Association between asthma and COVID-19 severity during Omicron epidemic: a retrospective cohort study using real-world data

BackgroundThe available evidence presented inconsistencies and inconclusive findings regarding the associations between co-existing asthma and mortality among COVID-19 patients. The objective of the current study is to investigate the relationship between asthma and severe outcomes after SARS-CoV-2 Omicron infection in an infection-na & iuml;ve population.MethodsA retrospective cohort study using propensity score matching was conducted. The COVID-19 patients requiring hospitalisation in Hong Kong from January 1, 2022, to November 13, 2022, an Omicron-predominated period, were identified. Severe clinical outcomes were defined as ICU admission and inpatient death after the first positive PCR results as well as a composite outcome of both.ResultsOf the 74,396 hospitalised COVID-19 patients admitted, 1,290 asthma patients and 18,641 non-asthma patients were included in the matched cohort. The rates of death and the composite outcome were 15<middle dot>3% and 17<middle dot>2%, respectively, among the non-asthma patients,12<middle dot>2% and 13<middle dot>6%, respectively, among the asthma patients, with adjusted hazard ratios equal to 0<middle dot>775 (95% CI: 0<middle dot>660-0<middle dot>909) and 0<middle dot>770 (95% CI: 0<middle dot>662-0<middle dot>895), respectively. The negative association was more apparent in the elderly and female groups. Asthma remained a factor that lowered the risk of disease severity even though the patients were not fully vaccinated with at least two doses.ConclusionsWe used real-world data to demonstrate that asthma was not a risk factor for COVID-19 severity of the infections of Omicron variant, even though the patients were not fully vaccinated.