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?:abstract
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Background The impact of asthma on COVID-19 remains largely unknown. Objective To investigate the asthma prevalence among COVID-19 patients and compare outcomes between asthma and non-asthma patients. Methods In this systematic review and meta-analysis, we searched PubMed, Embase, Web of Science, Biorxiv and Medrxiv for studies reporting asthma prevalence in general COVID-19 patients or comparing outcomes between asthma and non-asthma patients, 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. Results Based on 131 studies (410382 patients), we found great variability in the prevalence of comorbid asthma among COVID-19 patients in different countries or regions ranging from 1.1% to 16.9%. No significant difference in asthma prevalence was found between hospitalized and non-hospitalized (RR: 1.15, 95% confidence interval: 0.92-1.43), severe and non-severe (RR: 1.21, 95% confidence interval: 0.92-1.57), ICU and non-ICU (RR: 1.19, 95% confidence interval: 0.92-1.54,), dead and survived (RR: 0.90, 95% confidence interval: 0.73-1.11), intubated/mechanically ventilated and non-intubated/mechanically ventilated (RR: 0.91, 95% confidence interval: 0.71-1.17) COVID-19 patients. Asthmatic patients have a lower risk of death compared with non-asthmatic patients (RR: 0.65, 95% confidence interval: 0.43-0.98). Asthma is not associated with higher risk of intubation or mechanical ventilation (RR: 1.03, 95% confidence interval: 0.72-1.46). Conclusions There is great variability in asthma prevalence among COVID-19 patients in different countries or regions. Asthma is not associated with higher COVID-19 severity or worse prognosis, and asthmatic patients are found to have lower risk of death compared with non-asthmatic patients.
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