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Research Snapshot Theater: Pulmonary, Adult and Pediatric

Association of Asthma and Mortality in Critically Ill COVID-19 Patients: A Population-Level Study

Monday, March 23, 2026
11:30 AM - 12:30 PM Central Time
Location: Connections Central - RST 09

  • Bhamini Shekhawat, MD (she/her/hers)

    Texas Tech University Health Sciences Center, Texas

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • TA

    Truman Archer, n/a (he/him/his)

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • PS

    Pruitt Spencer, MD

    Associate Program Director
    Texas Tech University Health Sciences Center

    Disclosure information not submitted.

  • TV

    Thien Vo, MD

    Dr.
    Texas Tech University Health Sciences Center

    Disclosure information not submitted.

  • TV

    Tetyana Vasylyeva, MD, PhD, DSc

    Professor and Regional Assistant Dean for Research, Department of Pediatrics - Nephrology Section
    Texas Tech University Health Sciences Center

    Disclosure information not submitted.

  • JG

    John Garza, PhD

    Doctor
    Texas Tech University Health Sciences Center at the Permian Basin

    Disclosure information not submitted.

Introduction: Asthma is one of the most prevalent chronic respiratory conditions, but its role in outcomes among critically ill patients with COVID-19 remains unclear. Some evidence suggests asthma may be protective, while others cite increased vulnerability. This study aimed to examine the association between asthma and in-hospital mortality in critically ill adult patients hospitalized with COVID-19 in Texas.


Methods: We conducted a retrospective, population-based cohort study of deidentified administrative data from all non-federal acute care hospitals in Texas between Q2 2020 and Q2 2024. Adult patients admitted emergently to the ICU with a principal diagnosis of COVID-19 (Clinical Classification Software Refined [CCSR] category INF012) were included. Asthma was identified using CCSR category RSP009. Transfers, elective admissions, and discharges against medical advice were excluded. We compared patients with and without asthma using overlap propensity score weighting to balance demographics and comorbidities. The primary outcome was in-hospital mortality. Adjusted risk ratios (ARRs) and 95% confidence intervals (CIs) were calculated. Covariate balance was assessed via standardized mean differences. Subgroup analyses explored potential effect modifiers including age, sex, race, obesity, and comorbidity burden.


Results: A total of 138,870 hospitalizations from 287 hospitals were included in the study, of which 9,276 (7%) had asthma. Patients with asthma were more likely to be younger, female, Black, obese, and have comorbid mental illness. They had lower mean numbers of organ dysfunctions and lower mean Deyo comorbidity scores. Crude mortality was 11% in asthma vs 16% in non-asthma patients. However, in the overlap-weighted population, mortality was 14% in both groups. Asthma was not associated with mortality: ARR 0.95 [95% CI 0.88–1.02].


Conclusions: In this large cohort of critically ill COVID-19 patients, asthma was not associated with an increased risk of in-hospital mortality after adjusting for baseline clinical characteristics. These findings suggest asthma should not independently guide ICU-level triage or prognostication in COVID-19 cases.