Asthma is a major public health challenge and one of the most common chronic disorders worldwide, affecting approximately 272 million people of all ages. The ongoing COVID-19 pandemic is dreadful for all people, but asthmatic patients dread they will have a worse outcome or be more likely to contract the SARS-CoV-2 virus.
Asthma and Covid-19
COVID-19 is a disease caused by the severe acute respiratory syndrome SARS-CoV-2. Clinically, the severity of COVID-19 can differ from mild to very severe, causing mortality in some patients. Since the beginning of the pandemic, an association between COVID-19 severity and chronic medical conditions such as cardiovascular disease, diabetes mellitus, and high blood pressure has been suggested. Unlike influenza and other seasonal viruses, the impact of COVID-19 in patients with asthma has been less evident.
Ever since the WHO declared the COVID-19 outbreak a global pandemic on March 11, 2020, the clinicians worldwide have been particularly concerned about the impact of patients’ pre-existing chronic conditions on the course of this new disease. Whereas high blood pressure and diabetes have been closely associated with increased frequency of cases and severity of COVID-19, care-related data suggest that COVID-19 has not affected patients with asthma.
“In our study, the manifestation of COVID-19 in patients with asthma was favoured by older age, male sex, and the presence of several comorbidities. High blood pressure, dyslipidemia, diabetes, and obesity were the main risk factors for hospital admission due to poor prognosis.”European Respiratory Journal
According to a report in the European Respiratory Journal, “Co-morbidities play a major role in the manifestation of COVID-19-related complications. In our study, the manifestation of COVID-19 in patients with asthma was favoured by older age, male sex, and the presence of several comorbidities. High blood pressure, dyslipidemia, diabetes, and obesity were the main risk factors for hospital admission due to poor prognosis.”
As per their findings,
a) the frequency of SARS-CoV-2 infection has been low in patients with asthma, although higher than in the general population,
b) the increased risk for hospitalization due to COVID-19 in patients with asthma is largely associated with age and related comorbidities; mortality mainly affected elderly patients,
c) ICS showed a safe profile; compared to asthmatic patients who required hospitalization due to COVID-19, a significantly higher percentage of non-hospitalized patients used ICS.
Controller medications and COVID-19
A report in the American Academy of Allergy Asthma & Immunology (AAAAI) suggests that currently there is no evidence of increased infection rates in those with asthma.
The report states, “Although the Centers for Disease Control and Prevention states those patients with moderate-severe asthma could be at greater risk for more severe disease, there are no published data to support this determination at this time. People with asthma are placed on controller medications to keep their asthma under control. In the current pandemic, the best thing a person with asthma can do (with respect to asthma) is to get and keep their asthma under control. Stopping a controller medication will put the person at risk for developing an asthma exacerbation. In the current pandemic, treatment of an exacerbation will likely require going to the emergency department or urgent care, where the individual has a much higher risk of being exposed to someone with COVID-19. So, in a way, by continuing to keep asthma under control, the person with asthma is reducing their chance of exposure to COVID-19.”