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Abstract

Asthma is a lifelong pulmonary inflammatory disease of the airways [1]. Symptoms include episodes of wheezing, coughing, chest tightness, and shortness of breath [2]. Asthma is now considered an umbrella diagnosis for several diseases with distinct mechanistic pathways (endotypes) with variable clinical phenotypes (childhood atopic, non-atopic, middle-aged obese, and ARTICLE INFO AbstractBackground: Asthma is an inflammatory pulmonary disease. Cellular immune responses are the most frequent immunological response in asthma. Concerns about risk factors for infection have increased with the COVID-19 pandemic. Primary studies indicated that children with accompanying comorbidities such as asthma might be at greater risk of COVID-19 comparable to adults with similar comorbidities.Methods: This review study aimed to investigate the association between asthma COVID-19 infection. Google scholar database on October 1st, 2020 was used to identify eligible articles. The Keywords used to find papers: (Asthma*) and (COVID-19*), (Asthma*), and (COVID-19*) and (risk factor*). The publication time was limited to 2020 onward. A total of 6780 papers were identified by the initial search. Two reviewers independently reviewed the abstracts and full-texts. Reports on the topic of asthma as a risk factor for COVID-19 infection were included in this review.Results: 29 studies were included in this review. Given that overexpression of ACE2 in rhinovirus infections, and activation of ACE2 regulates many antiviral responses to cytokines. This may lead to cytokines exacerbation which is the COVID-19 pathological response. These results suggest that viral infections that cause worsening of asthma show synergistic biomolecular interactions due to COVID infection. Besides, people with asthma have a delay or deficiency in the antiviral immune response, with deficiency and delay in lung cell interferon (IFN)-α,5 IFN-β6, and IFN-λ7 responses reported in many studies, and deficiency of the latter IFN clearly related to increased asthma exacerbation. Conclusion:Clinical studies in different countries showed that asthmatic patients with COVID-19 infection are a small fraction of all infected patients. Although patients with asthma are vulnerable to respiratory infections such as rhinoviruses, there is no conclusive evidence to support an association between asthma and COVID-19 infection. Various studies suggested that asthmatic patients continue medications particularly inhaled corticosteroids and avoid allergens.