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Javier Dominguez-Ortega,1 Vicente Plaza,2 Antonio Nieto,3 Julio Delgado Romero,4 Julio Ancochea,5– 7 Natalia Mejia,8 Mariano Pastor,9 Marina Blanco-Aparicio10 1Department of Allergy, La Paz University Hospital, Institute for Health Research (IdiPAZ), Madrid, Spain; 2Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Instituto de Investigación Biomédica Sant Pau, Barcelona, Spain; 3Pediatric Pulmonology and Allergy Unit, Hospital Universitari i Politècnic La Fe, Health Research Institute La Fe, Valencia, Spain; 4Allergology Clinical Management Unit, Hospital Virgen Macarena, Sevilla, Spain; 5Pneumology Department, Instituto de Investigación Sanitaria de La Princesa, Madrid, Spain; 6Pneumology Department, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; 7Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; 8Medical Department, Novartis Farmacéutica, Barcelona, Spain; 9Fundación Española de Asociaciones de Pacientes Alérgicos y con Enfermedades Respiratorias (FENAER), Madrid, Spain; 10Pneumology Department, A Coruña University Hospital, A Coruña, SpainCorrespondence: Javier Dominguez-Ortega, La Paz University Hospital, Institute for Health Research (IdiPAZ), Madrid, Spain, Tel +34 616 719 390, Email javier.dominguez@salud.madrid.orgPurpose: ATLAS ASMA described the psychosocial impact of asthma on patients’ daily life from patients’ perspectives (in terms of impaired personal and intimate relationships, sleep quality, leisure time, daily activities, and others) in Spain. Secondary objective includes description of time since diagnosis, expectations, and satisfaction of patients about disease, treatment and medical assistance received, adherence to treatment, perceived control of asthma, and health-related quality of life.Patients and Methods: This was a cross-sectional, observational study, based on a self-administered online survey for adult patients (≥ 18 years) with asthma. Patients with asthma diagnosis of any type and severity who voluntarily participated in the survey through a web link were included consecutively. In the present manuscript, only adult patients’ data are included.Results: A total of 132 adults with asthma were included. Moderate/severe asthma constituted 59.1% of the patients (females 71.2%). Overall, most relevant areas affected due to asthma were leisure activities (67.0%) and the quality/quantity of sleep (52.3%). Moderate/severe patients perceived some degree of impairment in work, school, or at home due asthma more frequently vs mild patients (55.2% vs 10.9%). Poorly controlled asthma (ACT≤ 19) was reported in 41 (70.7%) and 10 (21.7%) moderate/severe and mild patients (p< 0.000), respectively. Mild patients obtained higher mean (SD) Mini-AQLQ score than moderate/severe asthma patients (5.6 [1.0] vs 4.3 [1.1], p< 0.000), likewise higher significant results for every individual dimension. Most patients cited little limitation to intense efforts (20.5%). Half of the patients mentioned needing more information about asthma. Topics those patients like to have more information were difficulties that may can have and legal topics (78.6%), asthma evolution (78.6%), secondary effects or issues related to the treatment (61.9%) and legal topics (61.9%).Conclusion: The study reported important insights on psychosocial impact of asthma on patients’ daily life from patients’ perspectives along with health determinants in asthma-related health outcomes, sociodemographic and psychosocial factors.Keywords: patient survey, psychosocial impact, health-related quality of life, healthcare resources utilization, Asthma Control Test, Mini-AQLQ

Alicia Habernau Mena,1,&ast; Ismael García-Moguel,2,3,&ast; María Vazquez de la Torre Gaspar,4 Victoria Mugica,5 Maria Isabel Alvarado Izquierdo,6 Maria Aranzazu Jimenez Blanco,7 Mar Gandolfo-Cano,8 Mar Jiménez Lara,9 Ana Gonzalez Moreno,10 Pilar Saura Foix,11 Ana Navarro-Pulido,12 Cristina Martin-Arriscado Arroba,13 Julio Delgado Romero,14 Javier Dominguez-Ortega15 On behalf of Asthma Committee of SOCIEDAD ESPAÑOLA DE ALERGOLOGÍA E INMUNOLOGÍA CLÍNICA (SEAIC)1Department of Allergy. Complejo Hospitalario de Mérida, Mérida, Spain; 2Department of Allergy, Hospital Universitario 12 de Octubre, Madrid, Spain; 3Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas 12), Madrid, Spain; 4Department of Allergy, Hospital Universitario Infanta Leonor, Madrid, Spain; 5Department of Allergy, Hospital de la Princesa, Madrid, Spain; 6Department of Allergy, Hospital Universitario de Cáceres, Cáceres, Spain; 7Department of Allergy, Hospital Cruz Roja, Madrid, Spain; 8Department of Allergy, Hospital Universitario de Fuenlabrada, Madrid, Spain; 9Department of Allergy, Hospital de Toledo, Toledo, Spain; 10Department of Allergy, Fundación Hospital Alcorcón, Madrid, Spain; 11Department of Allergy, Consorci Sanitari de Terrassa, Terrassa, Spain; 12Allergology Clinical Management Unit (UGC), El Tomillar Hospital, Sevilla, Spain; 13Research and Science Support Unit, Instituto de investigación Biomédica del Hospital Universitario 12 de Octubre I+12, Madrid, Spain; 14Department of Allergy, Hospital Universitario Virgen Macarena, Sevilla, Spain; 15Department of Allergy, Hospital Universitario La Paz. Instituto de Investigación (idiPaz), Madrid, Spain&ast;These authors contributed equally to this workCorrespondence: Ismael García-Moguel, Department of Allergy, Hospital Universitario 12 de Octubre, Av de Córdoba s/n, Zip code 28005, Madrid, Spain, Tel +34-645852229, Email Ismaelgmoguel@gmail.comPurpose: The acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has had a high impact on patients with chronic diseases. In the literature, there are different perspectives on asthma as comorbidity or risk factor on COVID-19 severity.Patients and Methods: The aim of this retrospective study across 13 allergy departments in Spain was to determine the severity of COVID-19 in asthmatic adults followed in allergy departments and its relationship with atopy, clinical and demographic characteristics, phenotypes and laboratory data. In addition, lung function test and asthma control test (ACT) before and after COVID-19 were analyzed. Data was obtained from electronic medical records from March 2020 to April 2021.Results: Two hundred one asthmatic patients were diagnosed with COVID-19 infection by validated detection test. About 30% of the patients were admitted for bilateral pneumonia. Advanced age, elevated D-dimer, lower numbers of lymphocytes and eosinophils, heart diseases and hypertension were associated with severe COVID-19. Allergic and mixed allergic/eosinophilic phenotype and their biomarkers (total IgE, aeroallergens sensitizations, allergic rhinitis, and blood eosinophilia) were related to fewer hospital admissions. Poor control and lower forced expiratory volume in the first second (FEV1) were related to worse prognosis of COVID-19.Conclusion: Asthmatic patients with allergic and eosinophilic phenotype have a better evolution of COVID-19 and lower risk of admissions. Older patients, cardiovascular comorbidities, AERD and eosinopenia are related to severity COVID-19.Keywords: COVID-19, allergic asthma, eosinophils, asthma phenotype, SARS-CoV-2

Ismael García-Moguel,1,2 Ana Rosado,3 Aída Gómez-Cardeñosa,4,5 Mar Gandolfo-Cano,6,7 Teresa Robledo Echarren,8 Maria del Mar Moro Moro,9 Mª del Mar Reaño Martos,10 Rafael Pineda-Pineda,11 Marcela Valverde-Monge,4,5 Cristina Martin-Arriscado Arroba,12 Javier Domínguez-Ortega13 On behalf of the AIRE Group1Department of Allergy, Hospital Universitario 12 de Octubre, Madrid, Spain; 2Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; 3Department of Allergy, Hospital Universitario Fundación Alcorcón, Madrid, Spain; 4Department of Allergy, University Hospital Fundación Jiménez Díaz, Madrid, Spain; 5Centro de investigación biomédica en enfermedades respiratorias (CIBERES), Instituto Carlos III, Madrid, Spain; 6Department of Allergy, Hospital Universitario de Fuenlabrada, Madrid, Spain; 7RETIC ARADyAL, Instituto de Salud Carlos III, Madrid, Spain; 8Department of Allergy, Hospital Clinico San Carlos (HCSC), Instituto de investigación sanitaria del Hospital Clínico San Carlos (IdSSC), Madrid, Spain; 9Department of Allergy, Complejo Hospitalario de Toledo, Toledo, Spain; 10Department of Allergy, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; 11Department of Allergy, Hospital Universitario del Sureste, Madrid, Spain; 12Research and Science Support Unit, Instituto de investigación Biomédica del Hospital Universitario 12 de Octubre I+12, Madrid, Spain; 13Department of Allergy, La Paz University Hospital, Institute for Health Research (IdiPAZ), Madrid, SpainCorrespondence: Ismael García-Moguel, Tel +34 645852229, Email Ismaelgmoguel@gmail.comIntroduction: The increase in drugs available for severe uncontrolled asthma and the lifestyle of these patients make it necessary to implement self-administration programs of these therapies at home. Benralizumab, a monoclonal antibody targeting IL5R, was authorized in Spain for poorly controlled severe eosinophilic asthma. The possibility of administration at home was approved in March 2020 in Spain. The aim of the Auto-Benra study was to evaluate the usability and satisfaction of the benralizumab prefilled syringe and autoinjector and assessing the effectivity of these devices in uncontrolled severe eosinophilic asthma (SEA) in home-self administration.Methods: This is a retrospective, observational multicenter study uncontrolled SEA patients treated with benralizumab at least with 3 doses self-administered at home before April 30, 2021. Reliability and satisfaction with benralizumab at home were evaluated with subcutaneous administration assessment questionnaire (SQAAQ) and visual analogic scales (VAS). Effectiveness was evaluated in all patients with asthma control test (ACT), Mini Asthma Quality of Life Questionnaire (MiniAQLQ), annual exacerbation rate, oral corticosteroid treatment (OCS) and asthma-related hospitalizations and emergency visits.Results: Fifty-four patients across 9 hospitals in Spain were included. The mean SQAAQ score was 6.89 (± 0.16) points. Patients and their caregivers and doctors report excellent satisfaction by VAS, with no differences between benralizumab devices used (prefilled syringe and autoinjector). Severe exacerbation rate decreased by 65% (p = 0.0007) after benralizumab treatment. ACT score improved on average 6.27 ± 5.35 points (p < 0.0001) and the mean MiniAQLQ increased up to 1.58 ± 1.47 points (p < 0.0001). Twenty-four patients were OCS-dependent and at the end of study 14 patients get complete OCS withdrawal.Conclusion: AUTO-BENRA study supports the use of benralizumab at home given the excellent results of satisfaction and usability by patients and their caregivers.Keywords: benralizumab, severe eosinophilic asthma, self-administration, severe asthma, eosinophilic asthma

Javier Domínguez-Ortega,1,2 Silvia Sánchez-García,3 Carlos Melero Moreno4 1Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; 2CIBER of Respiratory Diseases (CibeRes), Madrid, Spain; 3Department of Allergy, Hospital Infantil Universitario Niño Jesús, Madrid, Spain; 4Instituto de Investigación (i+12), Hospital Universitario 12 de Octubre, Madrid, SpainCorrespondence: Carlos Melero Moreno, Instituto de Investigación (i+12), Hospital Universitario 12 de Octubre, Av. de Córdoba, S/N, Madrid, 28041, Spain, Tel +34 913908000/ext. 4646, Email cmelero@separ.es; cmelero.imas12@h12o.es

Ignacio Esteban-Gorgojo,1 Darío Antolín-Amérigo,2 Javier Domínguez-Ortega,3,4 Santiago Quirce3,4 1Department of Allergy, Hospital General de Villalba, Madrid, Spain; 2Department of Allergy, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain; 3Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), 4CIBER de Enfermedades Respiratorias, CIBERES, Madrid, Spain Abstract: Although non-eosinophilic asthma (NEA) is not the best known and most prevalent asthma phenotype, its importance cannot be underestimated. NEA is characterized by airway inflammation with the absence of eosinophils, subsequent to activation of non-predominant type 2 immunologic pathways. This phenotype, which possibly includes several not well-defined subphenotypes, is defined by an eosinophil count