Does Coronavirus Affect Asthma? What Sufferers Need to Know About COVID-19

Around 2.5 million people live with asthma in the U.S.—but does the condition put them at any more risk of the new coronavirus?

The actor Idris Elba, who recently revealed he had been diagnosed with COVID-19, has asthma and admitted in a recent livestream that he was concerned. Elsewhere, organizations like the Centers for Disease Prevention and Control (CDC) and the World Health Organization (WHO) have included asthma sufferers on the list of people who are most at risk. But data on just how people with asthma may be affected by the new coronavirus is thin on the ground.

"Respiratory viruses such as influenza and rhinovirus—the common cold—are a common trigger for asthma exacerbations in children and adults but for reasons we don't fully understand, COVID-19 does not seem to have a more severe effect compared with these other viruses," David Stukus, a board-certified allergist and immunologist and Associate Professor of Pediatrics at Nationwide Children's Hospital in Columbus, Ohio, told Newsweek.

"This may change as more of the population is impacted and our understanding evolves, but for now, there is no evidence that this is the case."

Indeed, one study based on 140 patients hospitalized with COVID-19 found absolutely no link between the two conditions, concluding allergic diseases and asthma are not risk factors for the SARS-CoV-2 infection. However, previous research has suggested that asthma symptoms can worsen with other strains of coronavirus.

The Asthma and Allergy Foundation of America (AAFA) recommends people who have asthma take extra precautions when it comes to any type of respiratory infection.

"Just having asthma or any other chronic lung disease doesn't in and of itself predispose the individual to a higher likelihood of contracting COVID-19 any more than for influenza or other infectious disease," Dr. Albert Rizzo, Chief Medical Officer of the American Lung Association, told Newsweek.

"Having a chronic lung disease like asthma does put one at a higher risk of having more severe symptoms or complications of COVID-19 once infected."

Asthma inhaler
Albuterol sulfate inhaler, commonly used to treat asthma. More than 2 million American's have asthma. How might they be affected by the new coronavirus? Smith Collection/Gado/Getty

For this reason, Rizzo recommends patients with chronic lung disease pay special attention to preventive measures like hand washing and social distancing. The latter involves avoiding crowds, handshaking, hugs and other actions that put you in close contact with others.

This mirrors advice from the CDC encouraging those at high risk, either due to age or underlying health conditions, to reduce their chances of getting sick by limiting close contact, avoiding crowds and non-essential travel, as well as by adopting good hygiene practices. This includes washing hands frequently and for 20 seconds or more, and not touching the face.

Rizzo also recommends self-isolation. "Just like all of us should be doing in this phase of mitigation and social distancing that has been recommended throughout the country and for that matter, the world," he said.

Stukus, however, noted that asking everyone with asthma to self-isolate is neither practical nor needed at this time: "Asthma affects tens of millions of people and blanket recommendations for "anyone" with asthma to self-isolate is not necessary or practical at this time," he said.

He added asthma is highly variable and there are different levels of severity and risk. Those who have recently been admitted to hospital on account of severe exacerbation or have poorly controlled severe asthma at baseline might be given different recommendations from their personal physician.

People with asthma should also continue to take their asthma medication as prescribed to keep the condition under control.

"You need to make sure your asthma is under control. This often requires the use of inhaled corticosteroids (and sometimes oral corticosteroids)," Mitchell Grayson, chair of AAFA's Medical Scientific Council, told AAFA. "Inhaled corticosteroids do not likely reduce your immune system's ability to fight infections, but oral corticosteroids may. It is important to use the steps above to protect yourself to limit your exposure to any respiratory virus."

On the subject of medication, should people be stockpiling? Rizzo recommends making sure you have at least a month or two's worth of your medications. Grayson said people should not go overboard and hoard medicines that might limit access for other people.

"I don't think having a large stash of medicine on hand will be helpful. And it will limit the amount of drugs available to other people," Grayson told AAFA. "If you want to be safe, have a 30-day supply on hand. There is no need for more than that."

Stukus stressed the point that people with asthma should continue all prescribed daily controller medications. He also advises having an up-to-date copy of their asthma treatment plan. Asthma sufferers should make sure they know when and how to treat symptoms if they occur.

"There is a lot of misinformation circulating surrounding asthma and COVID-19 and everyone should always contact their personal doctor before making any changes to their treatment or stopping medicine," said Stukus, who is Social Media Editor for American Academy of Allergy Asthma and Immunology (AAAAI). "No commonly prescribed asthma medications pose risk for COVID-19 and anyone who stops their daily controller medication will increase their risk for exacerbation and possible need for emergency services."

He added: "We are also in the midst of spring tree pollen season, which can worsen symptoms for many people with asthma—another very important reason to continue all medications."

The CDC advises calling your doctor if you think you are developing symptoms, such as fever, cough, or shortness of breath.

Difficulty breathing or shortness of breath, persistent pain or pressure in the chest, new confusion or inability to arouse and bluish lips or face are more emergency warning signs and should be met with immediate medical attention.

"Most likely it is not COVID-19, but it is important to let them know about your illness," said Grayson. If possible (and I encourage this), avoid going to work or school (or any public places) when you have a fever so you do not spread your illness."

Correction 3/19/2020, 11:40 a.m.: The name of the American Lung Association has been corrected. The article has been updated to include comments from Professor David Stukus.

World Health Organization advice for avoiding spread of coronavirus disease (COVID-19)Hygiene advice

  • Clean hands frequently with soap and water, or alcohol-based hand rub.
  • Wash hands after coughing or sneezing; when caring for the sick; before; during and after food preparation; before eating; after using the toilet; when hands are visibly dirty; and after handling animals or waste.
  • Maintain at least 1 meter (3 feet) distance from anyone who is coughing or sneezing.
  • Avoid touching your hands, nose and mouth. Do not spit in public.
  • Cover your mouth and nose with a tissue or bent elbow when coughing or sneezing. Discard the tissue immediately and clean your hands.

Medical advice

  • If you feel unwell (fever, cough, difficulty breathing) seek medical care early and call local health authorities in advance.
  • Stay up to date on COVID-19 developments issued by health authorities and follow their guidance.

Mask usage

  • Healthy individuals only need to wear a mask if taking care of a sick person.
  • Wear a mask if you are coughing or sneezing.
  • Masks are effective when used in combination with frequent hand cleaning.
  • Do not touch the mask while wearing it. Clean hands if you touch the mask.
  • Learn how to properly put on, remove and dispose of masks. Clean hands after disposing of mask.
  • Do not reuse single-use masks.

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