does asthma increase severity of COVID-19

Researchers state that people with asthma do not seem to be at a higher risk of COVID-19, but more studies are needed. 

In a recent article written for the Journal of Allergy and Clinical Immunology: In Practice, researchers from Rutgers University discuss the incidence and impact of contracting COVID-19 for patients with asthma. 

At present, there is limited evidence to show that patients with asthma are more likely to contract COVID-19 or develop more severe symptoms. In fact, people with asthma seem to be no worse affected by COVID-19 than people without asthma. The Rutgers researchers discuss several reasons why this may be the case. 

With COVID-19 at the forefront of global media, this could have improved clinical outcomes of asthma management due to triggering better medication adherence. Social distancing and being quarantined at home means that people with asthma have had less exposure to seasonal triggers and allergens. Therefore, awareness of COVID-19 seems to have had a positive impact on asthma management in general, contributing to overall good health. 

Age is considered a factor when explaining why asthma sufferers seem to be at no greater risk of COVID-19. Many asthma sufferers are younger in age and susceptibility to, and severity of, COVID-19 increases with age. Younger people with asthma tend to have mainly allergic inflammation, but, a more severe type of asthma can develop in older asthma sufferers. Also, an enzyme that is thought to be the entry point for SAR-CoV-2 varies with age. This enzyme is potentially beneficial in clearing other respiratory viruses, especially in children. It remains unclear, however, how this enzyme affects the ability of SAR-CoV-2 to infect people. Age-adjusted models need to be developed to question if age explains why asthma patients may not be at greater risk of COVID-19. 

Far fewer co-morbidities are associated with asthma than with patients who have chronic obstructive pulmonary disease (COPD) or cardiovascular disease (CVD). This could be due to age or the adverse lifestyle habits associated with COPD and CVD. Diseases such as diabetes, heart disease, or high blood pressure, make people more susceptible to COVID-19 than asthma. However, older asthma sufferers who also have these co-morbidities are likely to have a similar incidence of contracting COVID-19. 

Commonly used to protect against asthma attacks, inhaled corticosteroids may also reduce the ability of SAR-CoV-2 to establish an infection. However, some studies show that steroids delay the clearing of SARS and Middle East Respiratory syndrome. Future studies are needed to address whether inhaled corticosteroids increase or decrease the risk of SAR-CoV-2 infection. 

Although asthma does not seem to increase the risk of contracting COVID-19 or influence its severity, further research is needed to clarify this. More studies should investigate how age, asthma therapy, and biological factors impact the risk of COVID-19 in people with asthma. 

Written by Helen Massy, BSc.

References:

EurekAlert!. 2020. Asthma Does Not Seem To Increase The Severity Of COVID-19. [online] Available at: <https://www.eurekalert.org/pub_releases/2020-07/ru-adn070220.php> [Accessed 7 July 2020].

Panettieri, R., Carson, J., Horton, D., Barrett, E., Roy, J. and Radbel, J., 2020. Asthma and COVID: What Are the Important Questions?. The Journal of Allergy and Clinical Immunology: In Practice.

Image by mohamed Hassan from Pixabay 

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