Severe COVID-19 Increases Stroke Risk for Patients With Asthma

Investigators of a study published in the Journal of Korean Medical Science found a significant association between severe COVID-19 and stroke occurrence for adults with asthma. They stated that the results highlight a need for stroke monitoring to improve long-term asthma outcomes.¹

According to research from the American Heart Association, patients who were infected with COVID-19 in 2020 could have double the risk for future heart attacks, stroke, and premature death from any cause up to 3 years later. This included patients who never had signs of severe illness. However, the analysis did not include patients who were infected after vaccines were made available.²

For patients with asthma, the disease and medication could be a risk factor for developing stroke. In a review published in Asthma Research and Practice, the authors state that “poorly controlled asthma and patients with frequent exacerbations show a greater risk for cardiovascular diseases and ischemic stroke.” However, pharmacotherapy for asthma, including β2-agonists and systemic corticosteroids, can also contribute to the development of asthma comorbidities, including stroke.³

In the current study, investigators aimed to investigate the lingering effects of COVID-19 on increasing the risk of stroke for patients with asthma, even after they recovered from infection. They also focused on the severity of COVID-19. In study 1, investigators focused on stroke risk according to COVID-29 status, and in study 2, investigators focused on stroke risk for individuals with asthma compared with the general public without asthma according to COVID-19 status.¹

In study 1, there were 9839 individuals included in both the asthma with COVID-19 cohort and the asthma without COVID-19 cohort, who had a mean age of 57 years, and approximately 40% were male. As for study 2, there were 6 groups included based on asthma status and COVID-19 severity. In the general population cohort, 9094 individuals without COVID, 8085 with nonsevere COVID-19, and 1009 with severe COVID-19 were included. For the asthma cohort, there were 9839 individuals without COVID-19, 8462 individuals with nonsevere COVID-19, and 1377 with severe COVID-19 included.¹

At a median follow-up of 76 days, approximately 0.40% of patients in the asthma cohort with COVID-19 developed stroke compared with 0.36% of patients in the asthma without COVID-19 cohort. Investigators noted that the incidence rates of stroke were higher in the asthma with COVID-19 cohort at 126.9 per 10,000 person-years compared with the asthma without COVID-19 cohort at 110.8 per 10,000 person-years. For severity, stroke occurred in 1.09% of patients with severe COVID-19 and 0.30% of patients with nonsevere COVID-19, with the incidence rates equating to 292.5 and 94.7 per 10,000 person-years, respectively. Furthermore, patients who did not have COVID-19 or asthma had an incidence of 58.3 per 10,000 person-years, and patients who had severe COVID-19 but not asthma had an incidence of 216.3 per 10,000 person-years.¹

“The increased risk of stroke in patients with asthma who experience severe COVID-19 underscores the necessity for vigilant monitoring and the proactive management of stroke risk factors in this vulnerable population,” the study authors said.¹ “Clinicians should consider incorporating routine stroke risk assessment and preventive strategies into the long-term care plans for asthmatic patients who are recovering from severe COVID-19.”

READ MORE: COVID-19 Resource Center

Are you ready to elevate your pharmacy practice? Sign up today for our free Drug Topics newsletter and get the latest drug information, industry trends, and patient care tips straight to your inbox.

REFERENCES

1. Zo S, Kim Y, Kim JS, et al. Risk of Stroke in COVID-19 Survivors With Asthma: A Nationwide, Population-Based Cohort Study. J Korean Med Sci. 2025;40(39):e247. Published 2025 Oct 13. doi:10.3346/jkms.2025.40.e247

2. Williamson L. COVID-19 may increase heart attack and stroke risk for years. American Heart Association. October 9, 2024. Accessed October 17, 2025. https://www.heart.org/en/news/2024/10/09/covid-19-may-increase-heart-attack-and-stroke-risk-for-years

3. Corlateanu A, Stratan I, Covantev S, Botnaru V, Corlateanu O, Siafakas N. Asthma and stroke: a narrative review. Asthma Res Pract. 2021;7(1):3. Published 2021 Feb 19. doi:10.1186/s40733-021-00069-x