■由于疾病的异质性和复杂性,评估哮喘患者的COVID-19风险具有挑战性。我们假设COVID-19的潜在危险因素在哮喘年龄组之间可能不同,一起研究时阻碍了重要的见解。
■我们纳入了来自瑞典国家气道登记机构(SNAR)的哮喘患者人群队列,并与来自多个国家健康登记机构的数据相关联。COVID-19结果包括感染,住院治疗,从2020年1月至2021年2月死亡。哮喘患者按年龄12-17、18-39、40-64和≥65岁分组。将具有不同COVID-19结局的哮喘患者的特征与相应年龄的各自来源人群的特征进行比较。
■在研究的201,140名哮喘患者中,11.2%的人年龄在12-17岁之间,26.4%18-39岁,37.6%40-64岁,24.9%≥65岁。我们观察到18,048(9.0%)COVID-19感染,2172(1.1%)住院,336例(0.2%)COVID-19死亡。死亡仅发生在≥40岁的患者中。当按年龄比较COVID-19病例和来源哮喘人群时,潜在风险因素出现了巨大差异,主要是因为COVID-19住院和死亡。对于12-17岁的人,这些包括教育,employment,自身免疫,精神病学,和抑郁状态,以及使用短效β-激动剂(SABA)和吸入性皮质类固醇(ICS)。在18-39岁年龄段,最大的差异是年龄,婚姻状况,呼吸衰竭,焦虑,和体重指数。40-64岁的性别表现出明显的差异,出生区域,癌症,口服皮质类固醇,抗组胺药,和吸烟。对于年龄≥65岁的人,心血管合并症的差异最大,1型糖尿病,慢性阻塞性肺疾病,过敏状况,和特定的哮喘治疗(ICS-SABA,ICS-长效支气管扩张剂(LABA))。哮喘控制和肺功能在所有年龄组都很重要。
■我们发现不同年龄的哮喘患者在COVID-19相关危险因素方面存在明显差异。这些信息对于评估哮喘患者的COVID-19风险以及相应地定制患者护理和公共卫生策略至关重要。
为什么要进行这项研究?哮喘患者可能更容易受到COVID-19结果的影响。哮喘影响所有年龄段,与COVID-19相关的危险因素可能随年龄而变化。调查导致COVID-19感染的因素,住院治疗,和不同年龄组哮喘患者的死亡率可以更全面地了解COVID-19风险的年龄特异性细微差别。研究人员做了什么和发现了什么?我们分析了社会人口统计学特征,合并症,处方药,不同年龄组COVID-19哮喘患者的临床特征,并与相应年龄来源的哮喘人群进行比较。COVID-19的潜在危险因素及其结果因年龄组而异。对于12-17岁的儿童,这些包括教育,employment,自身免疫,精神病学,和抑郁状态,以及使用短效β-激动剂(SABA)和吸入性皮质类固醇(ICS)。在18-39岁年龄段,最大的差异是年龄,婚姻状况,呼吸衰竭,焦虑,和体重指数。40-64岁的性别表现出明显的差异,出生区域,癌症,口服皮质类固醇,抗组胺药,和吸烟。对于年龄≥65岁的人,心血管合并症的差异最大,1型糖尿病,慢性阻塞性肺疾病,过敏性哮喘,和特定的哮喘治疗(ICS-SABA,ICS-长效支气管扩张剂(LABA))。哮喘控制和肺功能在所有年龄组都很重要。这些结果意味着什么?这些结果强调了在因果分析中认识到导致COVID-19风险的特定年龄模式的重要性。研究结果还强调了在临床和公共卫生干预措施中采用年龄特异性方法来管理哮喘患者的COVID-19的必要性。
UNASSIGNED: Assessing COVID-19 risk in asthma patients is challenging due to disease heterogeneity and complexity. We hypothesized that potential risk factors for COVID-19 may differ among asthma age groups, hindering important insights when studied together.
UNASSIGNED: We included a population-based cohort of asthma patients from the Swedish National Airway Register (SNAR) and linked to data from several national health registers. COVID-19 outcomes included infection, hospitalization, and death from Jan 2020 until Feb 2021.
Asthma patients were grouped by ages 12-17, 18-39, 40-64, and ≥65 years. Characteristics of asthma patients with different COVID-19 outcomes were compared with those in their age-corresponding respective source population.
UNASSIGNED: Among 201,140 asthma patients studied, 11.2% were aged 12-17 years, 26.4% 18-39, 37.6% 40-64, and 24.9% ≥65 years. We observed 18,048 (9.0%) COVID-19 infections, 2172 (1.1%) hospitalizations, and 336 (0.2%) COVID-19 deaths. Deaths occurred only among patients aged ≥40. When comparing COVID-19 cases to source asthma populations by age, large differences in potential risk factors emerged, mostly for COVID-19 hospitalizations and deaths. For ages 12-17, these included education, employment, autoimmune, psychiatric, and depressive conditions, and use of short-acting β-agonists (SABA) and inhaled corticosteroids (ICS). In the 18-39 age group, largest differences were for age, marital status, respiratory failure, anxiety, and body mass index. Ages 40-64 displayed notable differences for sex, birth region, cancer, oral corticosteroids, antihistamines, and smoking. For those aged ≥65, largest differences were observed for cardiovascular comorbidities, type 1 diabetes, chronic obstructive pulmonary disease, allergic conditions, and specific
asthma treatments (ICS-SABA, ICS-long-acting bronchodilators (LABA)).
Asthma control and lung function were important across all age groups.
UNASSIGNED: We identify distinct differences in COVID-19-related risk factors among asthma patients of different ages. This information is essential for assessing COVID-19 risk in asthma patients and for tailoring patient care and public health strategies accordingly.
Why was the study done?
Asthma patients may be more susceptible to COVID-19 outcomes.
Asthma affects all ages, and COVID-19-related risk factors may vary with age. Investigating factors that contribute to COVID-19 infection, hospitalization, and mortality within distinct age groups of asthma patients can yield a more comprehensive understanding of the age-specific nuances of COVID-19 risk. What did the researchers do and find? We analyzed sociodemographic characteristics, comorbidities, prescribed medications, and clinical characteristics of asthma patients with COVID-19 in different age groups and compared them with their age-corresponding source asthma populations. Potential risk factors for COVID-19 and its outcomes differed by age group For ages 12-17, these included education, employment, autoimmune, psychiatric, and depressive conditions, and use of short-acting β-agonists (SABA) and inhaled corticosteroids (ICS). In the 18-39 age group, largest differences were for age, marital status, respiratory failure, anxiety, and body mass index. Ages 40-64 displayed notable differences for sex, birth region, cancer, oral corticosteroids, antihistamines, and smoking. For those aged ≥65, largest differences were observed for cardiovascular comorbidities, type 1 diabetes, chronic obstructive pulmonary disease, allergic asthma, and specific
asthma treatments (ICS-SABA, ICS-long-acting bronchodilators (LABA)).
Asthma control and lung function were important across all age groups. What do these results mean? These results emphasize the importance of recognizing age-specific patterns contributing to COVID-19 risk for consideration in causal analyses. The findings also highlight the necessity for age-specific approaches in both clinical and public health interventions in managing COVID-19 in asthma patients.