Asthmatics at lower risk of getting covid.

[PupInAPram]

Well I wasn't expecting that! Asthmatics at significantly lower risk of catching covid. I'm double jabbed with booster booked. Always masked in school where I work, but every little helps. Finally, the asthma is a positive

erj.ersjournals.com/content/early/2021/08/19/13993003.01209-2021

"In conclusion, the findings from this analysis indicate the prevalence of asthma was 8.08% amongst people who were rt-PCR positive for COVID-19 in these controlled studies. The overall findings suggest people with asthma are at lower risk of being infected with COVID-19 compared to those without asthma but when rt-PCR positive, have a similar risk of hospitalisation, ICU admission, ventilator use and mortality."

Relevant paragraph.

I'm neither a scientist nor a statistician but surely this is another example of base rate fallacy? 8% of the people testing positive were asthmatics. But it depends surely on what the % of the total population who are asthmatics is?

I wonder if as well, people with asthma, as you say yourself, are more likely to be more aware of the need for mitigations to protect their own health, more likely to have taken up the vaccine as soon as it became available etc.

It's about 12%, according to NHS

But the issue I have with this is that it does not appear to account for behaviour. Were those with asthma behaving differently to the 'everyone else' in terms of levels of SD?

Now there were millions of people told to shield (CEV medical condition, not age) and further millions who were told they were CV. That made a difference to hwhat people chose to do. To the extent that at one stage, those with blood cancer were going to be dropped from CEV because they weren't dying or being hospitalised in the expected numbers. No that wasn't because the condition didn't have the expected effect, it's because it!'s a patient group that really responded well to the call to shield, and weren't catching it because they really did live in isolation. Fortunately, that never happened (patient groups and other scientists were really quite vocal about it) and indeed later were in the 500,000 most at risk third primary group.

It''s not numbers getting it that matters, unless you have properly evaluated it against confounders like assiduousness of anti infection measures, it's how seriously the co-morbidity influences the course of the disease.

The steroids in some asthma treatments are also used v Covid

@PAFMO

"In conclusion, the findings from this analysis indicate the prevalence of asthma was 8.08% amongst people who were rt-PCR positive for COVID-19 in these controlled studies. The overall findings suggest people with asthma are at lower risk of being infected with COVID-19 compared to those without asthma but when rt-PCR positive, have a similar risk of hospitalisation, ICU admission, ventilator use and mortality."

Relevant paragraph.

I'm neither a scientist nor a statistician but surely this is another example of base rate fallacy? 8% of the people testing positive were asthmatics. But it depends surely on what the % of the total population who are asthmatics is?

I wonder if as well, people with asthma, as you say yourself, are more likely to be more aware of the need for mitigations to protect their own health, more likely to have taken up the vaccine as soon as it became available etc.

^this

It ignores behaviour of individuals?

Yes, but how much that's a factor is moot because it's a meta analysis. So data from several countries (study had to be published in English, but could be discussing findings anywhere.

It does cover age and whether current or former smoker, and has passing mention of hypertension and COPD.

But anti-transmission measures, whether at population level or for certain groups and varying over time, don't seem to be included. you can only do meta analysis on what's in enough of the studies in the first place

I can't find the link, but I by understanding is that well controlled asthma is no greater risk when you get covid - and in fact properly used inhaled steroids help to protect you from some of the respiratory complications. (As the cortisteroids help to keep inflammation under control)

I have to admit my first thought was whether behaviour was examined. I suppose at the very least it’s a positive message in terms of ‘keep doing what you’re doing’.

Last year I struggled to get my steroid inhaler prescription as lots of supplies had been diverted to hospital to help Covid patients. If they are one of the treatments that are given to people suffering with Covid then it could be the case that the regular medication helps alleviate symptoms or acts as a preventative

I'm asthmatic and was off sick for 7 weeks with Covid over the summer. Double jabbed at the time.

I developed a secondary chest infection in week 2. As soon as I tested positive I followed my action plan for being unwell and increased my Fostair dose. Due to being asthmatic I was referred to the Covid Monitoring Service by my GP. Luckily my asthma didn't worsen beyond the chest infection. I had to give daily peak flow, blood pressure and pulse oximeter readings to the CMS until about 23 days in and they were ok throughout.

I think behaviour is a good point though - many asthmatics were told they were clinically vulnerable at the start and many severe asthmatics were deemed CEV and advised to shield. My own GP said I didn't need to shield but needed to be extra vigilant due to my asthma and some other conditions I have.

A lot of asthmatics I know are still largely WFH and generally being cautious, especially with the new variant. Some of them were hospitalised with Covid in the first wave and have been extra cautious ever since.

I think it could be behaviour affecting the prevalence- I have been much more careful than average and have so far avoided catching Covid. Many of my behaviours have changed due to being told I was CV.

The thing I found curious about that study was not only the lack of discussion of behaviour as a potential confounding factor but also, given the date range for the meta-analysis (December 1, 2019 until July 11, 2021) there is no mention of vaccines as a potential factor affecting infection rates.

In many (but not all) countries asthmatics were in a priority group for vaccination, immediately lowering their risk of infection relative to their unvaccinated peers in terms of factors the study did control for.

Given that asthmatics were likely to be vaccinated significantly earlier in that period in many of the studied countries, and therefore had maximum infection protection during that time (and particularly relative to their peers with better lungs) it seems like an odd oversight.

Unless I missed something in the analysis - I’ll admit I didn’t dive into the underlying studies!

With all the PPs here!
Anyone who spent their childhood turning blue on the sofa is going to be pretty motivated to avoid a disease which can put you on a ventilator!

The thing I found curious about that study was not only the lack of discussion of behaviour as a potential confounding factor but also, given the date range for the meta-analysis (December 1, 2019 until July 11, 2021) there is no mention of vaccines as a potential factor affecting infection rates.

That was my thought too, but looking at the studies themselves, almost all of them are from the first 6 months of 2020. So my guess is that behaviour modification is probably the main reason for this finding.

Interesting. My asthmatic BIL tested positive on a LFT test which he took for work. All his family caught it. Two DC (over 18) nd wife felt really ill and wife had ongoing problems with breathing - he was the one capable of keeping in touch with family, cooking and looking after his family.

Wasn't there news stories last week that included hayfever, eczema and psoriasis sufferers in those who are less likely to catch covid? I don't think eczema or hayfever sufferers were priority for vaccines so I would guess it's more likely to be the prescription medication?

Tbf I have these illnesses and I was surprised in the summer when I'd been at what turned out to be a sort of super spreader event and I was the only person in my group not to test positive.

I have moderate asthma. I’ve had covid twice & it didn’t go to my chest either time. I was really surprised. Minor colds trigger my asthma nearly everytime. But covid, nothing 🤷🏼‍♀️ First time, I wasn’t vaccinated (last December), second time I was doubled jabbed.

I have moderate asthma and did get a cough but I absolutely could separate the cough from my asthma symptoms in my head. I've had asthma for nearly 40 yrs though so lots of experience with chesty coughs!

Thought that the call from GP was a nice touch, though I didn't use their monitoring servicem

My youngest is asthmatic, and I think that has influenced us to be more careful than average. We still love our lives, but try to make mitigate our risks as much as possible.

My sister works in a hospital where theres a 44 year old who has just come out of a coma from having COVID he was fit and healthy apart from being asthmatic.

@Reallybadidea

The thing I found curious about that study was not only the lack of discussion of behaviour as a potential confounding factor but also, given the date range for the meta-analysis (December 1, 2019 until July 11, 2021) there is no mention of vaccines as a potential factor affecting infection rates.

That was my thought too, but looking at the studies themselves, almost all of them are from the first 6 months of 2020. So my guess is that behaviour modification is probably the main reason for this finding.

Oh god I totally misread the study - the trawl was conducted in the first half of 2021, not the studies, then.

Then yes I’d have said behvaiour was a significant factor at that point, I know lots who were super cautious as we knew so little.