Table 1 Summary description of study population in the synthesized articles

1.

Aghdam et al 2020 [18]

Ayatollah Moussavi Hospital, Zanjan, Iran.

To report a case of a child with asthma with an initialdiagnosis of COVID-19 pneumonia whose clinical courserevealed an underlying condition.

Case report

Iranian

7 years old boy.

1 (Allergic asthma)

Not reported

None

Not reported

Not applicable

In patients with COVID-19 and allergic asthma, other underlying hidden causes must be investigatedThis is because foreign body aspirationcontributed to the initial poor response to the treatment of this patient.

2.

Barsoum 2020 [19]

South West Acute Hospital, Ireland

To provide evidence to suggest that young people with asthma are at increased risk for COVID-19 infection

Case report

Not reported

12-year-old girl

Not reported 

Not applicable

Asthma

Not reported 

Not applicable

Oral corticosteroids used to management of asthma prolonged the duration of COVID-19 clearance. Thus, the investigation infers that asthma is a risk factor that can worsen prognosis in individuals infected with COVID-19 irrespective of age and should be further investigated through research.

3.

Renner et al. 2020 [20]

Helsinki University Hospital, Helsinki, Finland.

To report data on COVID-19 patients with severe asthma who are treated with monoclonal antibodies.

Case report

Finnish

41 years old male

1 (100%) asthmatic patients

Not reported 

Not reported 

Not reported 

Not reported 

Asthma is not associated with the severity of COVID-19.

4.

Schleicher et al. 2020 [21]

Wits Donald Gordon Medical Centre, Johannesburg, South Africa.

To describe the COVID-19 with other respiratory diseases.

Case report

African

53 years old man

1 (100%) asthmatic patients

Not reported 

Pneumonia and Cytokine Release Syndrome.

Not reported 

Not reported 

This case study of severe Covid-19 with asthma, pneumonia, and Cytokine Release Syndrome showed some of the diagnostic and therapeutic challenges and controversies regarding the management of this novel and complex infection.

5.

Turbin et al. 2020 [22]

Rutgers New Jersey Medical School, Newark, New Jersey, USA.

To report a COVID-19 patient with other comorbidities

Case report

American. 

12 and 15 years.

1 (50%) asthmatic patients

Not reported 

Orbital cellulitis, sinusitis, and intracranialabnormalities

Not reported 

Not reported 

The COVID-19 may associate with other bacterial diseases. 

6.

Vasconez et al. 2020 [23]

Miller School of Medicine, Miami, United States

To report COVID-19 with other comorbidities

Case report

American. 

A 16 years old female.

1 (100%) asthmatic patients

Not reported 

Severe diabetic ketoacidosis

Not reported 

Not reported 

Clinical suspicion of COVID should be heightened in children who present with unexplainedly severe diabetic ketoacidosis.

7.

Barroso et al 2020 [24]

Madrid, Spain

To report the prevalence of asthma and T2 diseases on a sample of hospitalized patients with COVID-19.

Case series

Not reported

Mean, or median age is not specified for all cases. But it was reported that the majority of the cases were females. No estimates were provided.

Of the 189 cases, 14 (7.4%) AR6 (3.2%) allergic asthma

Not reported

Most reported was diabetes, obesity, hypertension, hyperlipemia

Not reported

Quite a few were active smokers

There was no evidence in this case series that having allergic respiratory conditions with COVID-19 could predispose one to a risk of hospitalization or death.

8.

Bhatraju et al. 2020 [25]

University of Washington–Harborview Medical Center, USA

To describe the demographic characteristics, coexisting conditions, imaging findings, and outcomes among critically ill patients with Covid-19 in the Seattle metropolitan area.

Case series

Not reported 

Mean (±SD) ageof the 24 critically ill cases were 64±18 years (range, 23 to 97) and63% were men.

Not reported

Not reported

Out of the 24 cases, 14(58%) DM, 5 (21%) CRD, and 3 (14%) hadasthma, Of total cases, 8  (33%) had morethan one coexisting condition.

Not reported

A total of 24 cases, 5 (22%) were current or former smokers

There was no further specific information like clinical management and treatment outcomes for the three asthmatic cases identified.

9.

Garg et al. 2020 [26]

Department of Health and Human Services regions, USA

Report an endemiological changes in COVID-19 new cases in the USA.

Case series (Retrospective)

Non-Hispanic white (white) (45.0%)non-Hispanic black (black) (33.1%)Hispanic (8.1%)Asian (5.5%)American Indian/Alaskan Native (0.3%)other or unknown race (7.9%)

Age (18-65 years) Males 49% Females 51%

27 (17.0%) asthmatic patients

Allergic

HTN (49.7%) Obesity (48.3%) Chronic metabolic disease (36.1%) DMus (28.3%) Chronic lung disease (34.6%)

NR

NR

Among patients aged 18–49 years, obesity was the most prevalent underlying condition, followed by chronic lung disease (primarily asthma) and diabetes mellitus.

10.

Guan et al 2020 [27]

Wuhan JinYinTan Hospital, China

To evaluate the risk of serious adverse outcomes in patients with COVID-19 by stratifying the comorbidity status.

Case series (Retrospective)

NR

Mean age 48.9 years Males 57.3% Females 42.7%

0

-

HTN (16.9%), CHD (3.7%) cerebrovascular diseases (1.9%) DM (8.2%) hepatitis B infections (1.8%) COPD (1.5%) CRD (1.3%) malignancy (1.1%) immunodeficiency (0.2%)

-

7%

Patients with comorbidities show poor outcomes than patients without comorbidities.

11.

Gold et al., 2020 [28]

Emory Decatur Hospital, Decatur, Georgia, USA

Report an endemiological change in COVID-19 new cases in Georgia, USA.  

Case series

Black 81%Others 19%

Age (18-65 years) Males 49.5% Females 50.5%

32 (10.5%) asthmatic patients

NR

DM (39.7%) CHD (25.6%) CAD (11.5%) Congestive heart failure (10.8%) Arrhythmia (5.9%) Chronic lung disease (20.3%) COPD (5.2%) Severe obesity (12.7%) Immunocompromising conditions or therapies (9.2%) End-stage renal disease, on dialysis (5.2%) Liver disease (2.3)

NR

5.2%

Asthma associated with SARS-COV-2 may have a role in the severity of the disease.

12.

Otto et al., 2020 [29]

The Children’s Hospital of Philadelphia (CHOP) Care Network, Burlington, North Carolina, and Secaucus, New Jersey, USA

Understanding the prevalence and clinical presentation of COVID-19 in pediatric patients can help healthcare providers and systems prepare and respond to this emerging pandemic.

Case series (Retrospective)

White (49.8%) Black or African-American (29.6%) Asian or Asian Indian (3.2%) Multi-racial (3.6%) Other Races (13.8%) Not Hispanic or Latino (87.8%) Hispanic or Latino (10.2%) Not specified (2.0%)

Mean age 5.9 years Males 54.3% Females 45.7%

87 (20.5%) asthmatic patients

NR

NR

NR

NR

Most of the cases were mild, few children had the critical illness, and two patients died

13.

Takemoto et al., 2020 [30]

Departments of Health epidemiological reports, Brazil

To report the mortality data from Brazilian and compare to worldwide.

Case series

NR

Age (20-43 years) Females 100%

5 (25.0%) asthmatic patients

NR

Obesity Pyelonephritis CHD

NR

NR

There is one of the largest available series of maternal deaths due to COVID-19.

14.

Richardson et al., 2020 [31]

New York City Area the USA

To describe the clinical characteristics and outcomes of patients with COVID-19Hospitalized in a US health care system. 

Case series

African American 1230 (22.6) Asian 473 (8.7) White 2164 (39.8) Other/multiracial 1574 (28.9)

5700 Female 2263 (39.7) Male 3437 (60.3). The median age of the total population 63 years 

Asthma 479 (9%) BUT phenotype of asthma not reported

NR

Cancer 320 (6%) HTN 3026 (56.6%) CAD 595 (11.1) CHD 371 (6.9%) COPD 287 (5.4%) Obstructive sleep apnea 154 (2.9%) HIV 43 (0.8%) History of solid organ transplant 55 (1%) CRD 268 (5) End-staged 186 (3.5%) Liver disease Cirrhosis 19 (0.4%) Chronic HBV 8 (0.1%) HCV 3 (0.1%) Obesity (BMI ≥30) 1737 (41.7%) Morbid obesity (BMI ≥35) 791 (19.0%) DM 1808 (33.8%)

NR

Never smoker 3009 (84.4%)

This study provides characteristics and early outcomes of patients hospitalized with COVID-19 in New York.

15.

Argenziano et al. 2020 [32]

New York-Presbyterian/Columbia University Irving Medical Center, a quaternary care academic medical center in New York City, USA

To characterize patients with coronavirus disease 2019 (covid-19) in a large New York City medical center and describe their clinical course across the emergency department, hospital wards, and intensive care units

Cohort study

Asian, White, Hispanics/Latino and Blacks or African American

Median age 63.0 years (IQR: 50.0-75.0). Of a total of 1000 study population, males are 596. Median BMI for all patients was 28.6 (IQR: 25.2-33.1)

Not specified However, what was reported was that there were 113 asthmatic patients. It was not reported if this asthma was an allergic asthma  

Not reported 

Mainly cardiovascular with HTN as most prevalent, followed by diabetes. In addition, some had cancer, cirrhosis, viral hepatitis, renal disease, and HIV

Not reported 

About 181 are active smokers but not specified, which among these were the asthmatic.

Of the total 1000 study population, it would have been interesting to specifically profile and report those who had allergic respiratory conditions, their treatment, and outcomes

16.

Docherty et al., 2020 [33]

England, Wales, andScotlandUK

To depict the clinical features of COVID-19 patients during the first wave in the United Kingdom.

A prospective observational cohort study

NR

The total study population was 20133, of which Male 60%, n =120;68 Female 40%, n = 8065. The median age of the total population was 73 years 

Asthmatic patients were 2540 (14.5); Male 1192 (11.4) And Female 1348 (19.1). However, phenotype of asthma not reported

NR

Malignancy1743 (10.0%) CHD 5469 (30.9%) DM without complications 3650 (20.7%) DM with complications 1299 (7.4%) non-asthmatic CPD 3128 (17.7%) CRD 2830 (16.2%) Obesity1685 (10.5%) HIV 83 (0.5%) Moderate or severe liver disease 310 (1.8%) Mild liver disease 281 (1.6%) Chronic hematological disease 693 (4.0%) Rheumatological disorder 1696 (9.8%) Malnutrition 396 (2.4%)

NR

Never smoked 8968 (63.2) Former smoker 4364 (30.8) Yes 852 (6.0)

This study showed the importance of pandemic preparedness to reduce the mortality rate.

17.

Du et al., 2020 [34]

Wuhan China

To investigate the clinical characteristics ofCOVID-19 children with different severities and allergic status.

Retrospective Cohort Study

NR

Total population182. Male 120 (65.9%), Female 62 (34.1%). The median age of the total population was 6 years.

Asthma + urticaria +drug allergy 1 (2.3%) AR 28 (65.1%) AR + drug allergy 5 (11.6%) AR + AD 1 (2.3%) AR + food allergy 1 (2.3%) AR + food allergy + drug allergy 1 (2.3%) Asthma + urticaria +drug allergy 1 (2.3%) AD 3 (7.0%) Penicillin 10 (23.3%) Mango 1 (2.3%) Egg 1 (2.3%) Dust mite 1 (2.3%)

Allergic

Medical history except allergic. Nonallergic patients 8 (18.6%) Nonallergic patients 24 (17.3%)

NR

NR

The clinical course in Pediatric has a mild clinical course; also, there was no difference in disease between allergic and nonallergic COVID-19 children.

18.

Grandbastien et al. 2020 [35]

Chest Diseases Department of Strasbourg University Hospital, France

To assess the frequency of asthma exacerbation in patients with asthma hospitalized for SARS-CoV-2 pneumonia and compare symptoms and laboratory and radiological findings in patients with and without asthma with SARS-CoV-2 pneumonia.

Cohort study

NR

Mean age 63.5 years. Males 62.3% Females 37.7%

23 (21%) asthmatic patients

Allergic

Obesity (39.6%) HTN (42.5%) DM (21.7%) CHD (5.7%) CRD (4.8%) Lung cancer (6.6%) Obstructive sleep apnea (13.2%) 

NR

33 (31.1)

The study result found that the patient with asthma has no risk for SARS-COV-2 severe symptoms; also, SARS-CoV-2 pneumonia did not induce severe asthma symptoms.

19.

Ibrahim et al. 2020 [36]

The Royal Children’sHospital, Melbourne, Australia.

To presentearly data on Australian children. 

Retrospective cohort study

NR

Mean age 13.1yearsMales 25%Females 75%

1 (25%) asthmatic patient.  

NR

NR

NR

NR

The prevalence of SARS-COV-2 was low in the children; also, asthma had a low prevalence.

20.

Jacobs et al., 2020 [37]

USA

To review early clinical experience with the use of extracorporeal membrane oxygenation in patients with confirmed COVID-19 and pulmonary disease.

Cohort study

NR

Total population 32. Male 22 (68.8%), Female 10 (31.2%). The median age of the total population was 52 years

There was only 3 (9.4%) asthmatic patient but phenotype NOT reported

NR

Cancer 3 (9.4%) DM11 (34.4%) CHD4 (12.5%) Obesity Yes 14 (43.8)

NR

NR

Extracorporeal membrane oxygenation needs more studies to confirm using in COVID-19.

21.

Kim et al., 2020 [38]

Korea

To investigate the clinical course and outcomes of COVID-19 from early cases in Korea.

Retrospective multicenter Cohort Study

NR

Total population 28. Male 15 (53.6%), Female 13 (46.4%). Median age of total population was 40 years

There was only 1 (3.6%) asthmatic patient but phenotype NOT reported

NR

Cancer 1 (3.6%) HTN 0 Dyslipidaemia 0 DM without complication 2 (7.1%) CHD 0 CRD 0COPD 0 Liver disease, mild 1 (3.6%) HIV 0

NR

5 (18.5%)

The asthmatic patient showed bilateral CT only, was isolated without oxygen requirement, and received lopinavir/ritonavir antiviral therapy

22.

Li et al., 2020 [39]

China

To evaluate the severity on admission, complications, treatment, and outcomes of patients with COVID-19.

Retrospective cohort study

NR

The total study population was 548 Mean age 60 years, 279 of 548 (50.9%) were males, mean BMI was 24.7 (kg/m2)

5 of 548 (0.9%) patients had asthma Phenotype NOT reported

NR  

Tuberculosis 9 of 548 (1.6%), diabetes 83 of 548 (15.1%), HTN 166 of 548 (30.3%), CAD 34 of 548 (6.2%), hepatitis B 5 of 548 (0.9%), CRD 10 of 547 (1.8%), and tumor 24 of 513 (4.7%)

NR

Never smokers 452 of 544 (83.1%), Former smokers 51 of 544 (9.4%), Current smokers 41 of 544 (7.5%)

Older patients with hypertension and high lactate dehydrogenase need early support to reduce the severity of the disease.

23.

Mahdavinia et al., 2020 [40]

Rush University Medical Center. USA

To report the result of the role of asthma in the outcome of COVID-19 in a large cohort of COVID-19 positive patients.

Cohort

African American 59.7% Asian 8.7% White non-Latino 11.3% White Latino 5.1%

Age (18-65 years) Males 66.8% Females 33.2% 

241 (25.7%) asthmatic patients

NR

Obesity

NR

NR

Preexisting asthma is a risk for COVID-19 and predictor of intubation duration in COVID-19, especially in patients less than 65 years.

24.

Singer et al., 2020 [41]

New York Hospital and Predictors of ICU Care, USA

To report the COVID-19 cases and outcomes.

Retrospectivecohort

White (42%) Black (7%) Asian (3%) Other (1%) Unknown (47%) Hispanic (37%)

Mean age 50 years Males 54% Females 46%

106 (6%) asthmatic patients

NR

HTN (28%) DM (15%) CAD (7%) COPD (4%) CHF (3%) Cancer (4%) Immunosuppressed (4%) CKD (5%)

-

6%

9% of COVID-19 patient need immediate ICU, and 13% need mechanical ventilation within 2 to 3 days.

25.

Borba et al., 2020 [42]

Care facility in Manaus, Brazilian Amazon, Brazil

To evaluate the safety and efficacy of 2 CQ dosages in patients with severe COVID-19.

RCT

White (21%) Mixed (71.6%) Black (7.4%) Pregnant (10%)

Mean age 51.1yearsMales 75.3%Females 24.7%

4 (7.4%) asthmatic patients

Not reported

HTN (45.5) DM (25.5) Alcohol use disorder (27.5) HD (9.1) CRD (7.4) Rheumatic diseases (5.5) Liver diseases (3.6) Tuberculosis (3.6)

Not reported

4 (8.3%)

This study suggested that the higher chloroquine diphosphate is not recommended in COVID-19 patients.

26.

Chao et al.,  2020 [43]

Tertiary Care Medical Center in New York City.

To describe the clinical profiles and risk factors for COVID-19 patients.

Cohort study

White 1 (3) Black 3 (9.1) Latino 26 (78.8) Other 3 (9.1)

Mean age of 9.4 years Males 69.6% Females 30.4%

11 (23.65%) asthmatic patients

Not reported

Obesity (27.3%) Immunosuppressed 1 (3) Seizure disorder 1 (3)

Not reported

Not reported

pediatric with complications as diabetes need early admission in the intensive care unit.

27.

Chhiba et al., 2020 [44]

University Feinberg School of Medicine, Chicago.

To determine theprevalence of asthma among patients with COVID-19

Retrospective cohort

Non-Hispanic African American 358 (23.5) Non-Hispanic white 643 (42.1) Hispanic or Latino 324 (21.2) Non-Hispanic Asian 70 (4.6) Other 201 (13.2)

Mean age 55 years Males 47% Females 53%

220 (14.4%) asthmatic patients

Not reported

Not reported

Not reported

53 (3.5)

This study found that asthma prevalence was 14% in a cohort ofpatients with COVID-19.

28.

Desir et al., 2020 [45]

The New York-Presbyterian hospital network. 

The study objective was to determine whether underlying asthma was associated with poor outcomes among COVID-19 patients.

Retrospective cohort

Black 238 (21) White 218 (19) Asian 14 (1) Other 384 (34)

Mean age 51.5 years Males 98% Females 2%

163 (12.55%) asthmatic patients

Not reported

Obese 445 (39) Other 593 (52)

Not reported

55 (3%)

Asthma diagnosis was not associatedwith worse outcomes in COVID-19 patients.

29.

Salacup et al.,  2020 [46]

Einstein Healthcare Network is an inner-city urban community hospital in Northern Philadelphia

To describe the demographics and clinical factors of COVID‐19 patients of a minority population in an underserved area.

Retrospective cohort

Not reported

Mean age 66 years Males 49% Females 51%

18 (7%) asthmatic patients

Not reported

COPD 30 (12) CHD 35 (15) Atrial fibrillation 24 (10) Liver cirrhosis 8 (3) DM 118 (49) CRD 42 (17) CAD 45 (19) HTN 180 (74) Obesity 97 (40)

Not reported

Not reported

The mortality rate significantly increased with old age.

30.

Schultze et al.,  2020 [47]

London, UK.

To assess the association between inhaled corticosteroids and COVID-19-related death among people with COPD or asthma.

Cohort study

White (75%) Mixed (0.2%) Asian or Asian (0.6%) Black (0.2%) Other (0.3%) Unknown (23.7%)

Mean age 31 years Males 55% Females 45%

Not reported

Not reported

Not reported

Not reported

17 268 (39·9%)

This study results do not support the role of inhaled corticosteroids in protecting asthmatic patients against COVID-19.

31.

Yang et al.,  2020 [13]

South Korea

To determine the association of allergicdisorders with the likelihood of COVID-19.

A nationwide cohort study

Not reported

Mean age 49 years Males 47.4% Females 52.6%

725 (9.8%) asthmatic patients. 4210 (57.3) allergic rhinitis.

Not reported

Not reported

Not reported

Not reported

Asthma and allergic rhinitis confer risk for COVID-19. 

32.

Zhang et al.,  2020 [48]

Hospital of Wuhan, China.

To investigate the clinical characteristic and allergy status of COVID-19 patients

Cohort study

Not reported

Mean age 57yearsMales 50.7%Females 49.3%

0

Not reported

HTN 42 (30.0) DM 17 (12.1) Arrhythmia 5 (3.6) Urolithiasis 3 (2.1) Stroke 3 (2.1)CRD 2 (1.4) Aorta sclerosis 2 (1.4) COPD 2 (1.4)

Not reported

2 (1.4%)

Allergic diseases, asthma, and COPD are not risk factors for COVID-19.