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      The Impact of COVID-19 on Patients with Asthma

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          Abstract

          Background

          An association between the severity of COVID-19 and the presence of certain chronic conditions has been suggested. However, unlike influenza and other viruses, the disease burden in patients with asthma has been less evident.

          Objective

          To understand the impact of COVID-19 in patients with asthma.

          Methods

          Using big data analytics and artificial intelligence through the SAVANA Manager® clinical platform, we analysed clinical data from patients with asthma from January 1st to May 10th, 2020.

          Results

          Out of 71 182 patients with asthma, 1006 (1.41%) suffered from COVID-19. Compared to asthmatic individuals without COVID-19, patients with asthma and COVID-19 were significantly older (55 versus 42 years), predominantly female (66% versus 59%), smoked more frequently, and had higher prevalence of hypertension, dyslipidemias, diabetes, and obesity. Allergy-related factors such as rhinitis and eczema were less common in asthmatic patients with COVID-19 (p<.001). Higher prevalence of these comorbidities was also observed in patients with COVID-19 who required hospital admission. The use of inhaled corticosteroids (ICS) was lower in patients who required hospitalisation due to COVID-19, as compared to non-hospitalised patients (48.3% versus 61.5%; OR: 0.58: 95% CI 0.44–0.77). Although patients treated with biologics (n=865; 1.21%) showed increased severity and more comorbidities at the ENT level, COVID-19-related hospitalisations in these patients were relatively low (0.23%).

          Conclusion

          Patients with asthma and COVID-19 were older and at increased risk due to comorbidity-related factors. ICS and biologics are generally safe and may be associated with a protective effect against severe COVID-19 infection.

          Abstract

          The increased risk for hospitalisation due to COVID-19 in patients with asthma is largely associated with age and related comorbidities. ICS and biologics may be associated with a protective effect against the most severe manifestations of COVID-19.

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          Most cited references40

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          Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia

          Abstract Background The initial cases of novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the first 425 confirmed cases in Wuhan to determine the epidemiologic characteristics of NCIP. Methods We collected information on demographic characteristics, exposure history, and illness timelines of laboratory-confirmed cases of NCIP that had been reported by January 22, 2020. We described characteristics of the cases and estimated the key epidemiologic time-delay distributions. In the early period of exponential growth, we estimated the epidemic doubling time and the basic reproductive number. Results Among the first 425 patients with confirmed NCIP, the median age was 59 years and 56% were male. The majority of cases (55%) with onset before January 1, 2020, were linked to the Huanan Seafood Wholesale Market, as compared with 8.6% of the subsequent cases. The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days. In its early stages, the epidemic doubled in size every 7.4 days. With a mean serial interval of 7.5 days (95% CI, 5.3 to 19), the basic reproductive number was estimated to be 2.2 (95% CI, 1.4 to 3.9). Conclusions On the basis of this information, there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019. Considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere. Measures to prevent or reduce transmission should be implemented in populations at risk. (Funded by the Ministry of Science and Technology of China and others.)
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            The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.

            Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September, 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles.18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies.A detailed explanation and elaboration document is published separately and is freely available on the websites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE statement will contribute to improving the quality of reporting of observational studies
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              Detection of SARS-CoV-2 in Different Types of Clinical Specimens

              This study describes results of PCR and viral RNA testing for SARS-CoV-2 in bronchoalveolar fluid, sputum, feces, blood, and urine specimens from patients with COVID-19 infection in China to identify possible means of non-respiratory transmission.
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                Author and article information

                Journal
                Eur Respir J
                Eur Respir J
                ERJ
                erj
                The European Respiratory Journal
                European Respiratory Society
                0903-1936
                1399-3003
                5 November 2020
                5 November 2020
                : 2003142
                Affiliations
                [1 ]Respiratory Medicine, University Hospital of Guadalajara, Guadalajara, Spain
                [2 ]Department of Medicine and Medical Specialties, University of Alcalá, Madrid, Spain
                [3 ]Respiratory Medicine, University Hospital Ramón y Cajal, Madrid, Spain
                [4 ]Savana Medica, Madrid, Spain
                [5 ]Respiratory Medicine, Hospital Universitario de La Princesa, Madrid, Spain
                [6 ]Universidad Autónoma de Madrid. Madrid, Spain
                [7 ]Respiratory Diseases Networking Biomedical Research Centre (CIBERES), Institute of Health Carlos III (ISCIII), Madrid, Spain
                [8 ]Allergy, University Hospital of Guadalajara, Guadalajara, Spain
                Author notes
                Dr. Joan B Soriano, Servicio de Neumología, Hospital Universitario de la Princesa-UAM, Diego de León 62, 28005-Madrid, Spain. E-mail: jbsoriano2@ 123456gmail.com
                Author information
                https://orcid.org/0000-0001-9740-2994
                Article
                ERJ-03142-2020
                10.1183/13993003.03142-2020
                7651839
                33154029
                ae007b13-383e-4407-98bc-9bed693a803f
                Copyright ©ERS 2020

                This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.

                History
                : 14 August 2020
                : 20 October 2020
                Funding
                Funded by: Universidad de Alcalá , open-funder-registry 10.13039/501100006302;
                Award ID: Grant COVID-19 UAH 2019/00003/016/001/005 from the
                Categories
                Original Article

                Respiratory medicine
                Respiratory medicine

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