Data source
Our study was conducted at Stanford Health Care (SHC), an academic healthcare system that includes a tertiary and quaternary hospital, children’s hospital, and affiliated clinics and acute care facilities. Patients who underwent FDA emergency use authorized SARS-CoV-2 nucleic acid amplification tests from either nasal, nasopharyngeal swab, or bronchoalveolar lavage from March 1, 2020, to September 30, 2020, were included. Electronic health record (EHR) data on the SARS-CoV-2 positive patients were also obtained. This study was reviewed and approved with a waiver of consent by the Stanford Administrative Panel on Human Subjects in Medical Research.
Using an institutional informatics platform, we comprehensively characterized a cohort of patients who tested positive for SARS-CoV-2 and further categorized them by baseline asthma diagnosis using theInternational Classification of Disease (ICD-9/10) diagnostic codes (Supplemental Table 1) and hospitalization status.15 Patients were categorized as having allergic asthma if they had at least one ICD-10 code for a coexisting allergic disorder (Supplemental Table 2). Patients younger than 28 days old and those without additional encounters or ICD-10 codes within our EHR besides their SARS-CoV-2 diagnostic test were excluded from further analysis. Inpatients were defined as patients hospitalized at SHC within fourteen days of a positive test for SARS-CoV-2.
Asthma severity was categorized according to the five steps in the GINA 2020 guidelines.16 Each patient who was hospitalized was graded at peak COVID-19 disease severity during their hospitalization and classified according to the five severity of illness categories from the National Institutes of Health (NIH) COVID-19 Treatment Guidelines (Supplemental Table 3).17Additionally, we identified patients who were enrolled in a prospective, longitudinal study (NCT# 04373148) to quantitate clinical and immunological parameters in persons testing positive for SARS-CoV-2. Visits were conducted at prespecified intervals and symptom surveys were administered.