Table 1.
Clinical Characteristics of Cases
| Case no. 1 | Case no. 2 | Case no. 3 | Case no. 4 | |
|---|---|---|---|---|
| Age | 34 | 31 | 46 | 55 |
| Race | African American | African American | African American | African American |
| Sex | Female | Female | Female | Male |
| BMI | 43.6 | 29.2 | 41.3 | 31.1 |
| Age of asthma symptom onset | Childhood, Intubated as a child |
Childhood | Childhood | Childhood |
| Age of asthma diagnosis (y) | 21 | Childhood | Childhood | 30 |
| Allergic comorbidities: | ||||
| Allergic rhinitis | Allergic rhinitis | Allergic rhinitis | Allergic rhinitis | Allergic rhinitis |
| Chronic rhinosinusitis | – | – | – | – |
| Atopic dermatitis | – | – | – | – |
| Food allergy | – | Food allergy | Food allergy | – |
| Health comorbidities: | ||||
| Sleep apnea | Suspected (had PSG scheduled on the weekend of admission) | Negative | Negative | Positive |
| Allergic sensitivities | Tree, dust mite, dog, cockroach | Tree, grass, mold | Tree, grass, mold, dust mite | Tree, grass, mold, dust mite, cat |
| Controller baseline regimen: | ||||
| ICS/LABA (mcg) | 200 Fluticasone furoate/50 vilanterol | Budesonide/formoterol | Budesonide/formoterol | 200 Fluticasone furoate/50 vilanterol |
| LTRA | Montelukast | Montelukast | Montelukast | Montelukast |
| Biologic | Omalizumab | – | – | Omalizumab |
| Baseline prebronchodilator FEV1 | 99% | 95% | 89% | 85% |
| PEFR baseline | 400 | 370 | 410 | 350 |
| PEFR on day of ED visit (L/min) | Not measured | 230 | 290 | 260 |
| Smoking status | ||||
| Tobacco | Former (15 pack history, quit 5 y ago) | Never smoked | Never smoked | Former (20 pack history, quit 7 y ago) |
| Oxygen saturation (at the peak of symptoms) | 88% | 100% | 85% | 94% |
| Presenting symptoms | ||||
| Fever (Tmax [°F]) | Yes (104) | No | Yes (103) | Yes (102.7) |
| Cough | Yes | Yes | Yes | Yes |
| SOB | Yes | Yes | Yes | Yes |
| Wheezing | Yes | Yes | Yes | Yes |
| Arthralgia | Yes | Yes | Yes | Yes |
| Physical limitation | Yes | Yes | Yes | Yes |
| Anosmia | Yes | Yes | No | No |
| Diarrhea | Yes | No | Yes | Yes |
| Clinical course: | ||||
| Activity limitation | 21 days | 23 days | 25 days | 23 days |
| Level of care | ED + hospitalization | ED | ED + hospitalization | Frequent home nurse visits |
| Laboratory findings: | ||||
| WBC (4.0-10.0 K/mcL) | 3.81 (low) | 9.63 | ||
| Lymphocytes (1-4 K/mcL) | 1.3 | 0.930 (low) | ||
| AST (0-40 U/L) | 42 (high) | 51 (high) | ||
| ALT (3-44 U/L) | 49 | 25 | ||
| Creatinine (0.65-1.1 mg/dL) | 1.16 (high) | 1.14 (high) | ||
| CRP (less than 0.5 mg/L) | 6.1 | 69 (high) | ||
| LDH (100-190 U/L) | 196 (high) | 389 (high) |
Abbreviations: ALT, alanine aminotransferase; AST, aspartate aminotransferase; BMI, body mass index; CRP, C-reactive protein; ED, emergency department; FEV1, forced expiratory volume in 1 second; ICS, inhaled corticosteroid; LABA, long-acting beta-agonist; LDH, lactate dehydrogenase; LTRA, leukotriene receptor antagonist; PSG, polysomnography; SOB, shortness of breath; WBC, white blood cell count.