Severe asthma at COVID-19 time: what is new on biologic therapies

Patrucco, Filippo; Villa, Elisa; Foci, Valentina; Benfante, Alida; Bellocchia, Michela; Solidoro, Paolo

doi:10.23736/s0026-4806.20.06727-0

Cited by 11 publications

(11 citation statements)

References 21 publications

(15 reference statements)

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“… 10 Accordingly, other large studies and meta-analyses suggested that asthma patients may have a lower risk of severe COVID-19. 1 , 9 , 29 This could be related to the effect of atopy and type 2 inflammation in allergic patients. 30 An Italian study found a decreased risk of severe COVID-19 disease in patients with atopic disease.…”

Section: Resultsmentioning

confidence: 99%

“…Different phenotypes of asthma may be associated with different COVID-19 outcomes. 1 , 9 , 10 In particular, type 2 inflammation, mostly associated with asthma in the pediatric population or initiated during childhood, is characterized by a Th2 cells dominance and their hallmark cytokines IL-4, IL-5 and IL-13, together with eosinophilia. It has been shown that IL-13 downregulates the expression of ACE2 airway epithelial cells.…”

Section: Resultsmentioning

confidence: 99%

“…Recent publications on this matter revealed a variety of results, gaining even more complexity with increasing data indicating that different phenotypes of asthma may be associated with different COVID-19 outcomes. 1 , 9–12 …”

Section: Introductionmentioning

confidence: 99%

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Understanding and Managing Severe Asthma in the Context of COVID-19

Cardoso¹,

Ribeiro²,

Aguiar³

et al. 2021

ITT

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Coronavirus disease 2019 (COVID-19) continues to spread across the world. Since the beginning of the pandemic, the question of whether asthma is a risk factor for getting the infection or for poor outcomes motivated a great debate. In the field of severe asthma and its treatment during COVID-19 pandemic, several issues are also pending. A literature review focused on the management of severe asthma patients in the context of COVID-19 is performed. The available evidence suggests that severe asthma patients do not have an increased risk of poor COVID-19 outcomes and that it is safe to treat asthmatic patients with inhaled corticosteroids (ICS) and biologics during the pandemic, even though some studies indicate that high doses of ICS may predispose to COVID-19. The chronic use of oral corticosteroid (OCS) might be associated with poor COVID-19 outcomes, although there is no complete agreement. There is very limited evidence concerning the use of triple therapy for asthma in the context of this pandemic. Ultimately, severe asthma patients should maintain their medication during the COVID-19 pandemic, including biologic agents. More studies are needed to address the role of asthma medications and asthma’s different phenotypes on the incidence and course of COVID-19.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Understanding and Managing Severe Asthma in the Context of COVID-19

Cardoso¹,

Ribeiro²,

Aguiar³

et al. 2021

ITT

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“…Asthma is expected to be a risk factor for SARS-COVID2, while clinical data in COVID-19 wards are about 2 to 3% vs. 6% of the general population, and people with asthma appear to be less likely to develop SARS-COVID-2. This can be due to various factors, such as: 1-The anti-inflammatory effect exerted by ICS and their negative effect on cytokine storm 2 -Increased compliance with anti-asthma treatment due to fear of viral infection that disrupts the clinical course [43].…”

Section: Discussionmentioning

confidence: 99%

Untitled

2020

BJSTR

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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.

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“…Koronaviruso SARS-CoV-2 ligos (COVID- 19) pan demija -rimtas iššūkis tiek astma sergantiems asmenims, tiek sveikatos priežiūros specialistams. Viena pagrindinių problemų, susijusių su COVID-19, yra baimė dėl padidėjusios rizikos užsikrėsti naujuoju koronavirusu SARS-CoV-2 arba išsivystyti sunkios eigos COVID-19 bei su ja susijusioms komplikaci joms, ypač sergantiesiems sunkia astma [1,2].…”

Section: įVadasunclassified

Sunki astma ir COVID-19

Kalinauskaitė-Žukauskė

2021

PIA

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Sergančiajam sunkia astma reikalinga specializuota pagalba. Pandemijos akistatoje baiminamasi, kad sunkia astma sergantys asmenys greičiau susirgs COVID–19 arba jos eiga komplikuosis. Atliktų tyrimų duomenys rodo, kad susirgimų arba komplikacijų dažnis nesiskiria nuo bendrosios populiacijos, jei užtikrinama gera astmos simptomų kontrolė ir nėra nuolatinio geriamųjų gliukokortikoidų vartojimo. Daug abejonių būta ir dėl biologinių vaistų skyrimo pandemijos laikotarpiu, tačiau esama patirtis ir atliktų tyrimų duomenys rodo, kad netgi susirgus COVID–19, biologinė terapija turi būti tęsiama, nors pradėti nerekomenduojama. Atskiras daug diskusijų sukėlęs klausimas – vakcinacija. Vis tik kol kas tai vienas veiksmingiausių būdų valdyti pandemijai ir grįžti į kasdienį gyvenimą, buvusį iki pandemijos.

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Severe asthma at COVID-19 time: what is new on biologic therapies

Cited by 11 publications

References 21 publications

Understanding and Managing Severe Asthma in the Context of COVID-19

Understanding and Managing Severe Asthma in the Context of COVID-19

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Sunki astma ir COVID-19

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