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Article ; Online: Cystic Fibrosis Modulator Therapies.

Jia, Shijing / Taylor-Cousar, Jennifer L

2022 Volume 74, Page(s) 413–426

Abstract: Cystic fibrosis (CF) is an inherited multisystemic disease that can cause progressive bronchiectasis, pancreatic endocrine and exocrine insufficiency, distal intestinal obstruction syndrome, liver dysfunction, and other disorders. Traditional therapies ... ...

Abstract	Cystic fibrosis (CF) is an inherited multisystemic disease that can cause progressive bronchiectasis, pancreatic endocrine and exocrine insufficiency, distal intestinal obstruction syndrome, liver dysfunction, and other disorders. Traditional therapies focused on the treatment or prevention of damage to each organ system with incremental modalities such as nebulized medications for the lungs, insulin for diabetes, and supplementation with pancreatic enzymes. However, the advent of highly effective modulator therapies that target specific cystic fibrosis transmembrane conductance regulator protein malformations resulting from individual genetic mutations has transformed the lives and prognosis for persons with CF.
MeSH term(s)	Humans ; Cystic Fibrosis/drug therapy ; Cystic Fibrosis/genetics ; Prognosis ; Mutation ; Diabetes Mellitus ; Aminophenols/therapeutic use
Chemical Substances	Aminophenols
Language	English
Publishing date	2022-08-16
Publishing country	United States
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	207930-6
ISSN	1545-326X ; 0066-4219
ISSN (online)	1545-326X
ISSN	0066-4219
DOI	10.1146/annurev-med-042921-021447
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Article ; Online: Acute kidney injury in cystic fibrosis patients treated with intravenous colistimethate sodium or tobramycin.

Lipp, Madeline A / Crass, Ryan L / Fitzgerald, Linda J / Patel, Twisha S / Simon, Richard H / Lenhan, Blair E / Han, MeiLan K / Jia, Shijing

The Journal of antimicrobial chemotherapy

2022 Volume 77, Issue 9, Page(s) 2516–2521

Abstract: Objectives: Colistimethate sodium and tobramycin are important systemic antibiotics for treatment of cystic fibrosis (CF) pulmonary exacerbations but can induce acute kidney injury (AKI). We characterize the rate of AKI in CF patients treated with ... ...

Abstract	Objectives: Colistimethate sodium and tobramycin are important systemic antibiotics for treatment of cystic fibrosis (CF) pulmonary exacerbations but can induce acute kidney injury (AKI). We characterize the rate of AKI in CF patients treated with systemic colistimethate sodium compared with tobramycin. Methods: This single-centre, retrospective cohort study included hospitalized CF patients treated with IV colistimethate sodium or tobramycin. The primary outcome was AKI defined using the RIFLE criteria. Multivariate logistic regression using a mixed model was performed to identify variables that were independently associated with AKI. Results: Overall, 156 patients representing 507 care encounters were included. The OR of AKI was not increased with IV colistimethate sodium relative to IV tobramycin after adjusting for other potential predictor variables (aOR 1.00; 95% CI 0.16-6.03). The frequency of AKI was 9.5% across all encounters, 6.9% with IV colistimethate sodium and 9.9% with IV tobramycin, with RIFLE category R (risk) being the most common stage, accounting for 4.2% of encounters with IV colistimethate sodium and 9.2% with IV tobramycin. The concomitant use of another nephrotoxin (aOR 2.51; 95% CI 1.27-4.95) or the combination of vancomycin and piperacillin/tazobactam (aOR 5.95; 95% CI 2.05-17.3) were both associated with increased odds of AKI. Conclusions: Systemic treatment with colistimethate sodium or tobramycin in the CF patient population is associated with a similar rate of nephrotoxicity. However, clinicians should be mindful of the increased risk for AKI in patients treated with either IV colistimethate sodium or IV tobramycin when used concurrently with other nephrotoxic agents, particularly the combination of vancomycin and piperacillin/tazobactam.
MeSH term(s)	Acute Kidney Injury/chemically induced ; Acute Kidney Injury/epidemiology ; Anti-Bacterial Agents/adverse effects ; Colistin/analogs & derivatives ; Cystic Fibrosis/complications ; Cystic Fibrosis/drug therapy ; Drug Therapy, Combination ; Humans ; Piperacillin, Tazobactam Drug Combination/therapeutic use ; Retrospective Studies ; Tobramycin/adverse effects ; Vancomycin/adverse effects
Chemical Substances	Anti-Bacterial Agents ; Piperacillin, Tazobactam Drug Combination (157044-21-8) ; Vancomycin (6Q205EH1VU) ; colistinmethanesulfonic acid (DL2R53P963) ; Tobramycin (VZ8RRZ51VK) ; Colistin (Z67X93HJG1)
Language	English
Publishing date	2022-07-08
Publishing country	England
Document type	Journal Article
ZDB-ID	191709-2
ISSN	1460-2091 ; 0305-7453
ISSN (online)	1460-2091
ISSN	0305-7453
DOI	10.1093/jac/dkac187
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Article ; Online: Association between CFTR modulators and changes in iron deficiency markers in cystic fibrosis.

Jia, Shijing / Wang, Yizhuo / Ross, Melissa H / Zuckerman, Jonathan B / Murray, Susan / Han, MeiLan K / Cahalan, Shannon E / Lenhan, Blair E / Best, Ryan N / Taylor-Cousar, Jennifer L / Simon, Richard H / Fitzgerald, Linda J / Troost, Jonathan P / Sood, Suman L / Gifford, Alex H

Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society

2024

Abstract: Background: Iron deficiency (ID) is a common extrapulmonary manifestation in cystic fibrosis (CF). CF transmembrane conductance regulator (CFTR) modulator therapies, particularly highly-effective modulator therapy (HEMT), have drastically improved ... ...

Abstract	Background: Iron deficiency (ID) is a common extrapulmonary manifestation in cystic fibrosis (CF). CF transmembrane conductance regulator (CFTR) modulator therapies, particularly highly-effective modulator therapy (HEMT), have drastically improved health status in a majority of people with CF. We hypothesize that CFTR modulator use is associated with improved markers of ID. Methods: In a multicenter retrospective cohort study across 4 United States CF centers 2012-2022, the association between modulator therapies and ID laboratory outcomes was estimated using multivariable linear mixed effects models overall and by key subgroups. Summary statistics describe the prevalence and trends of ID, defined a priori as transferrin saturation (TSAT) <20 % or serum iron <60 μg/dL (<10.7 μmol/L). Results: A total of 568 patients with 2571 person-years of follow-up were included in analyses. Compared to off modulator therapy, HEMT was associated with +8.4 % TSAT (95 % confidence interval [CI], +6.3-10.6 %; p < 0.0001) and +34.4 μg/dL serum iron (95 % CI, +26.7-42.1 μg/dL; p < 0.0001) overall; +5.4 % TSAT (95 % CI, +2.8-8.0 %; p = 0.0001) and +22.1 μg/dL serum iron (95 % CI, +13.5-30.8 μg/dL; p < 0.0001) in females; and +11.4 % TSAT (95 % CI, +7.9-14.8 %; p < 0.0001) and +46.0 μg/dL serum iron (95 % CI, +33.3-58.8 μg/dL; p < 0.0001) in males. Ferritin was not different in those taking modulator therapy relative to off modulator therapy. Hemoglobin was overall higher with use of modulator therapy. The prevalence of ID was high throughout the study period (32.8 % in those treated with HEMT). Conclusions: ID remains a prevalent comorbidity in CF, despite availability of HEMT. Modulator use, particularly of HEMT, is associated with improved markers for ID (TSAT, serum iron) and anemia (hemoglobin).
Language	English
Publishing date	2024-03-14
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2084724-5
ISSN	1873-5010 ; 1569-1993
ISSN (online)	1873-5010
ISSN	1569-1993
DOI	10.1016/j.jcf.2024.03.002
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Article ; Online: Type I Collagen Signaling Regulates Opposing Fibrotic Pathways through α

Agarwal, Manisha / Goheen, Mitchell / Jia, Shijing / Ling, Song / White, Eric S / Kim, Kevin K

American journal of respiratory cell and molecular biology

2020 Volume 63, Issue 5, Page(s) 613–622

Abstract: Fibrosis is characterized by fibroblast activation, leading to matrix remodeling culminating in a stiff, type I collagen-rich fibrotic matrix. Alveolar epithelial cell (AEC) apoptosis is also a major feature of fibrogenesis, and AEC apoptosis is ... ...

Abstract	Fibrosis is characterized by fibroblast activation, leading to matrix remodeling culminating in a stiff, type I collagen-rich fibrotic matrix. Alveolar epithelial cell (AEC) apoptosis is also a major feature of fibrogenesis, and AEC apoptosis is sufficient to initiate a robust lung fibrotic response. TGF-β (transforming growth factor-β) is a major driver of fibrosis and can induce both AEC apoptosis and fibroblast activation. We and others have previously shown that changes in extracellular matrix stiffness and composition can regulate the cellular response to TGF-β. In the present study, we find that type I collagen signaling promotes TGF-β-mediated fibroblast activation and inhibits TGF-β-induced AEC death. Fibroblasts cultured on type I collagen or fibrotic decellularized lung matrix had augmented activation in response to TGF-β, whereas AECs on cultured on type I collagen or fibrotic lung matrix were more resistant to TGF-β-induced apoptosis. Both of these responses were mediated by integrin α
MeSH term(s)	Alveolar Epithelial Cells/metabolism ; Animals ; Apoptosis ; Collagen Type I/metabolism ; Extracellular Matrix/metabolism ; Integrin alpha2beta1/agonists ; Integrin alpha2beta1/metabolism ; Mice, Inbred C57BL ; Pulmonary Fibrosis/metabolism ; Signal Transduction
Chemical Substances	Collagen Type I ; Integrin alpha2beta1
Language	English
Publishing date	2020-08-18
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1025960-0
ISSN	1535-4989 ; 1044-1549
ISSN (online)	1535-4989
ISSN	1044-1549
DOI	10.1165/rcmb.2020-0150OC
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Article ; Online: Pharmacokinetics of Polymyxin B in Hospitalized Adults with Cystic Fibrosis.

Crass, Ryan L / Al Naimi, Tamara / Wen, Bo / Souza, Ernane / Murray, Susan / Pai, Manjunath P / Jia, Shijing

Antimicrobial agents and chemotherapy

2021 Volume 65, Issue 10, Page(s) e0079221

Abstract: The optimal polymyxin B dosage needed to achieve an efficacy target of 50 to 100 mg · h/liter when treating multidrug-resistant bacterial infections in adult cystic fibrosis (CF) patients is unclear. The pharmacokinetics of intravenous polymyxin B were ... ...

Abstract	The optimal polymyxin B dosage needed to achieve an efficacy target of 50 to 100 mg · h/liter when treating multidrug-resistant bacterial infections in adult cystic fibrosis (CF) patients is unclear. The pharmacokinetics of intravenous polymyxin B were evaluated to better inform dosing. This was a prospective, observational pharmacokinetic (PK) study of nine CF adults receiving intravenous polymyxin B as part of usual clinical care. Doses preceding PK sampling ranged from 50 to 100 mg every 12 h. Five PK samples were collected following the fourth or fifth dose and concentrations of polymyxin subcomponents B1 and B2 were quantified using liquid chromatography mass spectrometry (LC-MS). Population PK (NONMEM software) analysis was performed using pooled polymyxin B1+B2 concentrations. Participants were Caucasian, predominantly male, with mean age and weight of 31 years (range 21 to 57 years) and 58.0 kg (range 38.3 to 70.4 kg), respectively. A 1-compartment zero-order infusion and linear elimination model adequately described the data with estimated clearance and volume of distribution being 2.09 liters/h and 12.7 liters, respectively, corresponding to a 4.1 h mean half-life (
MeSH term(s)	Adult ; Anti-Bacterial Agents/pharmacokinetics ; Cystic Fibrosis/drug therapy ; Drug Resistance, Multiple, Bacterial ; Female ; Humans ; Male ; Middle Aged ; Polymyxin B/pharmacokinetics ; Prospective Studies ; Young Adult
Chemical Substances	Anti-Bacterial Agents ; Polymyxin B (J2VZ07J96K)
Language	English
Publishing date	2021-07-12
Publishing country	United States
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	217602-6
ISSN	1098-6596 ; 0066-4804
ISSN (online)	1098-6596
ISSN	0066-4804
DOI	10.1128/AAC.00792-21
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Article ; Online: Lung epithelial cell focal adhesion kinase signaling inhibits lung injury and fibrosis.

Wheaton, Amanda K / Agarwal, Manisha / Jia, Shijing / Kim, Kevin K

American journal of physiology. Lung cellular and molecular physiology

2017 Volume 312, Issue 5, Page(s) L722–L730

Abstract: Progressive pulmonary fibrosis is a devastating consequence of many acute and chronic insults to the lung. Lung injury leads to alveolar epithelial cell (AEC) death, destruction of the basement membrane, and activation of transforming growth factor-β ( ... ...

Abstract	Progressive pulmonary fibrosis is a devastating consequence of many acute and chronic insults to the lung. Lung injury leads to alveolar epithelial cell (AEC) death, destruction of the basement membrane, and activation of transforming growth factor-β (TGF-β). There is subsequent resolution of the injury and a coordinated and concurrent initiation of fibrosis. Both of these processes may involve activation of similar intracellular signaling pathways regulated in part by dynamic changes to the extracellular matrix. Matrix signaling can augment the profibrotic fibroblast response to TGF-β. However, similar matrix/integrin signaling pathways may also be involved in the inhibition of ongoing TGF-β-induced AEC apoptosis. Focal adhesion kinase (FAK) is an integrin-associated signaling molecule expressed by many cell types. We used mice with AEC-specific FAK deletion to isolate the epithelial aspect of integrin signaling in the bleomycin model of lung injury and fibrosis. Mice with AEC-specific deletion of FAK did not exhibit spontaneous lung injury but did have significantly greater terminal deoxynucleotidyl transferase dUTP-mediated nick-end labeling-positive cells (18.6 vs. 7.1) per ×200 field, greater bronchoalveolar lavage protein (3.2 vs. 1.8 mg/ml), and significantly greater death (77 vs. 19%) after bleomycin injury compared with littermate control mice. Within primary AECs, activated FAK directly associates with caspase-8 and inhibits activation of the caspase cascade resulting in less apoptosis in response to TGF-β. Our studies support a model in which dynamic changes to the extracellular matrix after injury promote fibroblast activation and inhibition of epithelial cell apoptosis in response to TGF-β through FAK activation potentially complicating attempts to nonspecifically target this pathway for antifibrotic therapy.
MeSH term(s)	Animals ; Apoptosis ; Bleomycin ; Caspase 8/metabolism ; Enzyme Activation ; Epithelial Cells/enzymology ; Epithelial Cells/pathology ; Focal Adhesion Protein-Tyrosine Kinases/metabolism ; Gene Deletion ; Lung/pathology ; Lung Injury/complications ; Lung Injury/enzymology ; Lung Injury/pathology ; Mice ; Models, Biological ; Organ Specificity ; Pulmonary Fibrosis/complications ; Pulmonary Fibrosis/enzymology ; Pulmonary Fibrosis/pathology ; Pulmonary Surfactant-Associated Protein C/metabolism ; Signal Transduction
Chemical Substances	Pulmonary Surfactant-Associated Protein C ; Bleomycin (11056-06-7) ; Focal Adhesion Protein-Tyrosine Kinases (EC 2.7.10.2) ; Caspase 8 (EC 3.4.22.-)
Language	English
Publishing date	2017-03-10
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1013184-x
ISSN	1522-1504 ; 1040-0605
ISSN (online)	1522-1504
ISSN	1040-0605
DOI	10.1152/ajplung.00478.2016
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Article ; Online: Complications and Practice Variation in the Use of Peripherally Inserted Central Venous Catheters in People With Cystic Fibrosis: The Prospective Study of Peripherally Inserted Venous Catheters in People With Cystic Fibrosis Study.

Gifford, Alex H / Hinton, Alexandra C / Jia, Shijing / Nasr, Samya Z / Mermis, Joel D / Lahiri, Thomas / Zemanick, Edith T / Teneback, Charlotte C / Flume, Patrick A / DiMango, Emily A / Sadeghi, Hossein / Polineni, Deepika / Dezube, Rebecca H / West, Natalie E / Dasenbrook, Elliott C / Lucas, F Lee / Zuckerman, Jonathan B

Chest

2023 Volume 164, Issue 3, Page(s) 614–624

Abstract: Background: Peripherally inserted central catheters (PICCs) are used commonly to administer antibiotics to people with cystic fibrosis (CF), but their use can be complicated by venous thrombosis and catheter occlusion.: Research question: Which ... ...

Abstract	Background: Peripherally inserted central catheters (PICCs) are used commonly to administer antibiotics to people with cystic fibrosis (CF), but their use can be complicated by venous thrombosis and catheter occlusion. Research question: Which participant-, catheter-, and catheter management-level attributes are associated with increased risk of complications of PICCs among people with CF? Study design and methods: This was a prospective observational study of adults and children with CF who received PICCs at 10 CF care centers in the United States. The primary end point was defined as occlusion of the catheter resulting in unplanned removal, symptomatic venous thrombosis in the extremity containing the catheter, or both. Three categories of composite secondary outcomes were identified: difficult line placement, local soft tissue or skin reactions, and catheter malfunction. Data specific to the participant, catheter placement, and catheter management were collected in a centralized database. Risk factors for primary and secondary outcomes were analyzed by multivariate logistic regression. Results: Between June 2018 and July 2021, 157 adults and 103 children older than 6 years with CF had 375 PICCs placed. Patients underwent 4,828 catheter-days of observation. Of the 375 PICCs, 334 (89%) were ≤ 4.5 F, 342 (91%) were single lumen, and 366 (98%) were placed using ultrasound guidance. The primary outcome occurred in 15 PICCs for an event rate of 3.11 per 1,000 catheter-days. No cases of catheter-related bloodstream infection occurred. Other secondary outcomes developed in 147 of 375 catheters (39%). Despite evidence of practice variation, no risk factors for the primary outcome and few risk factors for secondary outcomes were identified. Interpretation: This study affirmed the safety of contemporary approaches to inserting and using PICCs in people with CF. Given the low rate of complications in this study, observations may reflect a widespread shift to selecting smaller-diameter PICCs and using ultrasound to guide their placement.
MeSH term(s)	Adult ; Child ; Humans ; Prospective Studies ; Catheterization, Central Venous/adverse effects ; Catheterization, Central Venous/methods ; Central Venous Catheters ; Cystic Fibrosis/complications ; Cystic Fibrosis/therapy ; Retrospective Studies ; Catheterization, Peripheral/adverse effects ; Venous Thrombosis/etiology ; Catheter-Related Infections/epidemiology ; Catheter-Related Infections/etiology ; Catheters, Indwelling
Language	English
Publishing date	2023-04-03
Publishing country	United States
Document type	Observational Study ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1032552-9
ISSN	1931-3543 ; 0012-3692
ISSN (online)	1931-3543
ISSN	0012-3692
DOI	10.1016/j.chest.2023.03.043
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Article ; Online: Nutritional considerations for a new era: A CF foundation position paper.

Leonard, Amanda / Bailey, Julianna / Bruce, Amanda / Jia, Shijing / Stein, Adam / Fulton, Judith / Helmick, Meagan / Litvin, Marina / Patel, Alpa / Powers, Kate E / Reid, Elizabeth / Sankararaman, Senthilkumar / Clemm, Cristen / Reno, Kim / Hempstead, Sarah E / DiMango, Emily

Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society

2023 Volume 22, Issue 5, Page(s) 788–795

Abstract: Objective: To provide interim advice and considerations to the CF Community around CF nutrition in the current era.: Methods: The Cystic Fibrosis (CF) Foundation organized a multidisciplinary committee to develop a Nutrition Position Paper based on ... ...

Abstract	Objective: To provide interim advice and considerations to the CF Community around CF nutrition in the current era. Methods: The Cystic Fibrosis (CF) Foundation organized a multidisciplinary committee to develop a Nutrition Position Paper based on the rapidly changing nutrition landscape in CF, due in part to widespread use of cystic fibrosis transmembrane regulator highly effective modulator therapy (HEMT). Four workgroups were formed: Weight Management, Eating Behavior/Food Insecurity, Salt Homeostasis and Pancreatic Enzyme use. Each workgroup conducted their own focused review of the literature. Results: The committee summarized current understanding of issues pertaining to the four workgroup topics and provided 6 key take-aways around CF Nutrition in the new era. Conclusion: People with CF (pwCF) are living longer, particularly with the advent of HEMT. The traditional high fat, high calorie CF diet may have negative nutritional and cardiovascular consequences as pwCF age. Individuals with CF may have poor diet quality, food insecurity, distorted body image, and an higher incidence of eating disorders. An increase in overweight and obesity may lead to new considerations for nutritional management, given potential effects of overnutrition on pulmonary and cardiometabolic parameters.
MeSH term(s)	Humans ; Cystic Fibrosis/epidemiology ; Cystic Fibrosis/therapy ; Nutritional Status ; Energy Intake ; Nutrition Therapy ; Obesity
Language	English
Publishing date	2023-05-23
Publishing country	Netherlands
Document type	Review ; Journal Article
ZDB-ID	2084724-5
ISSN	1873-5010 ; 1569-1993
ISSN (online)	1873-5010
ISSN	1569-1993
DOI	10.1016/j.jcf.2023.05.010
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Article ; Online: Study on the effect of acupunture treatment on autonomic nerve dysfunction in convalescent period of stroke based on heart rate variability assessment technique.

Jia, Shijing / Lu, Wang / Hang, Minghui / Zhang, Chu / Ma, Zilin / Xue, Kun / Lu, Yunqi / Zhang, Shenghong / Guo, Yijin / Zhang, Jiabao / Zhang, Xinyu / Wang, Yimeng / Zhao, Haiyin

Medicine

2022 Volume 101, Issue 50, Page(s) e32355

Abstract: Stroke patients with autonomic dysfunction are more likely to develop cardiac problems, which have been linked to lower functional outcomes and increased mortality. In this study, heart rate variability (HRV) detection paired with the Clinical Feature ... ...

Abstract	Stroke patients with autonomic dysfunction are more likely to develop cardiac problems, which have been linked to lower functional outcomes and increased mortality. In this study, heart rate variability (HRV) detection paired with the Clinical Feature Scale will be utilized to elucidate the immediate impact of manual acupuncture on autonomic dysfunction of varying severity in the convalescence stroke phase. This is a randomized, single-blind, controlled clinical trial approach. At a ratio of 1:1, 60 appropriate patients will be randomly randomized into either the experimental or control group. On the basis of symptomatic treatment drugs, the experimental group will additionally undertake acupuncture therapy 3 times a week for 4 weeks, for a total of 12 times. Primary outcomes include 24-hour HRV and 60-minute HRV detection at week 4 compared with baseline. The secondary outcome is the score of clinical feature scale at week 4 compared with the baseline. Adverse events and safety indices will be recorded throughout the experiment. The SPSS V.25.0 statistical program was applied for analysis, and measurement data were expressed as mean ± SD.
Language	English
Publishing date	2022-12-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	80184-7
ISSN	1536-5964 ; 0025-7974
ISSN (online)	1536-5964
ISSN	0025-7974
DOI	10.1097/MD.0000000000032355
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Article ; Online: Asthma and coronavirus disease 2019-related outcomes in hospitalized patients: A single-center experience.

Ludwig, Amy / Brehm, Caryn Elizabeth / Fung, Christopher / Jia, Shijing / Troost, Jonathan P / Leuenberger, Laura / Kaakati, Rayan / Tarantine, Catherine / Christoph, Ella / Sjoding, Michael W / Lugogo, Njira

Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology

2022 Volume 129, Issue 1, Page(s) 79–87.e6

Abstract: Background: Several chronic conditions have been associated with a higher risk of severe coronavirus disease 2019 (COVID-19), including asthma. However, there are conflicting conclusions regarding risk of severe disease in this population.: Objective!# ...

Abstract	Background: Several chronic conditions have been associated with a higher risk of severe coronavirus disease 2019 (COVID-19), including asthma. However, there are conflicting conclusions regarding risk of severe disease in this population. Objective: To understand the impact of asthma on COVID-19 outcomes in a cohort of hospitalized patients and whether there is any association between asthma severity and worse outcomes. Methods: We identified hospitalized patients with COVID-19 with confirmatory polymerase chain reaction testing with (n = 183) and without asthma (n = 1319) using International Classification of Diseases, Tenth Revision, codes between March 1 and December 30, 2020. We determined asthma maintenance medications, pulmonary function tests, highest historical absolute eosinophil count, and immunoglobulin E. Primary outcomes included death, mechanical ventilation, intensive care unit (ICU) admission, and ICU and hospital length of stay. Analysis was adjusted for demographics, comorbidities, smoking status, and timing of illness in the pandemic. Results: In unadjusted analyses, we found no difference in our primary outcomes between patients with asthma and patients without asthma. However, in adjusted analyses, patients with asthma were more likely to have mechanical ventilation (odds ratio, 1.58; 95% confidence interval [CI], 1.02-2.44; P = .04), ICU admission (odds ratio, 1.58; 95% CI, 1.09-2.29; P = .02), longer hospital length of stay (risk ratio, 1.30; 95% CI, 1.09-1.55; P < .003), and higher mortality (hazard ratio, 1.53; 95% CI, 1.01-2.33; P = .04) compared with the non-asthma cohort. Inhaled corticosteroid use and eosinophilic phenotype were not associated with considerabledifferences. Interestingly, patients with moderate asthma had worse outcomes whereas patients with severe asthma did not. Conclusion: Asthma was associated with severe COVID-19 after controlling for other factors.
MeSH term(s)	Asthma/complications ; Asthma/epidemiology ; COVID-19/epidemiology ; Hospitalization ; Humans ; Intensive Care Units ; Pandemics ; Retrospective Studies ; SARS-CoV-2
Language	English
Publishing date	2022-03-24
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1228189-x
ISSN	1534-4436 ; 0003-4738 ; 1081-1206
ISSN (online)	1534-4436
ISSN	0003-4738 ; 1081-1206
DOI	10.1016/j.anai.2022.03.017
Database	MEDical Literature Analysis and Retrieval System OnLINE

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