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Allergic disorders and susceptibility to and severity of COVID-19: A nationwide cohort study.
J Allergy Clin Immunol. 2020 10; 146(4):790-798.JA

Abstract

BACKGROUND

There is inconclusive and controversial evidence of the association between allergic diseases and the risk of adverse clinical outcomes of coronavirus disease 2019 (COVID-19).

OBJECTIVE

We sought to determine the association of allergic disorders with the likelihood of a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test result and with clinical outcomes of COVID-19 (admission to intensive care unit, administration of invasive ventilation, and death).

METHODS

A propensity-score-matched nationwide cohort study was performed in South Korea. Data obtained from the Health Insurance Review & Assessment Service of Korea from all adult patients (age, >20 years) who were tested for SARS-CoV-2 in South Korea between January 1, 2020, and May 15, 2020, were analyzed. The association of SARS-CoV-2 test positivity and allergic diseases in the entire cohort (n = 219,959) and the difference in clinical outcomes of COVID-19 were evaluated in patients with allergic diseases and SARS-CoV-2 positivity (n = 7,340).

RESULTS

In the entire cohort, patients who underwent SARS-CoV-2 testing were evaluated to ascertain whether asthma and allergic rhinitis were associated with an increased likelihood of SARS-CoV-2 test positivity. After propensity score matching, we found that asthma and allergic rhinitis were associated with worse clinical outcomes of COVID-19 in patients with SARS-CoV-2 test positivity. Patients with nonallergic asthma had a greater risk of SARS-CoV-2 test positivity and worse clinical outcomes of COVID-19 than patients with allergic asthma.

CONCLUSIONS

In a Korean nationwide cohort, allergic rhinitis and asthma, especially nonallergic asthma, confers a greater risk of susceptibility to SARS-CoV-2 infection and severe clinical outcomes of COVID-19.

Authors+Show Affiliations

Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, Mass.Department of Data Science, Sejong University College of Software Convergence, Seoul, Korea.Department of Gastroenterology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.Department of Pediatrics, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.Department of Radiology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea.Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.Armed Force Medical Command, Republic of Korea Armed Forces, Seongnam, Korea; Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea. Electronic address: yonkkang@gmail.com.Department of Data Science, Sejong University College of Software Convergence, Seoul, Korea. Electronic address: swlsejong@sejong.ac.kr.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32810517

Citation

Yang, Jee Myung, et al. "Allergic Disorders and Susceptibility to and Severity of COVID-19: a Nationwide Cohort Study." The Journal of Allergy and Clinical Immunology, vol. 146, no. 4, 2020, pp. 790-798.
Yang JM, Koh HY, Moon SY, et al. Allergic disorders and susceptibility to and severity of COVID-19: A nationwide cohort study. J Allergy Clin Immunol. 2020;146(4):790-798.
Yang, J. M., Koh, H. Y., Moon, S. Y., Yoo, I. K., Ha, E. K., You, S., Kim, S. Y., Yon, D. K., & Lee, S. W. (2020). Allergic disorders and susceptibility to and severity of COVID-19: A nationwide cohort study. The Journal of Allergy and Clinical Immunology, 146(4), 790-798. https://doi.org/10.1016/j.jaci.2020.08.008
Yang JM, et al. Allergic Disorders and Susceptibility to and Severity of COVID-19: a Nationwide Cohort Study. J Allergy Clin Immunol. 2020;146(4):790-798. PubMed PMID: 32810517.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Allergic disorders and susceptibility to and severity of COVID-19: A nationwide cohort study. AU - Yang,Jee Myung, AU - Koh,Hyun Yong, AU - Moon,Sung Yong, AU - Yoo,In Kyung, AU - Ha,Eun Kyo, AU - You,Seulgi, AU - Kim,So Young, AU - Yon,Dong Keon, AU - Lee,Seung Won, Y1 - 2020/08/15/ PY - 2020/06/06/received PY - 2020/08/07/revised PY - 2020/08/07/accepted PY - 2020/8/19/pubmed PY - 2020/10/22/medline PY - 2020/8/19/entrez KW - COVID-19 KW - allergic rhinitis KW - asthma KW - atopic dermatitis SP - 790 EP - 798 JF - The Journal of allergy and clinical immunology JO - J Allergy Clin Immunol VL - 146 IS - 4 N2 - BACKGROUND: There is inconclusive and controversial evidence of the association between allergic diseases and the risk of adverse clinical outcomes of coronavirus disease 2019 (COVID-19). OBJECTIVE: We sought to determine the association of allergic disorders with the likelihood of a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test result and with clinical outcomes of COVID-19 (admission to intensive care unit, administration of invasive ventilation, and death). METHODS: A propensity-score-matched nationwide cohort study was performed in South Korea. Data obtained from the Health Insurance Review & Assessment Service of Korea from all adult patients (age, >20 years) who were tested for SARS-CoV-2 in South Korea between January 1, 2020, and May 15, 2020, were analyzed. The association of SARS-CoV-2 test positivity and allergic diseases in the entire cohort (n = 219,959) and the difference in clinical outcomes of COVID-19 were evaluated in patients with allergic diseases and SARS-CoV-2 positivity (n = 7,340). RESULTS: In the entire cohort, patients who underwent SARS-CoV-2 testing were evaluated to ascertain whether asthma and allergic rhinitis were associated with an increased likelihood of SARS-CoV-2 test positivity. After propensity score matching, we found that asthma and allergic rhinitis were associated with worse clinical outcomes of COVID-19 in patients with SARS-CoV-2 test positivity. Patients with nonallergic asthma had a greater risk of SARS-CoV-2 test positivity and worse clinical outcomes of COVID-19 than patients with allergic asthma. CONCLUSIONS: In a Korean nationwide cohort, allergic rhinitis and asthma, especially nonallergic asthma, confers a greater risk of susceptibility to SARS-CoV-2 infection and severe clinical outcomes of COVID-19. SN - 1097-6825 UR - https://www.unboundmedicine.com/medline/citation/32810517/Allergic_disorders_and_susceptibility_to_and_severity_of_COVID_19:_A_nationwide_cohort_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091-6749(20)31136-2 DB - PRIME DP - Unbound Medicine ER -