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Characteristics and outcomes of adult patients with asthma presenting with COVID-19: A comparative cohort study

Alhmoud et al., Qatar Medical Journal, doi:10.5339/qmj.2023.15
Sep 2023  
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Hospitalization 13% Improvement Relative Risk Montelukast for COVID-19  Alhmoud et al.  Prophylaxis Is prophylaxis with montelukast beneficial for COVID-19? Retrospective 616 patients in Qatar (March - August 2020) No significant difference in hospitalization Alhmoud et al., Qatar Medical J., September 2023 Favorsmontelukast Favorscontrol 0 0.5 1 1.5 2+
28th treatment shown to reduce risk in November 2021
*, now with p = 0.0045 from 8 studies.
Lower risk for mortality, hospitalization, and cases.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,400+ studies for 81 treatments.
Retrospective 616 COVID-19 patients with asthma in Qatar showing no significant difference in hospitalization risk with montelukast use.
Although the 13% lower hospitalization is not statistically significant, it is consistent with the significant 17% lower hospitalization [8‑25%] from meta analysis of the 6 hospitalization results to date.
risk of hospitalization, 13.0% lower, OR 0.87, p = 0.61, treatment 111, control 505, adjusted per study, multivariable, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Alhmoud et al., 23 Sep 2023, retrospective, Qatar, peer-reviewed, median age 44.0, 10 authors, study period 10 March, 2020 - 10 August, 2020. Contact:
This PaperMontelukastAll
Characteristics and outcomes of adult patients with asthma presenting with COVID-19: A comparative cohort study
Eman Alhmoud, Raja Barazi, Mohammed Saad, Dania Al Khiyami, Reem El Ajez, Dana Bakdach, Ali Omrani, Wanis Ibrahim, Rasha El Anany, Moza Al-Hail
Qatar Medical Journal, doi:10.5339/qmj.2023.15
Background: Bronchial asthma affects about 20% of Qatar's population. The impact of asthma on COVID-19 outcomes is controversial. The aim of this study was to explore the impact of asthma on COVID-19 outcomes and the predictors of COVID-19related morbidity and mortality in a cohort of asthma patients infected by COVID-19. Methods: This is a retrospective cohort study of adult patients with asthma infected with COVID-19, who were recruited from Hamad Medical Corporation (HMC), the main healthcare system in Qatar. Patients were matched to a control group of non-asthmatic COVID-19 patients (1:2) based on sex, age, and other comorbidities. Results: Between March and August 2020, 616 patients with asthma met the inclusion criteria. The need for hospitalization among patients with asthma was independently associated with older age (adjusted odds ratio [aOR] for 10 years, 1.32; 95% confidence interval [CI], 1.13-1.54; p = 0.001) and hypertension (aOR, 2.4; 95% CI, 1.43-3.93; p = 0.001) but not with the use of inhaled corticosteroids (ICS), long-acting beta2 agonists, montelukast, or tiotropium. Patients with asthma required less hospitalization for COVID-19 than non-asthmatic patients (28.2% vs. 37.3%, respectively; aOR, 0.59; 95% CI, 0.77-0.90; p < 0.001). However, admission to the intensive care unit (ICU) was comparable between both groups (3.3% vs. 2.2%; aOR, 1.64; 95% CI, 0.78-3.43; p = 0.193). No difference in mortality rate was observed between the two groups. 1
CONCLUSION Based on the results of the current study, older age and history of hypertension appear to be independently associated with COVID-19 hospitalization among patients with asthma. Patients with asthma had a lower risk of hospitalization, but not ICU admission, compared to non-asthmatic patients. Further research is warranted to explore the effects of different asthma phenotypes, ethnic backgrounds, and vaccination status on the outcomes of COVID-19 infections among this patient group. CONFLICT OF INTEREST The authors declare that there is no conflict of interest or financial disclosures to be disclosed. limitation of the study approval duration coupled with the available registry for matching. Extending the study period might have identified more patients with asthma and thus have resulted in a larger studied population. However, the advantage of such a cohort still exists in the fact that all included patients were still not vaccinated and thus helped in reducing the confounding effects of the vaccines on different COVID-19 outcomes. Second, given the retrospective nature of the study, along with the use of electronic health records to obtain the studied sample, misclassification and incomplete documentation issues are unavoidable and could have some impact on the internal validity of the study. Moreover, different studies have recently coupled the phenotype of asthma to COVID-19 severity. However, in our study, we have not recorded the different phenotypes of..
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