key: cord-0999614-kyisfyj9
authors: Alberca, Ricardo Wesley; Yendo, Tatiana; Aoki, Valéria; Sato, Maria Notomi
title: Asthmatic patients and COVID‐19: Different disease course?
date: 2021-03-06
journal: Allergy
DOI: 10.1111/all.14601
sha: 490dbc30a7d59161c9a49c4c9f69a55746213656
doc_id: 999614
cord_uid: kyisfyj9

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Asthma is a complex respiratory syndrome that compresses different inflammatory profiles which could influence the immune response to SARS-CoV-2 and ACE2 expression differently.

A caveat of this investigation is that all asthmatic patients were previously diagnosed and we could not determine their asthma endotype.

Inhaled corticosteroid (IC) and anti-asthma (AA) drugs could act as possible modulators of SARS-CoV-2 infection which could reduce the incidence of COVID-19 in asthma patients but in our cohort asthma patients did not regularly use IC or AA drugs. Although the number of cases was low our asthma patients also presented SAH a risk factor for COVID-19 but no difference was verified in the hospitalization time between all groups ( Figure 1A ).

The MODERATE group presented a lower ratio of neutrophils to lymphocytes and neutrophils in the blood which are relevant COVID-19 severity markers in relation to the other groups ( Figure 1B-C) .

Asthma patients showed reduced levels of creatinine C-reactive protein and platelets in comparison with SAH patients (Figure 1D -F).

Our data indicate that asthmatic patients did not present an increase in hospitalization time or COVID-19 severity; in contrast asthmatic patients exhibited a reduction in some of the COVID-19 severity-associated markers.

We hypothesize that type 2 cytokines produced in eosinophilic asthma may downregulate ACE2 expression or counteract type 1 cytokines released in COVID-19 5 therefore presenting as a protective factor; however patients with asthma are not immune to COVID-19. Our university hospital is a referral unit for moderate or severe cases of COVID-19; hence this profile may not be present in mild COVID-19 cases. Our study is the first asthma-related report in the Brazilian population but further investigation is needed to better understand the influence of asthma on COVID-19.

asthma, COVID-19, SARS-CoV-2, systemic arterial hypertension

The authors declare that they have no conflicts of interest. 

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