Abstract

While there are postulations that asthma is potentially associated with severe coronavirus disease 2019 (COVID-19), there has been conflicting results from studies among pediatric and adult populations on the impact mild-to-moderate COVID-19 infection on asthma control after its recovery.

An observation study on the association between mild-to-moderate COVID-19 and asthma control post infection was conducted in Queen Mary Hospital. The primary outcome was a reduction in Asthma Control Test (ACT) score by > 3 points post-COVID infection. The secondary outcomes included the magnitude of change in ACT score, the proportion of patient with ACT score who dropped to <15 on enrolment visi and the need for escalation of asthma maintenance therapy.

Out of the total of 221 adult patients with asthma recruited, 111 had mild-to-moderate COVID-19 within 30 to 270 days prior to study enrolment. The adjusted odds ratio (aOR) for a reduction in ACT score by > 3 points after COVID-19 was 3.105 (95% CI = 1.385 ? 6.959, p = 0.006). The odds of escalation of asthma maintenance therapy by at least 1 Global Initiative for Asthma (GINA) step was 4.733 (95% CI = 1.151 ? 19.467, p = 0.031) and asthma patient are more likely to become uncontrolled after COVID-19 [aOR = 5.509 (95% CI = 1.061 ? 28.600, p = 0.042)].

Mild-to-moderate COVID-19 among asthma patients, upon recovery, was associated with worsening of asthma symptom, lower ACT score, a higher need for escalation of asthma maintenance therapy and more uncontrolled asthma.