哮喘与COVID-19风险：一项系统综述和荟萃分析
2022/04/19
摘要
背景：关于哮喘患者对新型冠状病毒肺炎（COVID-19）的易感性和死亡风险，单独病例系列和队列研究报告了相互矛盾的结果。
目的：探索哮喘患者是否感染COVID-19或因COVID-19住院的风险更高，或者患 COVID-19 的临床结果更差。
方法：基于包括世界卫生组织 COVID-19 数据库在内的5个主要数据库，对 2019 年 12 月 1 日至 2021 年 7 月 11 日期间含对照组（非哮喘）组的研究进行系统评价和荟萃分析。采用 Sidik-Jonkman 随机效应荟萃分析汇总患病率和风险比。
结果：51 项研究汇总了 COVID-19 阳性病例中哮喘患者的患病率，为8.08%（95% 置信区间为 6.87-9.30%）。感染 COVID-19 的风险比为 0.83（95% 置信区间为0.73-0.95，p=0.01），住院率为 1.18（95% 置信区间为 0.98-1.42, p=0.08），重症监护病房 （ICU）入院率为 1.21 （95% 置信区间为0.97-1.51, p=0.09），呼吸机使用率为1.06 （95% 置信区间为 0.82-1.36，p=0.65），哮喘患者死亡率为 0.94（95% 置信区间为0.76-1.17，p=0.58）。不同大洲亚组分析显示，不同大洲之间在感染 COVID-19、ICU 入院、呼吸机使用和死亡的风险方面存在显著差异。
结论：与非哮喘组相比，哮喘患者组感染新型冠状病毒（SARS-Cov-2）的风险降低。两组之间住院率、ICU入院率和呼吸机使用率无统计学差异。亚组分析显示，美洲、欧洲和亚洲之间 COVID-19 的结局存在显著差异。仍需进一步研究来确证这种风险状况，尤其是研究较少的非洲和南美洲。
Asthma and COVID-19 risk: a systematic review and meta-analysis
Sunjaya AP, Allida SM, Di Tanna GL, Jenkins CR.
Abstract
BACKGROUND：Individual case series and cohort studies have reported conflicting results in people with asthma on the vulnerability to and risk of mortality from coronavirus disease 2019 (COVID-19).
RESEARCH QUESTION：Are people with asthma at a higher risk of being infected or hospitalised or poorer clinical outcomes from COVID-19?
METHODS：A systematic review and meta-analysis based on five main databases including the World Health Organization COVID-19 database between 1 December 2019 and 11 July 2021 on studies with a control (non-asthma) group was conducted. Prevalence and risk ratios were pooled using Sidik-Jonkman random-effects meta-analyses.
FINDINGS：51 studies with an 8.08% (95% CI 6.87-9.30%) pooled prevalence of people with asthma among COVID-19 positive cases. The risk ratios were 0.83 (95% CI 0.73-0.95, p=0.01) for acquiring COVID-19; 1.18 (95% CI 0.98-1.42, p=0.08) for hospitalisation; 1.21 (95% CI 0.97-1.51, p=0.09) for intensive care unit (ICU) admission; 1.06 (95% CI 0.82-1.36, p=0.65) for ventilator use; and 0.94 (95% CI 0.76-1.17, p=0.58) for mortality for people with asthma. Subgroup analyses by continent revealed a significant difference in risk of acquiring COVID-19, ICU admission, ventilator use and death between the continents.
INTERPRETATION：The risk of being infected with severe acute respiratory syndrome coronavirus 2 was reduced compared to the non-asthma group. No statistically significant differences in hospitalisation, ICU admission and ventilator use were found between groups. Subgroup analyses showed significant differences in outcomes from COVID-19 between America, Europe and Asia. Additional studies are required to confirm this risk profile, particularly in Africa and South America, where few studies originate.
背景：关于哮喘患者对新型冠状病毒肺炎（COVID-19）的易感性和死亡风险，单独病例系列和队列研究报告了相互矛盾的结果。
目的：探索哮喘患者是否感染COVID-19或因COVID-19住院的风险更高，或者患 COVID-19 的临床结果更差。
方法：基于包括世界卫生组织 COVID-19 数据库在内的5个主要数据库，对 2019 年 12 月 1 日至 2021 年 7 月 11 日期间含对照组（非哮喘）组的研究进行系统评价和荟萃分析。采用 Sidik-Jonkman 随机效应荟萃分析汇总患病率和风险比。
结果：51 项研究汇总了 COVID-19 阳性病例中哮喘患者的患病率，为8.08%（95% 置信区间为 6.87-9.30%）。感染 COVID-19 的风险比为 0.83（95% 置信区间为0.73-0.95，p=0.01），住院率为 1.18（95% 置信区间为 0.98-1.42, p=0.08），重症监护病房 （ICU）入院率为 1.21 （95% 置信区间为0.97-1.51, p=0.09），呼吸机使用率为1.06 （95% 置信区间为 0.82-1.36，p=0.65），哮喘患者死亡率为 0.94（95% 置信区间为0.76-1.17，p=0.58）。不同大洲亚组分析显示，不同大洲之间在感染 COVID-19、ICU 入院、呼吸机使用和死亡的风险方面存在显著差异。
结论：与非哮喘组相比，哮喘患者组感染新型冠状病毒（SARS-Cov-2）的风险降低。两组之间住院率、ICU入院率和呼吸机使用率无统计学差异。亚组分析显示，美洲、欧洲和亚洲之间 COVID-19 的结局存在显著差异。仍需进一步研究来确证这种风险状况，尤其是研究较少的非洲和南美洲。
(中日友好医院呼吸与危重症医学科 张婧媛 摘译 林江涛 审校)
(Eur Respir J. 2022;59(3):2101209. doi:10.1183/13993003.01209-2021)
(Eur Respir J. 2022;59(3):2101209. doi:10.1183/13993003.01209-2021)
Asthma and COVID-19 risk: a systematic review and meta-analysis
Sunjaya AP, Allida SM, Di Tanna GL, Jenkins CR.
Abstract
BACKGROUND：Individual case series and cohort studies have reported conflicting results in people with asthma on the vulnerability to and risk of mortality from coronavirus disease 2019 (COVID-19).
RESEARCH QUESTION：Are people with asthma at a higher risk of being infected or hospitalised or poorer clinical outcomes from COVID-19?
METHODS：A systematic review and meta-analysis based on five main databases including the World Health Organization COVID-19 database between 1 December 2019 and 11 July 2021 on studies with a control (non-asthma) group was conducted. Prevalence and risk ratios were pooled using Sidik-Jonkman random-effects meta-analyses.
FINDINGS：51 studies with an 8.08% (95% CI 6.87-9.30%) pooled prevalence of people with asthma among COVID-19 positive cases. The risk ratios were 0.83 (95% CI 0.73-0.95, p=0.01) for acquiring COVID-19; 1.18 (95% CI 0.98-1.42, p=0.08) for hospitalisation; 1.21 (95% CI 0.97-1.51, p=0.09) for intensive care unit (ICU) admission; 1.06 (95% CI 0.82-1.36, p=0.65) for ventilator use; and 0.94 (95% CI 0.76-1.17, p=0.58) for mortality for people with asthma. Subgroup analyses by continent revealed a significant difference in risk of acquiring COVID-19, ICU admission, ventilator use and death between the continents.
INTERPRETATION：The risk of being infected with severe acute respiratory syndrome coronavirus 2 was reduced compared to the non-asthma group. No statistically significant differences in hospitalisation, ICU admission and ventilator use were found between groups. Subgroup analyses showed significant differences in outcomes from COVID-19 between America, Europe and Asia. Additional studies are required to confirm this risk profile, particularly in Africa and South America, where few studies originate.
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哮喘儿童中肥胖、潮气量与肺内细颗粒物沉积的关系分析
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从儿童到成人的哮喘和过敏症状轨迹
