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Alicia Habernau Mena,1,* Ismael García-Moguel,2,3,* 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*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