What you as an asthmatic need to know about coronavirus
Corona pandemic
Around the globe, we are currently facing an unprecedented situation the world has never seen before. The novel coronavirus (COVID-19) is spreading rapidly, forcing politicians, health experts, and the rest of the population to adopt new approaches. Especially people with pre-existing respiratory tract conditions such as asthma are extremely worried about contracting the coronavirus.
For this reason, we have put together up-to-date information from experts intended to answer your most pressing questions:
Fractional exhaled Nitric Oxide (FeNO) level as a predictor of COVID-19 disease severity
An Israelian group examined in a cohort of 56 patients suffering from COVID-19 if FeNO levels can predict the severity of the disease. FeNO levels were measured with the Vivatmo me home use device from Bosch. They found that FeNO measurement was significantly lower among patients with severe hospitalization outcomes compared with that of patients who were discharged to their homes.
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9116042/
Covid-19 risk increases with airborne pollen
When airborne pollen levels are higher, increased SARS-CoV-2 infection rates can be observed. These results were determined by a large-scale study conducted by an international team headed by researchers at the Technical University of Munich (TUM) and the Helmholtz Zentrum München. Members of high-risk groups could protect themselves by watching pollen forecasts and wearing dust filter masks.
Source: https://www.tum.de/en/about-tum/news/covid-19/short/36479
Asthma spray vs. Corona
The results of the Steroids in Covid-19 Study (STOIC) were published in the journal “The Lancet Respiratory Medicine”. Several reports of patients hospitalized with COVID-19 showed that patients with chronic respiratory disease were significantly less represented in hospitals. It was hypothesized that the widespread use of inhaled glucocorticoids by patients was responsible for this finding. It was tested whether glucocorticoids would be an effective treatment for early COVID-19 disease. In-vitro studies have shown that inhaled glucocorticoids reduce SARS-CoV-2 replication in airway epithelial cells. Current evidence suggests that early administration of inhaled budesonide reduces the likelihood of urgent medical care. Also, administration shortens recovery time after early illness from COVID-19. These findings need to be confirmed by further studies.
source: https://www.sciencedirect.com/science/article/pii/S2213260021001600?via%3Dihub
Does Covid-19 risk increases with airborne pollen?
When airborne pollen levels are higher, increased SARS-CoV-2 infection rates can be observed. These results were determined by a large-scale study conducted by an international team headed by researchers at the Technical University of Munich (TUM) and the Helmholtz Zentrum München. Members of high-risk groups could protect themselves by watching pollen forecasts and wearing dust filter masks.
Source: https://www.tum.de/en/about-tum/news/covid-19/short/article/36479/ https://www.lungenaerzte-im-netz.de/news-archiv/meldung/article/gut-eingestellte-asthmatiker-sind-grundsaetzlich-nicht-staerker-durch-coronaviren-covid-19-gefaehr/
Are asthmatics more at risk than others of becoming infected with coronavirus?
The lung specialists from the Verband Pneumologischer Kliniken (VPK – German Association of Pneumological Clinics) say that asthmatics whose disease is well controlled are in principle at no greater risk of a coronavirus (COVID-19) infection than healthy people. According to the VPK, asthmatics whose therapy is well managed and well adjusted generally do not have an increased risk of infection. Provided, that is, that they continue to take their medication regularly.
Are people with pre-existing respiratory tract conditions at greater risk of experiencing more severe disease progression due to coronavirus (COVID-19)?
Although according to the Robert Koch Institute, severe cases frequently occur in patients without any underlying conditions, the following groups of persons have been identified as having a higher risk of developing serious symptoms:
- older persons (with the probability of serious disease progressions increasing steadily from around 50 – 60-year-olds)
- smokers
- people with certain underlying conditions affecting:
- the heart (e.g. coronary heart disease),
- the lungs (e.g. asthma, chronic bronchitis),
- patients with chronic liver disease,
- patients with diabetes mellitus,
- cancer patients,
- patients with a weakened immune system (e.g. due to an illness associated with immunodeficiency or treatment with immunosuppressive drugs, such as cortisone).
Source: https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Steckbrief.html#doc13776792bodyText2
Are children with asthma at greater risk of experiencing more severe disease progression due to coronavirus (COVID-19)?
According to a study commissioned by the Joint Commission on Vaccination and Immunization (JCVI), children with poorly controlled asthma have a higher hospitalization rate due to COVID-19 infection than children with well-controlled asthma or children without asthma.
Markers of poorly controlled asthma were asthma-related hospital admission or prescription of oral corticosteroid.
School-age children with asthma who have been hospitalized for asthma or received two or more oral corticosteroids in the past two years are at markedly increased risk of COVID-19 hospital admission. They should therefore be prioritized for vaccination, according to the researchers.
Should I continue taking cortisone medicines that inhibit the immune system during the current coronavirus pandemic?
Three specialist associations have now issued a joint statement concerning asthma therapy in which they say people who suffer from asthma should continue taking their meds as usual.
What will happen if asthmatics simply discontinue their medication?
Experts warn that suddenly discontinuing medication or changing your treatment can exacerbate asthma to the point that (otherwise avoidable) doctor’s visits or even hospital admissions become necessary. The risk to people with asthma of coming into contact with COVID-19 patients and getting infected there is significantly higher than a possible, as yet unconfirmed, risk of being more likely to catch the novel coronavirus as a result of taking immunosuppressive drugs.
When do we speak of controlled or uncontrolled asthma?
According to the Lungeninformationsdienst (Lung Information Service), a medical distinction is made between three degrees of asthma control, which form the basis for asthma therapy (adjustment):
- controlled asthma,
- partly controlled asthma,
- uncontrolled asthma.
With the help of easy-to-determine criteria, physicians are able to assess the degree of symptom control. The four questions relate to the last four weeks before the present check-up:
- Have you experienced daytime symptoms more than twice a week?
- Has your asthma caused you to wake during the night?
- Have you had to take on-demand medication more than twice a week (exception: when doing sport)?
- Has your asthma restricted you in your activities?
If none of these questions is answered with a “yes”, the asthma is considered controlled. If one or two criteria are met, the asthma is deemed partly controlled. In the case of three or four “yes” answers, we speak of uncontrolled asthma. Among children and youths, the classification is somewhat narrower. If they display daytime symptoms or need reliever medication, irrespective of how often, medical experts speak of partly controlled asthma.
Source: https://www.lungeninformationsdienst.de/krankheiten/asthma/grundlagen/index.html#c199214
Why is good asthma control important?
Being diagnosed with bronchial asthma is initially worrying for many people. According to the Deutscher Allergie- und Asthmabund (DAAB – German Allergy and Asthma Association), nowadays most children and adults with a diagnosis of asthma are able to live a perfectly normal life (including activities and sport, even competitive sports) provided that the disease is well controlled and shows a stable pattern. Asthma can be well controlled through continuous therapy supervised by a doctor and through targeted self-management. Ideally, primary-care physicians should regularly monitor whether their patients present controlled, partly controlled or uncontrolled asthma symptoms.
Source: https://www.daab.de/atemwege/asthma/asthma-kontrolle/asthma-kontrolle/
Who is a risk patient?
With respect to asthma, the most at risk are those who regularly show symptoms despite having started treatment. Older patients with severe asthma and patients taking cortisone in tablet form as part of long-term therapy also have a moderately increased risk.
What’s the best way to protect myself against catching coronavirus?
General recommendations issued by the Robert Koch Institute and the Federal Ministry of Health on prevention of COVID-19:
- Observe the rules for coughing and sneezing
- Wash your hands frequently and thoroughly with soap and water (for at least 20 to 30 seconds)
- Wherever possible, maintain a minimum distance of 1.5 meters from other persons
- Don’t shake hands
- Don’t touch your face
- Wherever possible, stay at home
Sources:
https://www.rki.de/SharedDocs/FAQ/NCOV2019/FAQ_Liste.html https://www.bundesgesundheitsministerium.de/fileadmin/Dateien/3_Downloads/C/Coronavirus/BMG_C-19_200315_info_VT_Patientinnen.pdf
https://www.infektionsschutz.de/
How can I generally protect myself against respiratory infections?
Apart from the general hygiene rules such as washing your hands and social distancing, the German Standing Vaccination Committee (STIKO) recommends vaccinations against the flu (influenza) and pneumococcus for certain groups of persons. This is based on the rationale that bacteria and viruses that cause inflammation of the bronchial tubes or lungs, or even a straightforward cold, can aggravate asthmatic symptoms. Getting vaccinated against pneumococcus and flu is therefore meaningful and appropriate – also with a view to preventing simultaneous infection with several different pathogens, which would place the organism under additional strain and exacerbate the course of the disease.
Source: https://www.impfen-info.de/
How can I generally protect myself against respiratory infections?
Apart from the general hygiene rules such as washing your hands and social distancing, the German Standing Vaccination Committee (STIKO) recommends vaccinations against the flu (influenza) and pneumococcus for certain groups of persons. This is based on the rationale that bacteria and viruses that cause inflammation of the bronchial tubes or lungs, or even a straightforward cold, can aggravate asthmatic symptoms. Getting vaccinated against pneumococcus and flu is therefore meaningful and appropriate – also with a view to preventing simultaneous infection with several different pathogens, which would place the organism under additional strain and exacerbate the course of the disease.
Source: https://www.impfen-info.de/
How can I generally protect myself against respiratory infections?
Apart from the general hygiene rules such as washing your hands and social distancing, the German Standing Vaccination Committee (STIKO) recommends vaccinations against the flu (influenza) and pneumococcus for certain groups of persons. This is based on the rationale that bacteria and viruses that cause inflammation of the bronchial tubes or lungs, or even a straightforward cold, can aggravate asthmatic symptoms. Getting vaccinated against pneumococcus and flu is therefore meaningful and appropriate – also with a view to preventing simultaneous infection with several different pathogens, which would place the organism under additional strain and exacerbate the course of the disease.
Source: https://www.impfen-info.de/
Further information is available from:
Information provided by the German Federal Ministry of Health
Information provided by the Robert Koch Institute (RKI) risk assessment for COVID-19
Information provided by the Robert Koch Institute (RKI) for risk groups
Information provided by the Atemwegsliga e.V. (German Airway League)
Information provided by the ELF (European Lung Foundation): your COVID-19 questions answered by a respiratory expert
