Is Asthma a Risk Factor for Coronavirus Disease-2019 Worse Outcomes?

The Answer Is No, But...

Priscila A. Franco; Sergio Jezler; Alvaro A. Cruz

Disclosures

Curr Opin Allergy Clin Immunol. 2021;21(3):223-228. 

In This Article

Abstract and Introduction

Abstract

Purpose of Review: To search for evidence on whether having asthma increases the risk of poor outcomes of COVID-19 and report on recommendations on optimal asthma management in times of COVID-19.

Recent Findings: Patients with asthma are neither at greater risk of becoming infected by SARS-CoV-2 nor they are at risk of complications of COVID-19 but those requiring frequent use of oral corticosteroid may be at greater risk.

Summary: In general, patients with asthma are not at risk of COVID-19 morbidity or mortality. On the contrary, patients with asthma may be at lower risk of hospitalizations during the COVID-19 pandemic. This may be related to asthma and its treatment, to patient's behavior, to the health system, and to collective changes in activities. It is likely that reduction in respiratory infections because of social distancing, face masks, and hand washing have a role in the reduction in asthma hospitalizations. Management of asthma in times of COVID-19 must be optimized, medication have to be used regularly and exacerbations detected early. Systemic corticosteroids may be used for control of severe asthma or severe exacerbations. Patient education on an action plan is crucial, as well as facilitating communications with the healthcare team.

Introduction

Lung diseases affect millions of people of all ages and levels of socioeconomic status. According to the Global Burden of Diseases (GBD) Study 2019, there were estimated 262 million cases and 461 000 deaths because of asthma in 2019.[1] Hence, globally, over 1000 people die from asthma every day. Most of these deaths are premature and preventable with proper and timely management.[2]

The novel coronavirus disease-2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).[3] The WHO declared the COVID-19 outbreak a pandemic on 11 March 2020, demanding effective national and global mitigation measures and strong public health response.[4] Since 31 December 2019 and as of 30th December 2020, 80 316 555 cases of COVID-19 (in accordance with the applied case definitions and testing strategies in the affected countries) have been reported, including 1 770 695 deaths.[5]

The major question we were asked is whether having asthma increases the risk of poor outcomes of COVID-19. The straight answer is no, but the most severe cases requiring frequent doses of oral corticosteroids may be at higher risk as we will discuss in this article. The review encompasses a hot and evolving topic, in which the evidence form longitudinal studies is scarce but comes up in novel reports daily. We ask the readers to understand the limitations of this article, which include publications available up to 31 December 2020 only.

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