Childhood severe acute respiratory syndrome, coronavirus infections and asthma

Bever, Hugo P. Van; Chng, Seo Yi; Goh, Daniel Y T

doi:10.1111/j.1399-3038.2004.00137.x

Cited by 58 publications

(68 citation statements)

References 23 publications

(23 reference statements)

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“…In previous SARS outbreaks, patients with asthma, in particular children, appeared to be less susceptible to the coronavirus, with a reported low rate of asthma exacerbations and a good prognosis on follow-up [10, 46]. In contrast, during influenza epidemics, asthma was associated with more severe disease, including the need for mechanical ventilation, not only in adults but also in children [47].…”

Section: Discussionmentioning

confidence: 99%

Asthma and the Coronavirus Disease 2019 Pandemic: A Literature Review

Morais‐Almeida

Pité

Aguiar

et al. 2020

Int Arch Allergy Immunol

106

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Even though respiratory viruses are one of the most common triggers for asthma exacerbations, not all of these viruses affect patients equally. There is no strong evidence supporting that patients with asthma have a higher risk of becoming seriously ill from coronavirus disease 2019 (CO-VID-19), although recent reports from the USA and the UK suggest that asthma is much more common in children and adults with mild to severe COVID-19 than has previously been reported in Asia and in Europe. As in previous severe acute respiratory syndrome (SARS) outbreaks, patients with asthma, especially children, appear to be less susceptible to the coronavirus with a low rate of asthma exacerbations. A different expression of viral receptors and T2 inflammation can be responsible for different outcomes. Future studies focused on asthma and on other allergic disorders are needed to provide a greater understanding of the impact of underlying asthma and allergic inflammation on COVID-19 susceptibility and disease severity. However, for the moment, it is crucial that asthmatic patients maintain their controller medication, from inhaled corticosteroids to biologics, without making any dose adjustments on their own or stopping the medication. New data are emerging daily, rapidly updating our understanding of this novel coronavirus.

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Section: Discussionmentioning

confidence: 99%

Asthma and the Coronavirus Disease 2019 Pandemic: A Literature Review

Morais‐Almeida

Pité

Aguiar

et al. 2020

Int Arch Allergy Immunol

106

View full text Add to dashboard Cite

show abstract

“…Unfortunately, current methods for detecting viral-infection history are not optimal, and in many cases, it is impossible to identify the previous infecting pathogens. SARS in children appears to manifest as a milder form of the disease compared with adults (44,45). Could such a difference be due to immunopathology occurring as a consequence of the reactivation of memory cells, which may be more diverse and prominent in more immunologically mature individuals?…”

Section: Discussionmentioning

confidence: 99%

Response of Memory CD8+ T Cells to Severe Acute Respiratory Syndrome (SARS) Coronavirus in Recovered SARS Patients and Healthy Individuals

Chen

Hou

Jiang

et al. 2005

The Journal of Immunology

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To date, the pathogenesis of severe acute respiratory syndrome (SARS) in humans is still not well understood. SARS coronavirus (SARS-CoV)-specific CTL responses, in particular their magnitude and duration of postinfection immunity, have not been extensively studied. In this study, we found that heat-inactivated SARS-CoV elicited recall CTL responses to newly identified spike protein-derived epitopes (SSp-1, S978, and S1202) in peripheral blood of all HLA-A*0201+ recovered SARS patients over 1 year postinfection. Intriguingly, heat-inactivated SARS-CoV elicited recall-like CTL responses to SSp-1 but not to S978, S1202, or dominant epitopes from several other human viruses in 5 of 36 (13.8%) HLA-A*0201+ healthy donors without any contact history with SARS-CoV. SSp-1-specific CTLs expanded from memory T cells of both recovered SARS patients, and the five exceptional healthy donors shared a differentiated effector CTL phenotype, CD45RA+CCR7−CD62L−, and expressed CCR5 and CD44. However, compared with the high avidity of SSp-1-specific CTLs derived from memory T cells of recovered SARS patients, SSp-1-specific CTLs from the five exceptional healthy donors were of low avidity, as determined by their rapid tetramer dissociation kinetics and reduced cytotoxic reactivity, IFN-γ secretion, and intracellular production of IFN-γ, TNF-α, perforin, and granzyme A. These results indicate that SARS-CoV infection induces strong and long-lasting CTL-mediated immunity in surviving SARS patients, and that cross-reactive memory T cells to SARS-CoV may exist in the T cell repertoire of a small subset of healthy individuals and can be reactivated by SARS-CoV infection.

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“…3 4 In the SARS coronavirus outbreak of 2003-2004, SARS did not appear to induce bronchial hyper-reactivity or eosinophilic inflammation to an extent to induce asthma attacks, though other non-SARS coronaviruses have been linked to asthma exacerbations. 5 To date, COVID-19 research has overwhelmingly focused on the acute and direct impact of the new virus. Of course, infection poses a risk to everyone, including PWAs, but focus on this particular risk has diverted attention from another pressing issue with the potential to affect PWAs long after the acute phase of the pandemic has ended, namely, disruptions to care.…”

Section: Summary Boxmentioning

confidence: 99%

Asthma and COVID-19: review of evidence on risks and management considerations

Hartmann‐Boyce

Gunnell

Drake

et al. 2020

BMJ EBM

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BackgroundRespiratory illnesses typically present increased risks to people with asthma (PWA). However, data on the risks of COVID-19 to PWA have presented contradictory findings, with implications for asthma management.ObjectiveTo assess the risks and management considerations of COVID-19 in people with asthma (PWA).MethodWe conducted a rapid literature review. We searched PubMed, medRxiv, LitCovid, TRIP, Google and Google Scholar for terms relating to asthma and COVID-19, and for systematic reviews related to specific management questions within our review, in April 2020. References were screened and data were extracted by one reviewer.ResultsWe extracted data from 139 references. The evidence available is limited, with some sources suggesting an under-representation of PWA in hospitalised cases and others showing an increased risk of worse outcomes in PWA, which may be associated with disease severity. Consensus broadly holds that asthma medications should be continued as usual. Almost all aspects of asthma care will be disrupted during the pandemic due not only to limits in face-to-face care but also to the fact that many of the diagnostic tools used in asthma are considered aerosol-generating procedures. Self-management and remote interventions may be of benefit for asthma care during this time but have not been tested in this context.ConclusionsEvidence on COVID-19 and asthma is limited and continuing to emerge. More research is needed on the possible associations between asthma and COVID-19 infection and severity, as well as on interventions to support asthma care in light of constraints and disruptions to healthcare systems. We found no evidence regarding health inequalities, and this urgently needs to be addressed in the literature as the burdens of asthma and of COVID-19 are not equally distributed across the population.

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Childhood severe acute respiratory syndrome, coronavirus infections and asthma

Cited by 58 publications

References 23 publications

Asthma and the Coronavirus Disease 2019 Pandemic: A Literature Review

Asthma and the Coronavirus Disease 2019 Pandemic: A Literature Review

Response of Memory CD8+ T Cells to Severe Acute Respiratory Syndrome (SARS) Coronavirus in Recovered SARS Patients and Healthy Individuals

Asthma and COVID-19: review of evidence on risks and management considerations

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