What you need to know about the risks COVID-19 poses for those with asthma and how to protect yourself

What you need to know about the risks COVID-19 poses for those with asthma and how to protect yourself
People with asthma should be sure to have up-to-date inhaler prescriptions during this time.Antonio Sanchez Albacete / EyeEm/Getty Images
  • There's not enough data to know for sure if the majority of asthmatics who get COVID-19 have worse health outcomes, but we do know that COVID-19 is likely to worsen the lung inflammation that causes asthma.
  • If someone has both COVID-19 and severe asthma, experts suspect that a ventilator may not be able to meet the needs of the lungs.
  • People with asthma should be diligent about using their controller medications, like daily corticosteroid inhalers, during the pandemic.

Asthma is a common respiratory condition that almost 25 million Americans struggle with. It causes narrowing and swelling of the airways, shortness of breath, coughing, and wheezing.

Various external factors, or triggers, can cause asthma flare-ups, exacerbations, or asthma attacks, where symptoms worsen. For example, some common asthma triggers are tobacco smoke, dust mites, mold, and pets.

Additionally, viral infections are a trigger that can exacerbate one's asthma, says Megan Conroy, MD, a pulmonologist and assistant professor of pulmonary and critical care medicine at The Ohio State University Wexner Medical Center.

This is where COVID-19 comes into play. Since it's a viral infection, it has the potential to worsen asthma, which can be very serious.

Does asthma affect your health outcome if you get coronavirus?

Doctors do not know for sure yet if a blanket statement can be made about how COVID-19 affects those with asthma. "We don't yet have large population data on outcomes of asthmatics who get infected with the novel coronavirus to know for sure if outcomes are worse, but the concern is that an asthma exacerbation on top of COVID-19 disease has a higher potential to lead to critical illness," says Conroy.


Charles L. Fishman, MD, a pulmonologist with New York-Presbyterian Medical Group - Westchester says that asthma does not make you more susceptible to contracting the virus in the first place, but he seconds Conroy's point that the main risk is that getting coronavirus could lead to worsened symptoms of asthma, such as wheezing, coughing, and difficulty breathing.

This is because both COVID-19 and asthma affect the lungs. Conroy says that having asthma at the same time as COVID-19 is likely to worsen inflammation in the lungs that causes asthma in the first place, resulting in worsening of asthma. However, she says that many specific details on the immune mechanisms involved with coronavirus, with or without asthma, are still unknown.

One of the most dangerous scenarios is if someone with both asthma and coronavirus requires a ventilator. It can become very difficult to meet the needs of the lungs, Conroy says. It's possible that even the ventilator wouldn't be enough to support the lungs in a case of a severe asthma exacerbation.

One of the most recent research papers on the link between COVID-19 severity and asthma was published in The Journal of Allergy and Clinical Immunology in August 2020. The study analyzed 492,768 participants, 65,677 of whom had asthma. The researchers determined that people with non-allergic asthma were 48% more likely to have a severe case of COVID-19. That being said, those with allergic asthma did not seem to be at a higher risk of having a severe case of COVID-19.

Conroy says that both asthma attacks and COVID-19 each on their own have the potential to be fatal. Therefore, having both at the same time may lead to more health complications. Theoretically, having both asthma and COVID-19 simultaneously can potentially lead to very severe illness, including pneumonia, acute respiratory disease, or asthma attacks, according to the CDC.


Precautions people with asthma should take during a coronavirus outbreak

Due to all of the uncertainty surrounding asthma and this relatively new virus, it's crucial to protect yourself. First and foremost, it's important to have your asthma under control.

Conroy recommends that asthma patients continue taking their controller medications such as daily corticosteroid inhalers or combination inhalers (like a corticosteroid with long-acting beta agonists, also known as LABAs) as prescribed to decrease lung inflammation and lower the risk of worsening asthma and asthma attacks in general.

Make sure you are using your inhaler correctly and do not skip doses. Additionally, you should make sure that your inhalers are not expired and that you have up-to-date prescriptions of your control and rescue inhalers. The CDC also recommends that asthmatics should have at least a 30 day supply of medication on hand.

On top of these asthma-specific precautions, asthmatics should be taking the same precautions that everyone should be taking to prevent contracting and spreading the novel coronavirus.

Fishman says you should take the following precautions, as per CDC guidelines:

  • Wear a face mask that covers both the mouth and nose when in public.
  • Avoiding people who aren't wearing masks.
  • Wash hands thoroughly and frequently.
  • Maintain social distancing — stay six feet apart from others.

Other respiratory infections that may exacerbate asthma

Conroy says that people with poorly controlled or more severe asthma are more likely to experience exacerbations when they get any respiratory virus. Some examples of these are:

  • The common cold
  • Pneumonia
  • The flu
  • Bronchitis

The bottom line

When it comes to both COVID-19 and asthma in general, it is always better to be safe than sorry. Asthmatics should try to minimize exposure to their triggers, whatever they may be, and take precautions to avoid catching a respiratory infection. Keep your asthma under control and follow the CDC guidelines to lower your risk of contracting coronavirus.

If you have any potential COVID-19 symptoms such as fever, cough, loss of taste and smell, or headache, be sure to contact a doctor to discuss testing options. Additionally, if you feel like you are having worsening asthma symptoms, don't hesitate to get in touch with your pulmonologist.

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