{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T18:58:30Z","timestamp":1762196310131,"version":"build-2065373602"},"reference-count":37,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T00:00:00Z","timestamp":1761350400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The SARS-CoV-2 pandemic raised concerns about severe asthma (SA) patients, especially those on biological therapy. While initial fears of increased risks diminished for the general asthma population, a subset of severe cases undergoing specific treatments continued to be closely monitored. Our study aimed to evaluate COVID-19 occurrence, asthma exacerbations, hospitalizations, and outcomes in severe asthma patients. Methods: This multicenter study gathered data from 237 adult severe asthma patients in Croatia and Serbia to assess COVID-19 impact compared to the general population. Participants received omalizumab, mepolizumab, benralizumab, or reslizumab. Data on demographics, clinical features, and COVID-19 were collected. COVID-19 symptoms and diagnostic testing were assessed as described. Results: No demographic differences were seen between COVID-19-positive and -negative groups, with eosinophilic asthma prevailing. Among patients with SA treated with biologics, the occurrence of COVID-19 did not differ significantly from that in the general population, and biologic therapy was not associated with more severe disease or higher mortality. Importantly, no meaningful differences were observed among different biologics regarding COVID-19 outcomes. Vaccination was associated with a reduction in severe cases and hospitalizations. Conclusions: Biologic therapy for severe asthma appears safe during the COVID-19 pandemic. Patients receiving biologics did not experience worse outcomes than the general population, and no biologic was linked to poorer COVID-19 prognosis. Vaccination further contributed to protection against severe disease.<\/jats:p>","DOI":"10.3390\/jcm14217583","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T09:16:24Z","timestamp":1761729384000},"page":"7583","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of SARS-CoV-2 on Severe Asthma Patients Undergoing Biological Therapy: A Multicenter Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9264-6922","authenticated-orcid":false,"given":"Marina","family":"Lampalo","sequence":"first","affiliation":[{"name":"University Hospital Center Zagreb, 10000 Zagreb, Croatia"},{"name":"Faculty of Health Studies, University of Rijeka, 51000 Rijeka, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Branislava","family":"Milenkovic","sequence":"additional","affiliation":[{"name":"Clinic for Pulmonary Diseases, University Clinical Centre of Serbia, 11000 Belgrade, Serbia"},{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anamarija","family":"Stajduhar","sequence":"additional","affiliation":[{"name":"University Hospital Center Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iva Lucija","family":"Burnac","sequence":"additional","affiliation":[{"name":"Clinical Hospital Sveti Duh, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7047-3538","authenticated-orcid":false,"given":"Vesna","family":"Tomic Spiric","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"},{"name":"Clinic for Allergy and Immunology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivana","family":"Stankovic","sequence":"additional","affiliation":[{"name":"Clinic for Lung Diseases, University Clinical Centre of Nis, 18000 Nis, Serbia"},{"name":"Faculty of Medicine, University of Nis, 18000 Nis, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zorica","family":"Lazic","sequence":"additional","affiliation":[{"name":"Clinic for Pulmonology, University Clinical Centre Kragujevac, 34000 Kragujevac, Serbia"},{"name":"Faculty of Medicine, University of Kragujevac, 34000 Kragujevac, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bojan","family":"Djokic","sequence":"additional","affiliation":[{"name":"Clinic for Pulmonology, University Clinical Centre Kragujevac, 34000 Kragujevac, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dragan","family":"Vukosavljevic","sequence":"additional","affiliation":[{"name":"Clinic for Pulmonary Diseases, University Clinical Centre of Serbia, 11000 Belgrade, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanja","family":"Dimic Janjic","sequence":"additional","affiliation":[{"name":"Clinic for Pulmonary Diseases, University Clinical Centre of Serbia, 11000 Belgrade, Serbia"},{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aleksandra","family":"Plavsic","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"},{"name":"Clinic for Allergy and Immunology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0800-7939","authenticated-orcid":false,"given":"Borislav","family":"Bozanic","sequence":"additional","affiliation":[{"name":"Clinic for Lung Diseases, University Clinical Centre of Nis, 18000 Nis, Serbia"},{"name":"Faculty of Medicine, University of Nis, 18000 Nis, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugenija","family":"Kasap Basioli","sequence":"additional","affiliation":[{"name":"General Hospital Zadar, 23000 Zadar, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8787-9550","authenticated-orcid":false,"given":"Bojan","family":"Mileti\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Health Studies, University of Rijeka, 51000 Rijeka, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanja","family":"Hromi\u0161","sequence":"additional","affiliation":[{"name":"Institute for Pulmonary Diseases of Vojvodina, 22000 Sremska Kamenica, Serbia"},{"name":"Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hana","family":"Safic Stanic","sequence":"additional","affiliation":[{"name":"Croatian Institute of Transfusion Medicine, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"106287","DOI":"10.1016\/j.rmed.2020.106287","article-title":"Poor outcome of SARS-CoV-2 infection in patients with severe asthma on biologic therapy","volume":"177","author":"Eger","year":"2020","journal-title":"Respir. 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