Managing asthma in the COVID-19 pandemic and current recommendations from professional bodies: a review

Ong, K. C. G.; Tan, Tze Lee; Chan, Adrian; Tan, Kaixuan; Koh, Mariko Siyue

doi:10.1080/02770903.2020.1804578

Cited by 17 publications

(30 citation statements)

References 17 publications

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“…From the first pandemic wave, we have learned some important lessons: it is fundamental to maintain asthma under control in order to limit the possibility of serious exacerbations occurrence, with all available treatment and those that are currently in place. Experts consensus and recommendations suggest maintaining the minimum steroid dosage effective to control symptoms and to avoid exacerbations, whereas biologic agent administration should be regularly scheduled, possibly at home, encouraging patient support programmes (28). It would be desirable an update of guidelines and recommendations for the second wave of the pandemic, in order to give to clinicians most recent information and indications for the management of severe asthmatic patients.…”

Section: Discussionmentioning

confidence: 99%

Severe asthma and COVID-19: lessons from the first wave

et al. 2020

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Section: Discussionmentioning

confidence: 99%

Severe asthma and COVID-19: lessons from the first wave

et al. 2020

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“…The presence of asthma in a well-controlled patient does not seem to increase the risk of infection from SARS-CoV-2 or developing complications due to COVID-19 [8]. Furthermore, the possibility that an infection with the coronavirus may cause an asthma exacerbation is currently not supported by any solid evidence [9]. Therefore, patients should continue their controller medications, ensure optimal control of asthma, and follow the other advice for the general public during this period (e.g.…”

Section: The Problemmentioning

confidence: 99%

“…Therefore, patients should continue their controller medications, ensure optimal control of asthma, and follow the other advice for the general public during this period (e.g. ensuring good personal hygiene, staying at home as much as possible, wearing masks in public areas, practising social distancing) [9]. Daily experience suggests that these advices are not a real problem for older people, who usually suffer more from COPD than asthma, but are not well accepted by young people who are the ones most likely to suffer from asthma, and this can be a problem when dealing with them.…”

Section: The Problemmentioning

confidence: 99%

“…The burden and severity of COVID-19 has prompted several international professional bodies to provide recommendations on the management of chronic respiratory diseases in the current context of the COVID-19 pandemic regardless of whether the patient to be managed is infected with SARS-CoV-2 or not [9]. Unfortunately, due to lack of solid evidence in producing such recommendations or even guidelines, it was not possible to follow the consolidated rigid approach that is now applied for guidance development and it was necessary to rely on the conflicting currently available evidence and on the opinion of experts.…”

Section: The Problemmentioning

confidence: 99%

“…It is important that appropriate care is taken to clean all the surfaces in the room or area where nebulization is performed [9]. Furthermore it is fundamental that patients do not share their inhalers and devices with anyone.…”

Section: Other Practical Strategies For Drug Delivery Via Nebulizersmentioning

confidence: 99%

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Guidance on nebulization during the current COVID-19 pandemic

Cazzola

Ora

Bianco

et al. 2021

Respiratory Medicine

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Awareness of the risk of airborne transmission of SARS-CoV-2 makes patients hesitant about using inhaled medications that are considered as a potential source of viral transmission and immunosuppression. However, patients with asthma or COPD should continue all prescribed inhaled medications. Apparently, inhalers, including pMDIs, DPIs, or SMIs, have a low risk of contamination although characteristics of drug formulation can precipitate cough, whereas some researchers do not rule out the probability that nebulizer treatments may increase the risk of infection transmission via droplet nuclei and aerosols. Considering that aerosol therapy generates fugitive emissions that are not inhaled by the patient and are released from the device during expiration, several international professional bodies have provided recommendations for drug delivery via inhalers and in particular, nebulizers. Unfortunately, these recommendations are often in conflict with each other and do not clarify whether it is appropriate to use nebulizers during this COVID-19 pandemic. Considering what is available in literature, there are no known infection-related hazards to an uninfected patient and also a patient with COVID-19 that preclude the use of a nebulizer at home, but it fundamental that all patients, regardless of whether or not suffering from COVID-19, always follow some practical advices.

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Asthma and COVID‐19: An early inpatient and outpatient experience at a US children's hospital

Farzan

Rai

Cerise

et al. 2021

Pediatric Pulmonology

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Background Initially, persistent asthma was deemed a risk factor for severe COVID‐19 disease. However, data suggests that asthmatics do not have an increased risk of COVID‐19 infection or disease. There is a paucity of data describing pediatric asthmatics with COVID‐19. Objective The objectives of this study were to determine the prevalence of asthma among hospitalized children with acute symptomatic COVID‐19, compare demographic and clinical outcomes between asthmatics and nonasthmatics, and characterize behaviors of our outpatient pediatric population. Methods We conducted a single‐center retrospective study of pediatric patients admitted to the Cohen Children's Medical Center at Northwell Health with symptomatic COVID‐19 within 4 months of the surge beginning in March 2020 and a retrospective analysis of pediatric asthma outpatients seen in the previous 6 months. Baseline demographic variables and clinical outcomes for inpatients, and medication compliance, health behaviors, and asthma control for outpatients were collected. Results Thirty‐eight inpatients and 95 outpatients were included. The inpatient prevalence of asthma was 34.2%. Asthmatics were less likely to have abnormal chest x‐rays (CXRs), require oxygen support, and be treated with remdesivir. Among outpatients, 41% reported improved asthma control and decreased rescue medication use, with no COVID‐19 hospitalizations, despite six suspected infections. Conclusions Among children hospitalized for acute symptomatic COVID‐19 at our institution, 34.2% had a diagnosis of asthma. Asthmatics did not have a more severe course and required a lower level of care. Outpatients had improved medication compliance and control and a low risk of hospitalization. Biological and behavioral factors may have mitigated against severe disease.

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Managing asthma in the COVID-19 pandemic and current recommendations from professional bodies: a review

Cited by 17 publications

References 17 publications

Severe asthma and COVID-19: lessons from the first wave

Severe asthma and COVID-19: lessons from the first wave

Guidance on nebulization during the current COVID-19 pandemic

Asthma and COVID‐19: An early inpatient and outpatient experience at a US children's hospital

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