Effect modification by age of the association between obstructive lung diseases, smoking, and COVID-19 severity
Introduction Obstructive lung diseases (asthma and chronic obstructive pulmonary disease (COPD)) and smoking are associated with greater risk of respiratory infections and hospitalisations, but conflicting data exist regarding their association with severity of COVID-19, and few studies have evaluat...
Saved in:
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2021-01-01
|
| Series: | BMJ Open Respiratory Research |
| Online Access: | https://bmjopenrespres.bmj.com/content/8/1/e001038.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846158107853455360 |
|---|---|
| author | Peter P Moschovis Elsie Taveras Patricia L Hibberd Lael M Yonker Douglas Hayden Mengdi Lu Jesiel Lombay Alexy Arauz Boudreau Virginia A Triant Andrea S Foulkes Ingrid Bassett T Bernard Kinane |
| author_facet | Peter P Moschovis Elsie Taveras Patricia L Hibberd Lael M Yonker Douglas Hayden Mengdi Lu Jesiel Lombay Alexy Arauz Boudreau Virginia A Triant Andrea S Foulkes Ingrid Bassett T Bernard Kinane |
| author_sort | Peter P Moschovis |
| collection | DOAJ |
| description | Introduction Obstructive lung diseases (asthma and chronic obstructive pulmonary disease (COPD)) and smoking are associated with greater risk of respiratory infections and hospitalisations, but conflicting data exist regarding their association with severity of COVID-19, and few studies have evaluated whether these associations differ by age.Objectives To examine the associations between asthma, COPD and smoking on the severity of COVID-19 among a cohort of hospitalised patients, and to test for effect modification by age.Methods We performed a retrospective analysis of electronic health record data of patients admitted to Massachusetts General Hospital, assigning the maximal WHO Clinical Progression Scale score for each patient during the first 28 days following hospital admission. Using ordered logistic regression, we measured the association between maximal severity score and asthma, COPD and smoking and their interaction with age.Measurements and main results Among 1391 patients hospitalised with COVID-19, we found an increased risk of severe disease among patients with COPD and prior smoking, independent of age. We also found evidence of effect modification by age with asthma and current smoking; in particular, asthma was associated with decreased COVID-19 severity among older adults, and current smoking was associated with decreased severity among younger patients.Conclusions This cohort study identifies age as a modifying factor for the association between asthma and smoking on severity of COVID-19. Our findings highlight the complexities of determining risk factors for COVID-19 severity, and suggest that the effect of risk factors may vary across the age spectrum. |
| format | Article |
| id | doaj-art-792a78b69a3c47c497dd8ac35a3e3037 |
| institution | Kabale University |
| issn | 2052-4439 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Respiratory Research |
| spelling | doaj-art-792a78b69a3c47c497dd8ac35a3e30372024-11-24T16:00:08ZengBMJ Publishing GroupBMJ Open Respiratory Research2052-44392021-01-018110.1136/bmjresp-2021-001038Effect modification by age of the association between obstructive lung diseases, smoking, and COVID-19 severityPeter P Moschovis0Elsie Taveras1Patricia L Hibberd2Lael M Yonker3Douglas Hayden4Mengdi Lu5Jesiel Lombay6Alexy Arauz Boudreau7Virginia A Triant8Andrea S Foulkes9Ingrid Bassett10T Bernard Kinane11Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USADepartment of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA4 School of Public Health, Boston University, Boston, Massachusetts, USADepartment of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USABiostatistics Center, Massachusetts General Hospital, Boston, Massachusetts, USADepartment of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USADepartment of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USADepartment of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USADepartment of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USABiostatistics Center, Massachusetts General Hospital, Boston, Massachusetts, USADepartment of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USADepartment of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USAIntroduction Obstructive lung diseases (asthma and chronic obstructive pulmonary disease (COPD)) and smoking are associated with greater risk of respiratory infections and hospitalisations, but conflicting data exist regarding their association with severity of COVID-19, and few studies have evaluated whether these associations differ by age.Objectives To examine the associations between asthma, COPD and smoking on the severity of COVID-19 among a cohort of hospitalised patients, and to test for effect modification by age.Methods We performed a retrospective analysis of electronic health record data of patients admitted to Massachusetts General Hospital, assigning the maximal WHO Clinical Progression Scale score for each patient during the first 28 days following hospital admission. Using ordered logistic regression, we measured the association between maximal severity score and asthma, COPD and smoking and their interaction with age.Measurements and main results Among 1391 patients hospitalised with COVID-19, we found an increased risk of severe disease among patients with COPD and prior smoking, independent of age. We also found evidence of effect modification by age with asthma and current smoking; in particular, asthma was associated with decreased COVID-19 severity among older adults, and current smoking was associated with decreased severity among younger patients.Conclusions This cohort study identifies age as a modifying factor for the association between asthma and smoking on severity of COVID-19. Our findings highlight the complexities of determining risk factors for COVID-19 severity, and suggest that the effect of risk factors may vary across the age spectrum.https://bmjopenrespres.bmj.com/content/8/1/e001038.full |
| spellingShingle | Peter P Moschovis Elsie Taveras Patricia L Hibberd Lael M Yonker Douglas Hayden Mengdi Lu Jesiel Lombay Alexy Arauz Boudreau Virginia A Triant Andrea S Foulkes Ingrid Bassett T Bernard Kinane Effect modification by age of the association between obstructive lung diseases, smoking, and COVID-19 severity BMJ Open Respiratory Research |
| title | Effect modification by age of the association between obstructive lung diseases, smoking, and COVID-19 severity |
| title_full | Effect modification by age of the association between obstructive lung diseases, smoking, and COVID-19 severity |
| title_fullStr | Effect modification by age of the association between obstructive lung diseases, smoking, and COVID-19 severity |
| title_full_unstemmed | Effect modification by age of the association between obstructive lung diseases, smoking, and COVID-19 severity |
| title_short | Effect modification by age of the association between obstructive lung diseases, smoking, and COVID-19 severity |
| title_sort | effect modification by age of the association between obstructive lung diseases smoking and covid 19 severity |
| url | https://bmjopenrespres.bmj.com/content/8/1/e001038.full |
| work_keys_str_mv | AT peterpmoschovis effectmodificationbyageoftheassociationbetweenobstructivelungdiseasessmokingandcovid19severity AT elsietaveras effectmodificationbyageoftheassociationbetweenobstructivelungdiseasessmokingandcovid19severity AT patricialhibberd effectmodificationbyageoftheassociationbetweenobstructivelungdiseasessmokingandcovid19severity AT laelmyonker effectmodificationbyageoftheassociationbetweenobstructivelungdiseasessmokingandcovid19severity AT douglashayden effectmodificationbyageoftheassociationbetweenobstructivelungdiseasessmokingandcovid19severity AT mengdilu effectmodificationbyageoftheassociationbetweenobstructivelungdiseasessmokingandcovid19severity AT jesiellombay effectmodificationbyageoftheassociationbetweenobstructivelungdiseasessmokingandcovid19severity AT alexyarauzboudreau effectmodificationbyageoftheassociationbetweenobstructivelungdiseasessmokingandcovid19severity AT virginiaatriant effectmodificationbyageoftheassociationbetweenobstructivelungdiseasessmokingandcovid19severity AT andreasfoulkes effectmodificationbyageoftheassociationbetweenobstructivelungdiseasessmokingandcovid19severity AT ingridbassett effectmodificationbyageoftheassociationbetweenobstructivelungdiseasessmokingandcovid19severity AT tbernardkinane effectmodificationbyageoftheassociationbetweenobstructivelungdiseasessmokingandcovid19severity |