TY - JOUR T1 - Is asthma associated with COVID-19 infection? A UK Biobank analysis JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00309-2021 SP - 00309-2021 AU - Caroline J. Lodge AU - Alice Doherty AU - Dinh Bui AU - Raisa Cassim AU - Adrian J. Lowe AU - Alvar Agusti AU - Melissa A. Russell AU - Shyamali C. Dharmage Y1 - 2021/01/01 UR - http://openres.ersjournals.com/content/early/2021/08/26/23120541.00309-2021.abstract N2 - Background The relationship between asthma and COVID-19 risk is not clear and may be influenced by level of airway obstruction, asthma medication, and known COVID risk factors. We aimed to investigate COVID-19 risk in people with asthma.Methods We used UK Biobank data from all participants tested for SARS-CoV-2 (n=107 412 (17 979 test positive)). Baseline questions at baseline defined ever asthma and asthma medications. Baseline Forced Expiratory Volume in the first second (FEV1) was categorized into quartiles. Logistic regression modelled relationships between asthma, and asthma categories (age at onset, medications, FEV1 quartiles), and risk of SARS-CoV-2 positive test. We investigated modification by sex, ethnic group, smoking, and BMI.Results There was a reduced risk of a positive test associated with with early-onset asthma (<13 years), (OR 0.91(95% CI 0.84, 0.99). This was found for early-onset asthmatics in males (OR 0·87 [95% CI: 0·78, 0·98]), non-smokers (0·87 [0·78, 0·98]), overweight/obese (0.85 [0.77, 0.93]), and non-Black participants (0·90 [0·82, 0.98]). There was increased risk amongst early onset asthmatics in the highest compared to lowest quartile of lung function (1.44 [1.05, 1.72]).Conclusion Amongst males, non-smokers, overweight/obese, and non-Black participants, having early-onset asthma was associated with lower risk of a SARS-CoV-2 positive test. We found no evidence of a protective effect from asthma medication. Early-onset asthmatics of normal weight and with better lung function may have lifestyle differences placing them at higher risk. Further research is needed to elucidate the contribution of asthma pathophysiology and different health-related behaviour, across population groups, to the observed risks.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. Lodge has nothing to disclose.Conflict of interest: A. Doherty has nothing to disclose.Conflict of interest: Dr. Bui has nothing to disclose.Conflict of interest: Dr. Cassim has nothing to disclose.Conflict of interest: Dr. Lowe reports receiving Research Fellowships from National Health and Medical Research Council, during the conduct of the study;.Conflict of interest: Dr. Agusti has nothing to disclose.Conflict of interest: Dr. Russell has nothing to disclose.Conflict of interest: Dr. Dharmage has nothing to disclose. ER -