Are Patients with Asthma and Chronic Obstructive Pulmonary Disease Preferred Targets of COVID-19?

Abstract

The coronavirus pandemic, known as coronavirus disease 2019 (COVID-19), is an infectious respiratory disease caused by SARS-CoV-2, a novel coronavirus first identified in patients from Wuhan, China. Since December 2019, SARS-CoV-2 spread swiftly around world and infected more than 25 million people and caused more than 800,000 deaths in 188 countries. Chronic respiratory diseases such as asthma and COPD appear to be a risk factor for COVID-19; however, their prevalence remains controversial. In fact, studies in China reported lower rates of chronic respiratory conditions in patients with COVID-19 than in the general population, while the trend is reversed in the United States and Europe. Although the underlying molecular mechanisms of a possible interaction between COVID-19 and chronic respiratory diseases remain unknown, some observations can help to resolve them. Indeed, physiological changes, immune response, or medication used against SARS-CoV-2 may have greater impact on patients with chronic respiratory conditions, already debilitated by chronic inflammation, dyspnea, and the use of immunosuppressant drugs like corticosteroids. In this review, we discuss the importance and the impact of COVID-19 on asthmatics and COPD patients, the possible available treatments, and patient management during the pandemic.

Gut Microbiota Disruption in COVID-19 or Post-COVID Illness Association with severity biomarkers: A Possible Role of Pre / Pro-biotics in manipulating microflora

“…It has been claimed that there are several predictors of death among hospitalized patients, including studies published in South Africa, China, Iran, Brazil, and India. There have also been multicountry studies conducted and exploring that growing age, male gender [ 2 ], and numerous chronic illnesses (such as asthma, COPD, diabetes, TB, obesity, CKD, hypertension, or CVD) are related to an increased risk of mortality [ [3] , [4] , [5] , [6] , [7] , [8] ]. These findings are in line with those from high-income nations and replicated in other countries [ 9 ].…”

Asthma, chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap syndrome and the risk of severe COVID-19

“…Considering current data, it seems that patients with asthma and patients with COPD may experience a different course of COVID-19. Even though the ACE2 and TMPRSS2 expression differs between COPD and asthmatic patients, changes in biological parameters and inflammation developed during SARS-CoV-2 infection can worsen symptoms which are already observed in both groups (Table 1) [56,59].…”

“…Such observations may indicate that viral entry to the host cells can be facilitated thanks to higher expression of ACE2, which probably leads to more severe COVID-19 symptoms among COPD patients. The opposite tendency in the expression of ACE2 among some asthmatic patients may have some protective contribution during COVID-19 because the viral entry is not as easy as in case of the normal expression level of ACE2 [53,56].…”

COVID-19 and corticosteroids: a narrative review

“…Nevertheless, self-initiation of short-term use of OCS should be avoided when common signs of COVID-19 appeared, and procedure previously described in the management of exacerbations has been successfully applied in serious or crucial cases of COVID-19-associated asthma and COPD receiving intensive treatment (Singh and Halpin 2020 ). Concerning hospitalized patients who did not develop exacerbation so far, but administered long-term treatment of ICS/OCS lasting 3 months consecutive to probable adrenal insufficiency, endocrinologists/diabetologists recommended taking into account a normal systemic corticosteroids dosage that recommended the use of corticosteroids considering the sternness of COVID-19 in sick persons developing both asthma and COPD (Bouazza et al 2021 ). Systemic corticosteroids might be beneficial in severe or critical illness, particularly developing septic shock or ARDS, whenever cytokine level increase was confirmed.…”

“…This was confident with the previous findings, even so, it further needs to be proven. Hence, airway corticosteroids therapy was frequently used, but rarely through nebulizer despite the fact that joint guidance gave advice that nebulized treatment could be used safely (Bouazza et al 2021 ). Moreover, the nebulized treatment may be implicated in enhancing contamination in the hospital, hence, metered-dose inhalers with space devices were recommended instead of nebulizers to convey drugs everywhere.…”