In this interview for uah.es noticia, José Luis Izquierdo, professor at the UAH and pneumologist at the Guadalajara hospital, comments on the main keys to the development of this research project he has led.

- First of all, what has the study 'The impact of COVID-19 in patients with asthma' consisted of?

One of the main concerns we had when the first cases of COVID-19 appeared was to know what impact would be on chronic respiratory pathologies. We soon learned that the severity was greater in patients with hypertension, diabetes or cardiovascular disease. Recently, we have published one of the largest series of medical literature on the impact of COVID-19 in patients with COPD using Big Data and artificial intelligence.

Bronchial asthma is another great chronic respiratory pathology, in which there were multiple doubts, both regarding its evolution in patients with COVID-19, and the role that treatments could have.

This study constitutes one of the largest series of literature, which analyzes the impact of COVID-19 in asthmatic patients. The most novel thing is that it uses a methodology based on artificial intelligence and Big Data, which allows obtaining clinical information almost immediately, in real life conditions, without all the limitations and biases that a system based on records can generate.

- How have you made the sample? How has Artificial Intelligence and Big Data contributed to this study? Why have you used these technologies?

Unlike the classic research methods, which are very time consuming, the new techniques available, such as the analysis of Big Data, Artificial Intelligence, machine learning, etc., facilitate very fast interventions. These tools are especially important when the clinical question requires the collection of data from a large number of patients in a very limited time, as in the case of the COVID-19 pandemic.

Taking into account the increasing availability of digitized health records, the Big Data provides the necessary tools to support the clinical work of the physician, to identify population groups at risk, to know the effect of real life treatments and to implement preventive measures and cost-efficient actions at regional and national levels. The BigCoviData program, of which this study is a part, is a good example in this line.

José Luis Izquierdo

- In their study they comment 'unlike the flu and other viruses, the disease burden of SARS-CoV-2 in patients with asthma - that is, the rate of people who are sick - has been less evident, although higher than in the general population'. Does this show that the incidence of COVID-19 is somewhat higher in people with asthma?

Unlike what has been described so far, using this large amount of information it has been possible to identify two very important aspects of COVID-19 in asthmatic patients. First, the asthmatic patient does have a higher risk of developing the disease, and second, when they do develop the disease they have a higher chance of complications, hospitalizations, and even higher mortality than COVID-19 patients without asthma. However, this occurs mainly in a special group of asthmatics with older age and associated comorbidities, so this type of population must be specially protected against COVID-19.

- What do you advise an asthmatic person to do to prevent COVID-19 infection? Tips and care for people who are asthmatic in the face of the challenge of COVID-19.

The third unanswered question was what might be the role of treatments, especially inhaled steroids and biological treatments used by severe asthmatics, might play in the progression of those who develop COVID-19. This is extremely important given that many patients have abandoned the treatments, either for fear of interactions with the virus or because of logistical problems in administering the biological treatments, which are often managed by hospital pharmacies, whose access in some health areas has suffered some complications during the height of the pandemic. In fact, in many healthcare areas in Spain there has been a high number of patients who have not been given biological treatment, due to administrative factors or the patient's own fear.

With the information from this study, we can convey to asthmatic patients the message that they should be specially protected, vaccinated against influenza and strictly treated because in this way it is possible to reduce the possibility of complications, even serious ones. In this study, the use of inhaled corticosteroids (the basis of bronchial asthma treatment) and biological treatments (key in the most severe forms of asthma) are safe and are associated with a protective effect against severe forms of COVID-19.

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