Updated on June 19, 2020.
Many people with asthma already know what it feels like to gasp for air or struggle to breathe. Now, amid the pandemic, worries about asthma flare-ups may be compounded by fears of COVID-19 infection. Those with asthma and other chronic lung conditions are among the groups at higher risk for complications from the disease caused by the coronavirus called SARS-CoV-2.
How asthma affects COVID-19 risk
First the good news. Based on what we know so far, people with asthma don’t appear to be at higher risk for getting infected with SARS-CoV-2 than people without asthma.
But if you do develop COVID-19, having asthma is associated with a greater risk for complications. This is particularly true if your asthma is moderate to severe. COVID-19 can trigger asthma attacks, according to the Centers for Disease Control and Prevention, in addition to causing pneumonia and respiratory failure in some patients.
A pre-proof of a study conducted by researchers at Harvard T.H. Chan School of Public Health and Massachusetts General Hospital published online in June 2020 in The Journal of Allergy and Clinical Immunology found that adults with non-allergic asthma (asthma triggered by weather, stress, exercise and viral infections—not allergens) who were infected with SARS-CoV-2 were more likely to develop more serious infections than adults who didn’t have this type of asthma.
For the study, the team examined data from the UK Biobank on 492,768 people, including 65,677 with asthma. Of the 641 participants who developed severe COVID-19, 67 had non-allergic asthma and 49 had allergic asthma. After taking the participants’ age, BMI and other risk factors into account, they found that having non-allergic asthma increased the risk for severe COVID-19 by up to 48 percent. The risk jumped as high as 82 percent for those with both asthma and chronic obstructive pulmonary disease (COPD).
The researchers pointed out, however, that allergy-induced asthma (asthma triggered by common allergens, such as pollen, dust mites, mold and pet dander) was not linked to more severe COVID-19 infections.
Age is another factor to consider. Older people are more likely to develop severe cases of COVID-19 than kids and young adults. Of the 19 million adults in the United States with asthma, 4 million are age 65 or older and more than 9 million are between the ages of 35 and 64. Both of these age groups are more likely than younger people to develop serious COVID-19 infections and related complications.
Don’t stop taking asthma medication
Because steroids are known to suppress the immune system, many people have wondered if the steroids they take to control their asthma could make them more susceptible to COVID-19. Fortunately, there is no evidence that’s the case.
There also is no evidence that the use of asthma medications—including oral or inhaled steroids, montelukast or biologics—increases the risk for infection.
If you have asthma, it’s important to continue your treatment as directed and not stop taking any of your medications unless instructed to do so by your doctor. This will not only help control your asthma and prevent flare-ups, but also help you avoid trips to the emergency room where you may be exposed to SARS-CoV-2.
Don’t get lax about prevention
If you’re not already being conscientious about your asthma care, now is a good time to start. Again, by doing your best to keep your symptoms under meticulous control—steering clear of your triggers, taking your medications as prescribed and following an asthma action plan—you stand a better chance of avoiding crowded clinics or emergency rooms.
Keeping your asthma under control is the most important thing you can do to reduce your risk of complications, and that likely includes severe complications from COVID-19. Aside from adhering to your treatment plan, take the following steps:
- Stock up on your medications. If your insurance allows, it’s wise to obtain a backup supply of your asthma medicines. In some parts of the country, it has become more difficult to obtain albuterol inhalers since they are in high demand among hospitals treating COVID-19 patients. If you need an inhaler and can’t get one, you have options. Those include using expired inhalers (which are often at least somewhat effective) and getting a different prescription from your healthcare provider (HCP).
- Stay in touch with your doctor. Be sure to discuss any new or worsening symptoms with your doctor. When you call your HCP’s office, ask if telemedicine is an option for your follow-up appointments.
While it’s hard to guarantee safety from SARS-CoV-2, there are steps you can take to reduce your risk for COVID-19, including:
- Follow basic public-health precautions to avoid infection. This includes social distancing, wearing a facemask when going out in public, washing your hands correctly and often, and not sharing personal items, such as drinking glasses, utensils and towels with others.
- Try to avoid repeat trips to the pharmacy and grocery store. If possible, take advantage of mail service or local delivery service to receive your medications and essential items.
- Don’t forget about the flu. Looking ahead to the fall, it’s possible to be infected with the flu and COVID-19 at the same time. Once the 2020/2021 flu shot is available, be sure to get vaccinated.
- Keep your belongings and home disinfected. This includes routinely cleaning commonly used surfaces like phones, keyboards, toilets and doorknobs each day. Ideally, someone without asthma should do the cleaning. People with asthma should avoid being around disinfectants, which could trigger an attack. If that’s not possible, using a fan to blow air outdoors can improve indoor ventilation. Applying cleaning products to a cloth rather than spraying it onto a surface can also help reduce the risk of a flare-up for those with asthma.
- Be mindful of your family members or roommates. Use your nebulizer if you need it but, if possible, try to do it alone—perhaps on a porch or in a garage—to reduce the risk of spreading SARS-CoV-2. The coronavirus may be carried through droplets in the air and linger, potentially infecting others.
Keeping track of your symptoms
There is some overlap between respiratory symptoms caused by the coronavirus and by other problems like cold, flu and seasonal allergies. For example, a sore throat and body aches could be caused by COVID-19, but also by a cold or the flu.
If you’re in doubt, call your HCP for instructions. Do not go to your doctor’s office without calling ahead first and letting the office staff know that you suspect you’ve been exposed to COVID-19.
Your doctor should determine if you can be treated at home, if you should be tested for the coronavirus and where that should be done.
A couple clues that suggest COVID-19, however, are new loss of sense of smell or shortness of breath. Still, these symptoms alone are not a slam-dunk. Respiratory viruses other than SARV-CoV-2 can trigger loss of your sense of smell. And although colds and flu don’t cause shortness of breath on their own, they can trigger asthma attacks, leading to asthma-related shortness of breath.
If you’re having trouble breathing or develop any other serious symptoms, you need to seek immediate medical attention. These additional reg flags may include:
- Persistent pain or pressure in the chest
- Feeling confused
- Bluish lips or face
Call 911 and let the operator know that you have asthma and may have COVID-19. If you have a medical mask and it doesn’t make it more difficult for you to breathe, put it on before help arrives.
