The COVID-19 pandemic is scary for all people, but for those with asthma there is great fear that they will have a worse outcome or be more likely to get the virus that causes COVID-19. It is important to know that currently there is no evidence of increased infection rates in those with asthma. And although the Centers for Disease Control and Prevention states that patients with moderate-severe asthma could be at greater risk for more severe disease, there are no published data to support this at this time. There has been one report suggesting that asthma may increase the risk of hospitalization from COVID-19 in 18-49 year old adults; however, this is based on a small number of patients. And in the opposite direction are data from New York where asthma was under-represented (so possibly protective) in those who died from COVID-19. It is important to remember we are dealing with an evolving pandemic and new information could change the situation in the future.
Early reports suggested that steroids were not recommended in patients with COVID-19 disease, although there have been some indications that steroids are useful in severe COVID-19 disease. Given the varying opinions on the use of steroids and COVID-19, many are wondering what to do if their controller medication is a steroid (inhaled or oral). The short answer is continue taking your controller medications and do not stop them. The data suggesting that steroids might increase the shedding of SARS-CoV-2 comes from treating hospitalized patients with systemic steroids just for the viral illness. The use of inhaled or oral steroids for treating other diseases (like asthma) was not studied. However, people with asthma are placed on controller medications to keep their asthma under control. In the current pandemic, the best thing a person with asthma can do (with respect to asthma) is to get and keep their asthma under control. Stopping a controller medication will put the person at risk for developing an asthma exacerbation. In the current pandemic, treatment of an exacerbation will likely require going to the emergency department or urgent care, where the individual has a much higher risk of being exposed to someone with COVID-19. So, in a way, by continuing to keep asthma under control, the person with asthma is actually reducing their chance of exposure to COVID-19.
The bottom line for people with asthma during this pandemic is to keep doing what you have been doing all along—continue taking your controller medication and inform your healthcare provider of any symptoms that you may develop. And of course, remember to practice social distancing and wash your hands.
- Take your daily asthma controller medications as prescribed in your Asthma Action Plan
- Don’t stop any medications or change your asthma treatment plan without talking to your healthcare provider.
- Check to see if your prescriptions are up to date and not expired.
- Keep an emergency supply of prescription and OTC medications, including asthma
inhalers (but do not hoard medications).
- Know how to correctly use your inhaler and discuss with your allergist if you are unsure.
- Only use a nebulizer in a place where any droplets in the air cannot be inhaled by others.
- Avoid your asthma triggers.
- Monitor breathing with a peak flow meter and take note of any changes.
- Help yourself cope with stress and anxiety – consider stress-relieving activities
(exercise, yoga, etc.)