(<65岁)是预防COVID-19感染的保护因素，而哮喘则增加COVID-19住院风险。在AR和/或哮喘患者中，没有一种长期用药与COVID-19的感染、严重程度和死亡率有显著相关性。
Impact of Allergic Rhinitis and Asthma on COVID-19 Infection, Hospitalization, and Mortality
Jianjun Ren, Wendu Pang, Yaxin Luo, Danni Cheng, Ke Qiu, Yufang Rao, Yongbo Zheng, Yijun Dong, Jiajia Peng, Yao Hu, Zhiye Ying, Haopeng Yu, Xiaoxi Zeng, Zhiyong Zong, Geoffrey Liu, Deyun Wang, Gang Wang, Wei Zhang, Wei Xu, Yu Zhao
Abstract
BACKGROUND:It remains unclear if patients with allergic rhinitis (AR) and/or asthma are susceptible to corona virus disease 2019 (COVID-19) infection, severity, and mortality.
OBJECTIVE: To investigate the role of AR and/or asthma in COVID-19 infection, severity, and mortality, and assess whether long-term AR and/or asthma medications affected the outcomes of COVID-19.
METHODS: Demographic and clinical data of 70,557 adult participants completed SARS-CoV-2 testing between March 16 and December 31, 2020, in the UK Biobank were analyzed. The rates of COVID-19 infection, hospitalization, and mortality in relation to pre-existing AR and/or asthma were assessed based on adjusted generalized linear models. We further analyzed the impact of long-term AR and/or asthma medications on the risk of COVID-19 hospitalization and mortality.
RESULTS: Patients with AR of all ages had lower positive rates of SARS-CoV-2 tests (relative risk [RR]: 0.75, 95% confidence interval [CI]: 0.69-0.81, P < .001), with lower susceptibility in males (RR: 0.74, 95% CI: 0.65-0.85, P < .001) than females (RR: 0.8, 95% CI: 0.72-0.9, P < .001). However, similar effects of asthma against COVID-19 hospitalization were only major in participants aged <65 (RR: 0.93, 95% CI: 0.86-1, P = .044) instead of elderlies. In contrast, patients with asthma tested positively had higher risk of hospitalization (RR: 1.42, 95% CI: 1.32-1.54, P < .001). Neither AR nor asthma had an impact on COVID-19 mortality. None of conventional medications for AR or asthma, for example, antihistamines, corticosteroids, or β2 adrenoceptor agonists, showed association with COVID-19 infection or severity.
CONCLUSION:AR (all ages) and asthma (aged <65) act as protective factors against COVID-19 infection, whereas asthma increases risk for COVID-19 hospitalization. None of the long-term medications had a significant association with infection, severity, and mortality of COVID-19 among patients with AR and/or asthma.
背景：目前尚不清楚变应性鼻炎(AR)和/或哮喘患者是否易受2019年冠状病毒病(COVID-19)感染、严重程度和死亡率的影响。
目的：探讨AR和/或哮喘在COVID-19感染、严重程度和死亡率中的作用，并评估长期服用AR和/或哮喘药物是否影响COVID-19的预后。
方法：分析2020年3月16日至12月31日期间在英国生物银行完成SARS-CoV-2检测的70557名成人参与者的人口统计学和临床数据。基于调整后的广义线性模型评估新冠肺炎感染率、住院率和死亡率与既往AR和/或哮喘的关系。
对2020年3月16日至12月31日期间在英国生物银行完成SARS-CoV-2检测的70557名成人参与者的人口统计学和临床数据进行了分析。2019冠状病毒疾病的感染率、住院率和死亡率与预先存在的AR和/或哮喘有关，基于调整的广义线性模型进行评估。我们进一步分析了长期服用 AR 和/或哮喘药物对 COVID-19 住院和死亡风险的影响。
结果：各年龄段AR患者SARS-CoV-2检测阳性率明显较低（相对危险度[RR]：0.75，95%可信区间[CI]：0.69-0.81，P<0.001），男性患者的易感性（RR:0.74，95%可信区间：0.65-0.85，P<0.001）低于女性（RR:0.8，95%可信区间：0.72-0.9，P<0.001）。然而，哮喘对COVID-19住院治疗的类似影响主要发生在65岁以下的参与者中 (RR：0.93，95%CI：0.86-1，P=0.044)，而非老年人。相反，哮喘患者COVID-19检测阳性的住院风险较高(RR：1.42，95%CI：1.32-1.54，P<0.001)。AR和哮喘对COVID-19死亡率均无影响。AR或哮喘的常规药物，如抗组胺药、糖皮质激素、β-2肾上腺素受体激动剂等均未发现与COVID-19感染或严重程度相关。
结论：AR(各年龄段)和哮喘(<65岁)是预防COVID-19感染的保护因素，而哮喘则增加COVID-19住院风险。在AR和/或哮喘患者中，没有一种长期用药与COVID-19的感染、严重程度和死亡率有显著相关性。
(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. 2021 Oct 30;S2213-2198(21)01202-2.doi: 10.1016/j.jaip.2021.10.049. Online ahead of print.)
(J Allergy Clin Immunol Pract. 2021 Oct 30;S2213-2198(21)01202-2.doi: 10.1016/j.jaip.2021.10.049. Online ahead of print.)
Impact of Allergic Rhinitis and Asthma on COVID-19 Infection, Hospitalization, and Mortality
Jianjun Ren, Wendu Pang, Yaxin Luo, Danni Cheng, Ke Qiu, Yufang Rao, Yongbo Zheng, Yijun Dong, Jiajia Peng, Yao Hu, Zhiye Ying, Haopeng Yu, Xiaoxi Zeng, Zhiyong Zong, Geoffrey Liu, Deyun Wang, Gang Wang, Wei Zhang, Wei Xu, Yu Zhao
Abstract
BACKGROUND:It remains unclear if patients with allergic rhinitis (AR) and/or asthma are susceptible to corona virus disease 2019 (COVID-19) infection, severity, and mortality.
OBJECTIVE: To investigate the role of AR and/or asthma in COVID-19 infection, severity, and mortality, and assess whether long-term AR and/or asthma medications affected the outcomes of COVID-19.
METHODS: Demographic and clinical data of 70,557 adult participants completed SARS-CoV-2 testing between March 16 and December 31, 2020, in the UK Biobank were analyzed. The rates of COVID-19 infection, hospitalization, and mortality in relation to pre-existing AR and/or asthma were assessed based on adjusted generalized linear models. We further analyzed the impact of long-term AR and/or asthma medications on the risk of COVID-19 hospitalization and mortality.
RESULTS: Patients with AR of all ages had lower positive rates of SARS-CoV-2 tests (relative risk [RR]: 0.75, 95% confidence interval [CI]: 0.69-0.81, P < .001), with lower susceptibility in males (RR: 0.74, 95% CI: 0.65-0.85, P < .001) than females (RR: 0.8, 95% CI: 0.72-0.9, P < .001). However, similar effects of asthma against COVID-19 hospitalization were only major in participants aged <65 (RR: 0.93, 95% CI: 0.86-1, P = .044) instead of elderlies. In contrast, patients with asthma tested positively had higher risk of hospitalization (RR: 1.42, 95% CI: 1.32-1.54, P < .001). Neither AR nor asthma had an impact on COVID-19 mortality. None of conventional medications for AR or asthma, for example, antihistamines, corticosteroids, or β2 adrenoceptor agonists, showed association with COVID-19 infection or severity.
CONCLUSION:AR (all ages) and asthma (aged <65) act as protective factors against COVID-19 infection, whereas asthma increases risk for COVID-19 hospitalization. None of the long-term medications had a significant association with infection, severity, and mortality of COVID-19 among patients with AR and/or asthma.
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哮喘，慢性阻塞性肺疾病和随后的女性类风湿关节炎事件风险：一项前瞻性队列研究
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