There have been many studies that have examined whether people living with asthma are at higher risk of being infected with COVID-19 and whether the disease strikes harder for these individuals. The results from these studies are unfortunately still somewhat contradictory, but with the help of summarising publications from the WHO and the Global Initiative for Asthma (GINA), you might see relatively clear picture of the actual situation to date.
Based on recent research, both WHO and GINA state that people with asthma do not appear to be at increased risk of acquiring COVID-19.1,2 There also seems to be no link between asthma and the risk of developing severe COVID-19 in people with well-controlled, mild-to-moderate asthma.2 However, there are some evidence that patients with moderate to severe asthma, may be at increased risk of severe illness and death from COVID-19. This is especially true if they have recently been treated with systemic cortisone or if they are hospitalized due to severe asthma.2
During the pandemic there have been a reduction in exacerbations
Another interesting fact that is mentioned in the GINA update is that in 2020, many countries saw an over-all reduction in asthma exacerbations and influenza-related illness. This is believed to be due to increased handwashing, using of masks, and social and physical distancing that reduce the incidence of other respiratory infections.2
Is ICS protective in COVID-19?
In the past year, studies have been published that suggest that treatment with standard ICS may have some positive effects in COVID-19 infection. Interesting data that, however, still need to be confirmed in larger studies.3,4
Some practical clinical advice
According to GINA the clinical implications for asthma management in times of the COVID-19 pandemic is to continue good asthma management, with strategies to maintain good symptom control, reduce the risk of severe exacerbations and minimise the need for OCS. Patients should be advised to continue taking their prescribed asthma medications, particularly inhaled corticosteroids (ICS).2
WHO: Asthma and COVID-19. Scientific brief 19 April 2021. www.who.int/publications/i/item/who-2019- ncov-sci-brief-asthma-2021.1
Bloom CI, Drake TM, Docherty AB et al. Lancet Respir Med 2021; 9: 699–711.
Ramakrishnan S, Nicolau Jr DV, Langford B et al. Lancet Respir Med 2021; 9: 763–772