• Shuang Liu, Yang Cao, Tian Du, and Yuxiang Zhi.
• Department of Allergy & Clinical Immunology, National Clinical Research Center for Immunologic Diseases, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China; School of Clinical Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
• J Allergy Clin Immunol Pract. 2021 Feb 1; 9 (2): 693-701.

BackgroundThe impact of asthma on coronavirus disease 2019 (COVID-19) remains largely unknown.ObjectiveTo investigate the asthma prevalence among patients with COVID-19 and compare outcomes between patients with and without asthma.MethodsIn this systematic review and meta-analysis, we searched PubMed, Embase, Web of Science, bioRxiv, and medRxiv for studies reporting asthma prevalence in general patients with COVID-19 or comparing outcomes between patients with and without asthma, and excluded duplicate publications, reviews, editorials, comments, single case reports, or small case series (<10 cases). We determined the pooled estimates of effect using random-effect model.ResultsOn the basis of 131 studies (410,382 patients), we found great variability in the prevalence of comorbid asthma among patients with COVID-19 in different countries or regions ranging from 1.1% to 16.9%. No significant difference in asthma prevalence was found between hospitalized and nonhospitalized (risk ratio [RR], 1.15; 95% CI, 0.92-1.43), severe and nonsevere (RR, 1.21; 95% CI, 0.92-1.57), intensive care unit and non-intensive care unit (RR, 1.19; 95% CI, 0.92-1.54), dead and survived (RR, 0.90; 95% CI, 0.73-1.11), intubated/mechanically ventilated and nonintubated/mechanically ventilated (RR, 0.91; 95% CI, 0.71-1.17) patients with COVID-19. Patients with asthma have a lower risk of death compared with patients without asthma (RR, 0.65; 95% CI, 0.43-0.98). Asthma is not associated with a higher risk of intubation or mechanical ventilation (RR, 1.03; 95% CI, 0.72-1.46).ConclusionsThere is great variability in asthma prevalence among patients with COVID-19 in different countries or regions. Asthma is not associated with higher COVID-19 severity or worse prognosis, and patients with asthma are found to have a lower risk of death compared with patients without asthma.Copyright © 2020 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

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