RT Journal Article SR Electronic T1 Is asthma associated with COVID-19 infection? A UK Biobank analysis JF ERJ Open Research JO erjor FD European Respiratory Society SP 00309-2021 DO 10.1183/23120541.00309-2021 VO 7 IS 4 A1 Caroline J. Lodge A1 Alice Doherty A1 Dinh S. Bui A1 Raisa Cassim A1 Adrian J. Lowe A1 Alvar Agusti A1 Melissa A. Russell A1 Shyamali C. Dharmage YR 2021 UL http://openres.ersjournals.com/content/7/4/00309-2021.abstract AB Background The relationship between asthma and coronavirus disease 2019 (COVID-19) risk is not clear and may be influenced by level of airway obstruction, asthma medication and known COVID-19 risk factors. We aimed to investigate COVID-19 risk in people with asthma.Methods We used UK Biobank data from all participants tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (n=107 412; 17 979 test positive). Questions at baseline defined ever asthma and asthma medications. Baseline forced expiratory volume in 1 s (FEV1) was categorised 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 body mass index.Results There was a reduced risk of a positive test associated with early-onset asthma (<13 years) (OR 0.91, 95% CI 0.84–0.99). This was found for participants with early-onset asthma who were male (OR 0.87, 95% CI 0.78–0.98), nonsmokers (OR 0.87, 95% CI 0.78–0.98), overweight/obese (OR 0.85, 95% CI 0.77–0.93) and non-Black (OR 0.90, 95% CI 0.82–0.98). There was increased risk amongst early-onset individuals with asthma in the highest compared to lowest quartile of lung function (1.44, 1.05–1.72).Conclusion Amongst male, nonsmoking, 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. Individuals with early-onset asthma 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.Reduced risk of positive #SARSCoV2 test was associated with early-onset asthma in males, nonsmokers, overweight/obese and non-black participants. Lack of phenotyping and unappreciated interactions may contribute to inconsistent findings for asthma and #COVID19. https://bit.ly/3yn3Nvi