RESULTS
A total of 108 patients with severe asthma in treatment with MAB were
enrolled, of whom only 106 patients were included in the study. Due to
exclusion criteria, two patients were excluded: one case had started
biological treatment two months ago, and the other case had discontinued
biological treatment by self-decision.
Descriptive analysis of patients’ clinical characteristics are shown in
Table 2.
When analyzing patients’ responses to the questionnaire (Table 3), 11
patients (10.38%) declared to have had suggestive COVID-19 symptoms.
Most common symptoms between these patients were: cough (7 patients;
63%) and fever (7 patients; 63%). Other less common symptoms referred
were odynophagia (3 patients; 27.3%), dyspnea (2 patients; 18.1%),
headache (1 patient; 9%), and asthenia (1 patient; 9%). No one needed
hospitalization.
From the 106 patients included, 9 (8.49%) had COVID-19 polymerase chain
reaction test (RT-PCR) done at their ambulatory centre, being negative
for the 9 (100%) of them. From these 9 patients, only 2 (22.2%) had
referred suggestive COVID-19 symptoms; the other 9 patients with
suggestive COVID-19 symptoms did not have RT-PCR done. In the case of
serology test for COVID-19, 10 (9.43%) of the 106 patients had the test
done, only being positive for 2 of them (20%), none of which
corresponded to the 11 patients with suggestive COVID-19 symptoms. From
these, only 1 patient had serology test done, which gave a negative
result.
When asked about their mood (question 7), a stable mood and anxiety,
were the most relevant answers. In reference to the need of medical
ambulatory assistance during the confinement (question 8), a total of 27
patients referred they had needed medical attention, being the most
common reason, asthma exacerbation symptoms (14 patients (51,9%)), from
which 7 (25.9) corresponded to those who referred possible COVID-19
symptoms. Other symptoms that motivated medical assistance where, chest
pain, odynophagia, upper respiratory infection, herpes virus, rhinitis,
urine infection and renal colic. No one needed hospitalization. In
reference to the 2 patients with a positive result in the serology test,
one had to receive medical ambulatory assistance due to unspecific chest
pain, while the other did not experiment any symptoms nor needed medical
attention.
Regarding direct exposition with a person positive for COVID-19
(question 13), 8 patients (7.55%) declared that they had been in
contact; from whom, 1 (12,5%) corresponded to the patient with a
positive serology test, who had experimented chest pain symptoms; 2
(25%) corresponded to patients with possible COVID-19 symptoms, but
with no RT-PCR or serology test done; and the other 5 patients (62.5%)
had no symptoms.
Questions 15 to 19 made reference to social and work activity. When
analyzing these variables, it can be highlighted that 50.94% of the
patients studied had assisted to crowded meetings weeks before the
pandemic arrived to Spain. 71,7% of the patients had a normal or active
level of activity. 72.64% have had contact with young children and/or
adolescents, mainly their children or grandchildren; and 91.51% lived
with more people at home, meaning that the risk of being infected by
SARS-Cov-2 was not only conditioned by their own public exposition, but
also by the exposition of people in direct contact with them. It draws
the attention that during the period of confinement declared in Spain,
from the 15 of March 2020, until the end of May, period in which the
analysis was completed, 58.49% of the patients left their home for
various reasons, with no effect on the number of positive cases.
Table 4 shows the clinical characteristics of the 2 patients with a
positive serological test for COVID-19. From their questionnaire, it is
worth outlining that Patient 1 needed medical assistance due to
unspecific chest pain, and patient 2 did not have symptoms. Neither
needed to use their short acting bronchodilator, nor needed
hospitalization. Both referred good asthma control in the ACT test. None
of them worked, however Patient 1 had an active level of activity, and
patient 2 a moderate level. Both of them went out during the pandemic,
more than 5 times per month.
Lastly, serological tests were performed by using total SARS-Cov-2
antibody test, in order to study the real prevalence of the disease
between the patients who referred suggestive COVID-19 symptoms, and
patients with asthma exacerbation symptoms, odynophagia or upper
respiratory infection who had needed medical attention during the state
of alarm, (a total of 21 patients). For all of them, test results were
negative. Clinical characteristics and serological tests results for
these patients are shown in Table 5.
When comparing patient’s responses to the questionnaire, according to
suggestive COVID-19 symptoms or a positive serological test result,
statistical significance was achieved for questions shown in Table 6,
which make reference to the need of medical assistance during the state
of alarm, asthma control (ACT) and contact why positive COVID-19
patients. With these results we can state that patients with bad asthma
control and/or contact with positive COVID-19 cases, have needed more
medical assistance in comparison to the rest of the patients studied.