- Experts say people with asthma don’t face a higher risk of contracting COVID-19, but they do face a higher risk of serious illness if they contract with the virus.
- Experts recommend people with asthma consult with their doctor about their medications.
- People with asthma are also advised to reduce stress and take extra precautions around their home.
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COVID-19 can pose a threat to everyone.
But people with preexisting respiratory illnesses such as asthma are at particularly high risk of having serious consequences that could arise from a coronavirus infection.
Observing pandemic prevention advice such as social distancing and frequent handwashing can help people with asthma avoid contracting COVID-19, just like everyone else.
And there are additional steps you can take to protect your health if you have asthma.
There’s no clear evidence that people with asthma are at higher risk of contracting COVID-19, according to the American College of Allergy, Asthma and Immunology (ACAAI).
“We know that the number one cause of asthma attacks are viral illnesses, so it makes sense that COVID-19, which is a viral illness that causes respiratory disease, could be worse for people who have asthma,” Dr. Sylvia Owusu-Ansah, a pediatric emergency medicine and emergency medical physician at UPMC Children’s Hospital of Pittsburgh, told Healthline.
“Patients with underlying conditions that specifically involve their lungs, like asthma, COPD, and chronic bronchitis, seem to be more at risk to develop pneumonias and the dreaded acute respiratory syndrome associated with COVID-19,” said Dr. Mauricio Heilbron, a trauma surgeon and vice chief of staff at St. Mary’s Medical Center in Long Beach, California.
“Logic would dictate that anyone with lung disease at baseline potentially has much less reserve to deal with a process that limits the ability to get oxygen from air into the bloodstream, which is exactly what our lungs do,” said Dr. Louis B. Malinow, a Baltimore-based internal medicine physician with national primary care network MDVIP.
“For instance, a person with 100 percent lung function may drop to 70 percent with COVID-19, which is still enough lung function to not threaten that person,” Malinow said. “An asthmatic under poor control, who starts with 70 percent lung function for instance, and is then impacted and trying to function with 40 percent lung function, is going to be struggling a lot more.”
The ACAAI emphasizes that there is no evidence that asthma medications used to prevent symptoms, such as inhaled steroids, oral steroids, montelukast, and biologics, increase your risk of contracting COVID-19.
However, a recent editorial published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism warns that individuals taking a class of steroid hormones called glucocorticoids for conditions such as asthma, allergies, and arthritis may be unable to mount a normal stress response and are at high risk if they contract the coronavirus.
“People with asthma who have an inhibited immune defense, or who have been admitted to a hospital because of asthma within the last 12 months, could be at particular risk of becoming very ill from a coronavirus infection,” Dr. Jonas Nilsen, co-founder of Practio, a travel vaccination and infectious disease advice specialist service, told Healthline.
But people with asthma are far from helpless in lowering their risk of infection or developing serious COVID-19 complications.
First and foremost is to continue to take their maintenance, or preventive, asthma inhaler daily as prescribed.
“This will help decrease their risk of an asthma attack triggered by any respiratory virus, including coronavirus,” Nilsen said.
Be sure to have an ample supply of asthma medication on hand, including both maintenance and rescue inhalers.
Albuterol inhalers have been in short supply in some parts of the country, according to the ACAAI, in part because they also are used by hospitals to treat COVID-19 patients.
“Talk to your doctor, insurance company, and pharmacist about creating an emergency supply of prescription medications such as inhalers in case you are quarantined or need to stay home for an extended period of time,” said Dr. Florencia Segura, a pediatrician at Einstein Pediatrics of Vienna, Virginia.
People with asthma should also use telehealth to maintain routine contact and appointments with their allergist, the ACAAI advised.
Stress also can inhibit your immune system and people with asthma may be particularly stressed knowing that their risk of COVID-19 complications is elevated.
“It is well known that anxiety can bring on asthma attacks, or make them worse once you’ve already started,” Heilbron told Healthline. “Patients often also know their asthma triggers. Being aware of those can help them manage or even avoid attacks.”
Beyond using the coping mechanisms many people with asthma have already developed to reduce stress, such as exercise, healthy eating, and meditation, Heilbron advised eliminating COVID-19 related stressors whenever possible, “which means stepping away from their phones and their televisions and their computer screens for extended periods of time.”
In a time of imposed physical isolation, it’s also important to reach out to your support network of family, friends, and community groups whether by phone or online, said Dr. Judd Dawson, a family physician at Centura Health in Longmont, Colorado.
Sheltering in place and self-quarantining at home can pose particular challenges for people with asthma, said Judith E. Quaranta, RN, PhD, CPN, AE-C, an assistant professor of nursing and asthma educator at Binghamton University Nursing in New York.
“Staying indoors may increase exposure to certain asthma triggers,” Quaranta told Healthline. “If possible, a room in your home should be maintained as trigger-free as possible. Depending on your triggers, keep all pets out of your room. Try to maintain a dust-free environment. If possible, have someone other than the person with asthma clean with a HEPA-filtered vacuum and dust frequently. Maintain low humidity to reduce mold and dust mites.”
As pollen counts rise in spring, windows also should be kept closed to reduce exposure, said Quaranta, who also advised avoiding any type of smoke.
“Also, be careful with household cleaners trying to keep your home sterile, as the fumes may irritate your lungs,” Dawson said.
People with asthma who’ve been diagnosed with COVID-19 or suspect they have the illness and are using an inhaler at home need to do so in a location that minimizes exposure to other family members, since the coronavirus spreads via exhaled droplets of water.
“Choose a location for your treatment where air is not recirculated into the home — places like a porch or patio, or in a garage — areas where surfaces can be cleaned more easily or may not need cleaning,” the ACAAI advised.
Lastly, be vigilant about any respiratory symptoms you experience — don’t brush them off as “just” allergies or asthma.
“Anyone with asthma or another chronic condition should take early note of any symptoms such as shortness of breath, a new or worsening cough, a fever, or severe body aches and reach out to a care provider at the early onset of symptoms,” Dr. Lisa Ide, chief medical officer at the national telehealth company Zipnosis, told Healthline.