Introduction UK public health policy emphasises the need for increased influenza vaccination during the COVID-19 pandemic However, there are claims on social media that influenza vaccination increases risk of adverse outcomes in SARSCoV- 2 infection that may compromise uptake, especially in high risk groups such as those with airways disease There is also emerging evidence that inhaled corticosteroids (ICS) may modify this risk We therefore sought to urgently assess the risk of morbidity and mortality in individuals admitted with COVID-19, and whether this influenced by influenza vaccination, airways disease and ICS use Method We examined data in patients admitted to a large acute hospital with microbiologically proven COVID-19 infection (positive PCR) between 23/01/2020 to 21/06/2020 Demographic and outcome data was extracted from discharge summaries, death certificates and electronic patient records Multiple logistic regressions was performed using STATA version 12, and results for inpatient mortality expressed as odds ratios, and length of stay (morbidity) as coefficients with 95% CIs Results 525 patients were hospitalised with COVID-19 of whom 451 had a vaccination record available and 64% had been vaccinated 22% had airways disease (10% asthma, 12% COPD) and 17 5% were on an inhaled corticosteroid Increasing age (OR=1 04 [1 02, 1 05], p&lt;0 001) and male gender (OR=2 26 [1 5, 3 4], p&lt;0 001) were important predictors of inpatient mortality Previous influenza vaccination (OR=0 99 [0 6, 1 6], p=0 98), the presence of airways disease (Asthma OR=0 74 [0 4, 1 5], p=0 41, COPD OR= 1 1 [0 6, 2 0], p=0 68), and ICS use (OR=0 84 [0 3, 2 1], p=0 71) did not increase risk of in-hospital mortality and were not associated with an increased length of stay, after adjusting for age and gender Further sub-analysis including type of airways disease and dose of ICS did not change the risk Conclusions Advancing age and male gender increased the risk of in-hospital mortality from COVID-19 Furthermore previous influenza vaccination and the presence of airways disease and/or the use of ICS did not impact morbidity or mortality Whilst this requires replication using national data sets, it is reassuring data from a single centre that supports the current public health message
Influenza vaccination, airways disease and the risk of COVID-19 related mortality