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.