Welcome to our December research update! Getting involved with research is an important way to impact asthma and allergy treatments, education, and awareness.

This month, we are highlighting clinical trials, surveys, and news on:

• Chronic hives triggered by sunlight (solar urticaria)
• The impacts of the changing inhaler market on people with chronic lung disease
• Long-term exposure to particulate matter and asthma
  
  

Note: The links below will take you to external websites.

Latest Asthma and Allergy News

Asthma

The Effects of Inhaler Market Changes on People with Chronic Lung Disease
Asthma and chronic obstructive pulmonary disease (COPD) affect 545 million people worldwide and about 34 million people in the United States. People in the United States with these chronic lung conditions spend about $4,000 out-of-pocket each year.

A recent study found major challenges that people living with asthma and COPD face because of changes to the inhaler market. These challenges include:

• Rising medicine costs
• Discontinued branded medicines
• Lack of insurance coverage for generics
• Medicine shortages
  
  

Insurance policies also force non-medical switches in medicine or devices.

For health care providers, more administrative work, inhaler denials, and limits on prescribing suitable treatments create major challenges. These challenges can reduce patient trust and increase the burden of asthma and COPD care.

Asthma Visits are More Common After Flovent Discontinuation
Flovent, a prescription inhaled corticosteroid, was discontinued on Jan. 1, 2024. Before being discontinued, it was used for the long-term treatment of asthma in people aged 4 and older. After its discontinuation, people who used Flovent were directed to generic options. But people were concerned about insurance coverage and effectiveness.

To study the impact of Flovent’s discontinuation, researchers looked at emergency department (ED) visits, hospital admissions, and ICU stays for over 3 million people who were prescribed fluticasone propionate in the first (Q1) and second (Q2) quarters of 2024. Compared to the same periods in 2022 and 2023, asthma-related hospital admissions increased by 17.5% in Q1 and 24.1% in Q2. ICU admissions rose 17.4% in Q1 and 21.3% in Q2. ED visits saw smaller increases, up 6.5% in Q1 and 3.6% in Q2.

These findings suggest that the discontinuation of Flovent may have contributed to higher rates of severe asthma episodes. This highlights challenges people face with medicine transitions. But more research is needed to understand the long-term impacts of the discontinuation.

The Impact of Long-Term Exposure to Air Pollution on Asthma
Asthma affects over 250 million people worldwide. Long-term exposure to fine particulate matter (PM2.5) is a major risk factor. Particulate matter is usually found in polluted air. A recent study combined data from reviews and analyses to look at the impact of particulate matter exposure on asthma risk. In this study, risk was defined by the number of total asthma cases, new asthma cases, and asthma deaths.

The review found that asthma risk rises by 21.4% in children and 7.1% in adults for every 10 micrograms per cubic meter of an increase in particulate matter. The researchers also believe that in 2019 nearly 1/3 of global asthma cases were linked to particulate matter exposure.

These findings highlight the major role of air pollution in asthma prevalence and stress the need for stronger efforts to reduce particulate matter levels worldwide.

Jewelry, treats, stuffed animals, perfume, plants, and candles may be popular gifts for many occasions. But if you give them to someone you know with asthma and allergies, you may give them something you didn’t plan on – triggers that cause symptoms.

Instead, consider giving non-traditional gifts to people who have asthma or allergies. They will appreciate your efforts. And you can help them avoid an allergic reaction or an asthma episode. Use this as a chance to give creative asthma and allergy friendly gifts they won’t forget.

Consider the following when giving gifts to people with asthma and allergies.

Choose Gifts Free of Pollen and Scents

Flowers and plants can carry pollen or mold. They can cause allergy symptoms or trigger allergic asthma.

Some items have strong scents that can irritate the airways of a person with asthma:

• Perfume and cologne
• Wax candles and potpourri
• Scented personal care products
• Some flowers
• Air fresheners and diffusers

Instead, give gifts such as homemade cards, special heartfelt notes, gift cards, homemade “coupon” books, LED candles, or photos. Plan a trip or a fun night out.

If you’re thinking about a cozy evening at home, don’t light the fireplace or fire pit. Smoke of any type can trigger asthma symptoms. Use a blanket instead for a smoke-free night.

Give Items That Won’t Irritate Their Skin

If you plan to give to someone who has skin allergies, avoid gifts that contain nickel, such as nickel-plated jewelry. Also, be careful with personal care items like scented lotions and shower gels. These items can trigger symptoms for some people with skin conditions such as atopic dermatitis (eczema).

Watch for Food Allergens in Meals and Candy

Does your gift recipient have a food allergy? If you are considering a food gift, talk to them first. Learn how to read labels. For example, many chocolates come in contact with common allergens like nuts and milk during manufacturing.

Not all restaurants handle food allergies the same way. Restaurants can be busier on holidays and weekends, so there’s a higher chance of mix-ups in the kitchen. Try a creative food-free experience instead. Or make a safe meal together at home.

Give Them a Healthier Home

Cleaning can expose people to dust mites or mold. Improve someone’s indoor air quality by cleaning for them. Focus on places where allergens and asthma triggers like to hide the most. These are bedrooms, living rooms, and kitchens. And don’t forget the bathrooms where mold loves to grow. Use cleaning products that don't have strong scents, such as bleach, when you can. Clean when they aren't home, if possible. You could even give a CERTIFIED asthma & allergy friendly® product. They are scientifically tested to make sure they create a healthier home.

Honor Them by Helping Other People

Managing asthma and allergies can have a great impact on a person’s well-being and quality of life. Give a donation in their honor to the Asthma and Allergy Foundation of America (AAFA). Your donation can help educate, advocate for and support people with asthma and allergies. Supporting people also facing these conditions is a great way to show you care.

Asthma symptoms and severity can vary from person to person, especially if you have mild to moderate asthma. Join John James, MD, board-certified allergist, and the Asthma and Allergy Foundation of America (AAFA) as we explore mild to moderate asthma in our upcoming webinar.

Understanding Mild to Moderate Asthma

Thursday, Dec. 12 at 1 p.m. ET (10 a.m. PT)

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During the webinar, you'll learn about:

• Symptoms of mild to moderate asthma
• Asthma self-management and control
• Available treatment options
• Shared decision making

You can submit your questions when you register. Don't miss this chance to hear from the experts on identifying asthma symptoms, tips on keeping your asthma in control, treatment options and more!

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Related Resources

• Asthma Facts
• What Are Asthma Triggers?
• How to Correctly Use Your Asthma Devices
• Eczema

With every cough or sniffle, you may wonder if it’s asthma or allergies, the flu, respiratory syncytial [sin-SISH-uhl] virus (RSV), the common cold, or even COVID-19. But how can you tell the difference?

The Asthma and Allergy Foundation of America (AAFA) created a respiratory symptoms chart to help you recognize the similarities and differences between these conditions.

Click to see larger image (English)

Click to see larger image (Spanish)

Asthma Symptoms

Asthma is a chronic disease that causes your airways to be inflamed. The best way to manage it is to take your asthma medicines, avoid your triggers, and treat asthma symptoms as soon as they occur.

Common symptoms of asthma include:

• Shortness of breath
• Cough
• Chest tightness or pain
• Wheeze (a whistling sound when you breathe)
• Waking at night due to asthma symptoms
• A drop in your peak flow meter reading (if you use one)
  
  

Symptoms can come on gradually, or they can come on suddenly.

What to Do If You Have Asthma Symptoms

At the first sign of asthma symptoms, take your quick-relief (sometimes called “rescue”) medicine. Follow the Yellow/Caution Zone on your Asthma Action Plan. The earlier you treat asthma symptoms, the better your chances are of not having an asthma emergency.

Asthma can be life-threatening, so it’s important to know the signs of an asthma emergency and to keep your quick-relief inhaler with you at all times.

Red/Danger Zone symptoms are a medical emergency. Take your quick-relief medicines right away as directed on your Asthma Action Plan and then get immediate medical attention. Call 911 or go directly to the emergency room if you have these asthma symptoms:

• Asthma is getting worse quickly
• Asthma quick-relief medicines are not helping
• Chest tightness or pain
• Severe shortness of breath
• Breathing is faster or slower than normal
• Breathing may be hard or shallow
• Trouble walking or talking due to shortness of breath
• Chest retractions (skin sucks in between or around the neck, chest plate, and/or rib bones when inhaling; this is rare in adults)
• Ribs or stomach moving in and out deeply and rapidly
• Expanded chest that does not deflate when you exhale
• Shoulders hunched over
• Cyanosis, a tissue color change on mucus membranes (tongue, lips, and around the eyes) and fingertips or nail beds – the color appears grayish or whitish on darker skin tones and bluish on lighter skin tones
  
  

COVID-19 Symptoms

COVID-19 is caused by the SARS-CoV-2 virus. According to the Centers for Disease Control and Prevention (CDC), COVID-19 symptoms can include:

• Fever
• Chills
• Cough
• Shortness of breath or trouble breathing
• Feeling tired and weak – more than usual
• Muscle or body aches
• Headache
• New loss of taste or smell
• Sore throat
• Stuffy or runny nose
• Diarrhea
• Nausea or vomiting
  
  

This list may not include all of the symptoms. Symptoms may appear 2 to 14 days after coming in contact with the virus. If you have any symptoms that are severe or concerning, call your doctor.

If you have these severe symptoms, call 911 or go to the emergency room right away:

• Trouble breathing or shortness of breath
• Pain or pressure in the chest that doesn’t go away
• New and sudden confusion
• Can’t wake up or stay awake
• Cyanosis which is tissue color changes on mucus membranes (like tongue, lips, and around the eyes) and fingertips or nail beds – the color appears grayish or whitish on darker skin tones and bluish on lighter skin tones
  
  

People ages 6 months and older can get a COVID-19 vaccine.

What to Do If You Have COVID-19 Symptoms

If you have any of the symptoms above or if you have been exposed to someone who has COVID-19, get tested. If you test positive, contact your doctor right away. They may want you to take an antiviral medicine and or additional medicines to support your symptoms.

Also wash your hands often, wear a mask, and stay home if you are sick. Pay attention to your symptoms, and if they get worse, call your doctor and get emergency care right away. Get plenty of rest and continue to take your asthma medicines as prescribed by your health care provider.

Flu (Influenza) Symptoms

The flu is a contagious respiratory illness caused by influenza viruses. Symptoms can start suddenly and can cause mild to severe illness. It can also cause death in severe cases. Common flu symptoms include:

• Fever (often very high, 101°F or above)
• Headache
• Extreme tiredness
• Chills
• Constant cough
• Sore throat
• Runny or stuffy nose
• Body aches in bones and/or muscles
• Diarrhea and vomiting (more common in children)
  
  

Thankfully, a flu vaccine is available. To reduce your chances of getting and spreading the flu, get the flu vaccine every year. The CDC recommends that people ages 6 months and older get the flu vaccine. Even if you catch a strain of flu that isn’t covered by the current year’s vaccine, getting vaccinated can make your illness less severe and lower your chance of being hospitalized.

People with asthma, as well as senior adults and people with other pre-existing conditions, are at high risk of complications from the flu.

It is important to get the flu vaccine every year. It can reduce your chances of having complications (serious health problems).

What to Do If You Have Flu Symptoms

If you have flu symptoms or are exposed to someone with the flu, contact your doctor right away. There are antiviral treatments for the flu that can lessen symptoms and may shorten the time you are sick. But you have to take them within 1 to 2 days of getting sick.

If you start having flu symptoms and have trouble breathing, follow your Asthma Action Plan and contact your doctor right away.

Respiratory Syncytial Virus (RSV)

RSV is a virus that affects your lungs. It is a common virus with cold-like symptoms that can affect people of all ages. RSV is the most common cause of pneumonia and airway inflammation in children in the United States younger than 1 year of age.

Most people have mild symptoms and recover from RSV within a week or two. But RSV can be serious for certain people who are at high risk, like infants and older adults.

RSV symptoms can take as long as 4 to 6 days to show up after contact with the virus. Symptoms include:

• Runny nose
• Stuffy nose
• Eating less or not interested in eating
• Coughing
• Sneezing
• Red, inflamed eyes (conjunctivitis)
• Fever
• Wheezing (a whistling sound when breathing)
  
  

Symptoms in very young infants may be different. They can include:

• Being irritable or cranky (fussiness)
• Eating or drinking less or not interested in eating
• Decreased activity and poor responsiveness
• Trouble breathing (for example, cough, shortness of breath, wheezing, and respiratory distress)
• Faster breathing than usual
• Pauses in breathing that last more than 10 seconds
  
  

Call your child’s doctor right away if your child is having trouble breathing, not drinking enough fluids, not responding well, and/or their symptoms are getting worse.

What to Do If You Have RSV Symptoms

If you have asthma, contact your doctor right away if you have symptoms of RSV. Or if your infant has RSV symptoms – whether they have asthma or not – contact their doctor.

Most RSV infections will go away on their own. RSV is caused by a virus, so antibiotics will not help. Talk with your doctor about taking over-the-counter medicines to help with symptoms, like pain relievers or cough and cold medicine. Be sure to talk with your doctor about how to take these medicines appropriately. Ask about nasal suction and lubrication – such as a nasal saline spray, mist, or drops – which may help ease congestion. Drink plenty of fluids and rest. Limit your time around other people to prevent spreading RSV.

Cold Symptoms

The common cold is usually mild compared to the flu and COVID-19. But even a mild cold can trigger asthma symptoms, so if you catch a cold, you want to take it seriously.

Common symptoms of a cold include:

• Mild cough
• Sneezing
• Runny or stuffy nose
• Sore throat
• A short fever
• Aches and pains
  
  

What to Do If You Have Cold and Other Respiratory Symptoms

If you start having trouble breathing when sick with a cold, follow your Asthma Action Plan. Contact your doctor if symptoms do not improve. And get medical help right away for emergency asthma symptoms.

Nasal Allergy (Rhinitis) Symptoms

Irritants and allergens can cause inflammation (swelling) in your nose. This is called rhinitis. When you have symptoms during a certain season of the year or when you are exposed to certain allergens, it’s commonly called allergic rhinitis or “hay fever.”

Common allergens that can cause rhinitis include animal dander, dust mites, mold, and pollen.

Allergy symptoms can include:

• Itching in the nose and eyes
• Sneezing
• Stuffy nose (congestion)
• Runny nose
• Mucus (phlegm) in the throat (postnasal drip)
  
  

The inflammation (swelling and irritation) in your nose can cause it to produce a fluid called mucus. The mucus may flow out of your nose, as well as down the back of your throat. It can irritate the back of your throat and cause coughing.

Allergies are not contagious, unlike colds, the flu, and COVID-19. They are caused by a reaction of your immune system.

What to Do If You Have Allergy Symptoms

If you have allergies, the best way to prevent or reduce symptoms is to reduce or avoid contact with the things you are allergic to. Some steps you can take include:

For dust mite allergy:

• Use CERTIFIED asthma & allergy friendly® dust mite-proof covers for pillows, comforters, duvets, mattresses, and box springs.
• Wash your bedding and pillowcases in hot water weekly to reduce allergens.
  
  

For animal dander allergy:

• Keep pets out of the bedroom to reduce pet dander allergen in your bedding.
  
  

For mold allergy:

• Run a fan in your bathroom for 15 to 20 minutes after showering or bathing.
• Fix plumbing leaks in your home as soon as possible.
  
  

For pollen allergy:

• Plan indoor activities on days when pollen counts are high.
• Keep your windows closed during high pollen and mold seasons, if possible. When entering your home, leave your shoes at the door.
• Wear sunglasses, a hat, and a face mask to protect pollen from getting in your eyes, nose, and mouth when outdoors on high pollen days.
  
  

In general:

• Replace the filters on your heating/air conditioning units as recommended by the manufacturer.
  
  

If reducing your exposure to allergens isn’t enough, there are several treatments that can help. Treatments can include nasal sprays, antihistamines, decongestants, and immunotherapy (allergy shots). See a board-certified allergist for allergy testing. They can recommend a treatment plan to help you get relief.

Uncontrolled rhinitis can lead to sinusitis, a sinus infection. If you have asthma, rhinitis symptoms can irritate your lungs and cause asthma symptoms. If you have allergies, it’s important to get treatment to make sure they are well-controlled.

How to Reduce the Spread of COVID-19, the Flu, and Other Respiratory Illnesses

What can you do to reduce your chances of getting sick? To stop the spread of respiratory infections:

• Get vaccinated
• Wash hands often for at least 20 seconds with soap and water
• Wear an N95 face mask when respiratory infections are high in your community
• Increase air flow in your indoor environment

If you have asthma, keeping your asthma under control can reduce your chances of having a severe asthma episode or attack if you get sick.

If you do get sick, get plenty of rest, drink water, and follow your Asthma Action Plan if you have asthma.

Always contact your doctor about any concerning symptoms, no matter what. And go to the emergency department or call 911 for emergency signs and symptoms.

Medical Review: based on the following webpages: COVID-19 (Coronavirus Disease), Asthma, and Allergies reviewed September 2024 by Neeta Ogden, MD; Flu (Influenza) reviewed September 2024 by John James, MD; Respiratory Syncytial Virus (RSV) October 2024 by John James, MD; and Nasal Allergies (Rhinitis)

COVID-19 is a disease caused by a virus called SARS-CoV-2 (a type of coronavirus). It causes respiratory symptoms, but it can also affect other parts of your body.

COVID-19 spreads through close contact from person to person. A person with the virus can spread it to others by talking, coughing, sneezing, singing, or breathing. The virus will be in large or small droplets that are exhaled from the mouth or nose out into the air.

If you are within 6 feet (2 meters) of someone who is ill with COVID-19, you may be at greatest risk for becoming infected. But it may be possible to catch the virus even if you are more than 6 feet away from an infected person because very small droplets can spread in the air. If someone who is sick coughs on or near your face, you may get infected. People may be infected with the coronavirus and not show any symptoms. They may spread the virus without knowing it. The virus may also spread through direct contact with a person who has COVID-19.

What Are the Symptoms of COVID-19?

According to the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO), COVID-19 symptoms can include:

• Fever
• Chills
• Cough
• Shortness of breath or trouble breathing
• Feeling tired and weak
• Muscle or body aches
• Headache
• New loss of taste or smell
• Sore throat
• Stuffy or runny nose
• Nausea or vomiting
• Diarrhea
  
  

If you or someone you know has these emergency warning signs, call 911 or go to the emergency room immediately:

• Trouble breathing or shortness of breath
• Pain or pressure in the chest that doesn’t go away
• Newly confused
• Can’t wake up or stay awake
• Cyanosis which is tissue color changes on mucus membranes (like tongue, lips, and around the eyes) and fingertips or nail beds – the color appears grayish or whitish on darker skin tones and bluish on lighter skin tones
  
  

According to the CDC, this list may not include all symptoms. If you have any symptoms that are severe or concerning, call your doctor.

The CDC warns that symptoms may appear two to 14 days after coming in contact with the virus.

How Can I Tell the Difference Between Asthma, COVID-19, the Flu, a Cold, RSV, or Seasonal Allergies?

Some symptoms are similar between these respiratory illnesses. Respiratory illnesses may worsen asthma, so it’s important to keep taking your asthma medicines. If you have a fever and a cough, call your doctor. If you have seasonal allergies, there are things you can do to treat them at home. If your allergy symptoms are hard to control, make an appointment with an allergist.

This chart can help you figure out if you may be feeling symptoms of asthma, allergies, or a respiratory illness like COVID-19, the flu, respiratory syncytial virus (RSV), or a cold:

Click to see larger image (English)

Click to see larger image (Spanish)

Are People With Asthma at Risk of Severe Illness From COVID-19?

Many studies show that having asthma does not put you at a greater risk of getting COVID-19 or having severe COVID-19.^1,2,3 A study published in “The Journal of Allergy and Clinical Immunology: In Practice” (JACI: In Practice) found that people with well-controlled asthma have less severe COVID-19 outcomes than people with uncontrolled asthma.⁴

The CDC continues to list moderate to severe asthma as a chronic lung disease that can make you more likely to have severe illness from COVID-19.

No matter what, it is important to keep your asthma well-controlled. If your asthma is not under control, you are at a greater risk in general of having an asthma episode or attack, going to the emergency room, staying in the hospital, or even death. If you feel like your asthma is not well-controlled, talk with your doctor as soon as possible.

Even though people with asthma are not at the highest risk for COVID-19, it is still important to keep your asthma under control. Common medicines you may take for asthma and allergies do not increase your risk of getting COVID-19. They will help you keep your asthma under control. You are at greater risk for having an asthma attack if you stop taking your medicines. Take your medicines at the first sign of symptoms as listed on your Asthma Action Plan. Continue to take these medicines as prescribed:

• Quick-relief medicine (such as albuterol)
• Inhaled corticosteroids (controller medicines)
• Oral corticosteroids (such as prednisone)
• Biologics
• Antihistamines (allergy medicine)
• Proton pump inhibitors for acid reflux
• Nasal allergy sprays
• Allergy shots
  
  

If you have any questions about asthma medicines and COVID-19, talk with your doctor.

If you need to take quick-relief medicine (such as albuterol) for an asthma episode, use an inhaler (with a spacer if directed by your doctor) if possible. Using a nebulizer can increase the risk of sending virus particles in the air if you are sick. But if you have a nebulizer and solution, it is OK to use it to treat an asthma episode. When using a nebulizer, limit the number of people in the room or use it in a room by yourself.

How Can I Avoid Getting COVID-19 (And Other Respiratory Infections)?

The following steps will help you avoid COVID-19, the flu, and other respiratory infections:

1. Get your vaccines.

Vaccines can help protect you, your loved ones, older adults near you, teachers, and essential workers from getting a respiratory infection. They can also cut down your symptom severity if you do get sick. Vaccines reduce the burden on our health care system by reducing the number of people who get COVID-19 or the flu.

Everyone who is 6 months and older can get a COVID-19 vaccine in the United States. There vaccines available are: Pfizer, Moderna, and Novavax.

Visit vaccines.gov to find out where you can get the COVID-19 vaccine near you. Most people can get the COVID-19 vaccine with no issues. Allergic and adverse reactions are rare.

The flu vaccine is recommended for everyone age 6 months and older with rare exceptions.

It is safe to get both the COVID-19 vaccine and the flu vaccine at the same time.

2. Wear a mask.

Face masks can help reduce the spread of the coronavirus. They can benefit people who are vaccinated and unvaccinated alike. Some people may have COVID-19 and not show symptoms for a few days, while some may not have any symptoms at all. And some vaccinated people have gotten breakthrough infections, which have usually been mild.

Wear a mask that fits snugly on your face, and covers your nose, mouth, and beard completely. Wear a mask when you leave your home, if you are caring for someone at home who is sick, and if you have been exposed to someone with COVID-19. People with asthma should be able to wear face masks.

Face masks offer other benefits as well. They can reduce your exposure to pollen, air pollution, and other respiratory infections like the flu.

3. Keep a physical distance from people outside your household.

In general, the more closely you interact with other people and the longer that interaction, the higher the risk of coronavirus or flu spread. Try to stay home when possible when these illnesses are spreading in your community. Avoid large crowds of people, especially in indoor locations. When in public, keep at least 6 feet apart. Stay away from people who are sick or have been in contact with someone who is sick. Even when you’re at home with family, don’t share makeup, food, dishes, or eating utensils.

4. Wash your hands properly and often.

Use soap and warm water to wash your hands for 20 to 30 seconds. Always wash your hands before and after eating and after coughing or sneezing. Don’t touch your eyes, nose, or mouth.

If you don’t have access to running water, use an alcohol-based hand sanitizer that is at least 60% ethyl alcohol (ethanol) or 70% isopropyl alcohol (isopropanol).

5. Make sure your indoor spaces are well-ventilated and have good indoor air quality.

If you are staying indoors more because of COVID-19, be mindful of the quality of your indoor air. The air inside our homes can often be more polluted than the air outside. Unhealthy indoor air can be full of asthma triggers and allergens that can cause symptoms and make your asthma harder to control. Take steps to improve and maintain healthy indoor air quality.

Air circulation is important too. Keep your indoor spaces well-ventilated by opening windows or doors, using fans, running air cleaners, or using proper air filters in your HVAC system.

Current evidence shows the risk of the coronavirus spreading is much lower outdoors than indoors. Good ventilation in your indoor environment may help reduce the spread of the coronavirus. It may also affect the risk of transmission (how fast it spreads).

On days when pollen is low and air quality is good, open your windows to let in fresh air. Run your HVAC system as much as possible (especially when windows are closed). Use high efficiency air filters in your HVAC system and replace them at least every three months.

6. Take care of your health.

Take your asthma control medicines as directed to keep your airways open. Eat well and get enough sleep.

Pollen (such as grass or ragweed pollen) may impact people across the U.S. too. Seasonal allergies can affect people with allergic asthma. If pollen allergies trigger asthma symptoms for you, be sure to follow your allergy treatment plan to keep your allergies under control to prevent asthma episodes or attacks.

If you stopped seeing your allergist or getting allergy shots (immunotherapy) during the COVID-19 pandemic, consider making an appointment soon. Keeping up with your regular allergist visits is an important part of keeping your asthma controlled.

The most important thing you can do is to keep your asthma under control. If your asthma is not under control, call your doctor right away.

In general, tracking your symptoms and following your Asthma Action Plan are key to managing your asthma. Some people use peak flow meters to monitor their airways. Monitoring your blood oxygen levels with a pulse oximeter (or “pulse ox”) is not a recommended part of home management of asthma. Many pulse oximeters you can buy for home use are not as accurate as medical grade devices.

It is important to remember that the symptoms you feel should always come before pulse ox and peak flow numbers. But if your peak flow numbers are down and you don’t have symptoms, follow your asthma action plan and contact your doctor.

There are no data demonstrating that monitoring your pulse ox through an oximeter or smartphone app will help manage your asthma. As always, talk with your doctor about the best ways to monitor your symptoms and asthma control.⁶

If I Think I Have COVID-19, What Should I Do?

If you start having symptoms of COVID-19, get tested or take an at-home test. If you have mild symptoms and are not at high risk for having more severe COVID-19, you do not need to call your doctor. Call your local health department within 24 hours to let them know so they accurately report local cases.

If you are at high risk for severe COVID-19, call your doctor within 24 hours if you test positive. They may want to you to take the medicine Paxlovid.

Many pharmacies have various testing options (including at-home or drive-thru tests). At times, free tests are available from covidtests.gov.

Some doctors may offer telehealth (video or virtual appointments). If that is an option, ask your insurance company if telehealth is covered under your plan. And if you have Medicare, you might be able to have a virtual visit with your doctor. The government expanded the coverage of telehealth services during the COVID-19 pandemic.

Stay home and isolate from family members so you don’t spread the coronavirus to other people.

Medical Review, July 2022 by Mitchell Grayson, MD; updated November 2024

References
1. Chhiba, K.D., Patel, G.B., Vu, T.H.T, Chen, M.M., Guo, A., Kudlaty, E., Mai, Q., Yeh, C., Muhammad, L.N., Harris, K.E., Bochner, B.S., Grammar, L.C., Greenberger, P.A., Kalhan, R., Kuang, F.L., Saltoun, C.A., Schleimer, R.P., Stevens, W.W., & Peters, A.T. (2020). Prevalence and characterization of asthma in hospitalized and non-hospitalized patients with COVID-19, Journal of Allergy and Clinical Immunology. https://doi.org/10.1016/j.jaci.2020.06.010.
2. Butler, M. W., O’Reilly, A., Dunican, E. M., Mallon, P., Feeney, E. R., Keane, M. P., & McCarthy, C. (2020). Prevalence of comorbid asthma in COVID-19 patients. Journal of Allergy and Clinical Immunology. https://doi.org/10.1016/j.jaci.2020.04.061
3. Lieberman-Cribbin, W., Rapp, J., Alpert, N., Tuminello, S., & Taioli, E. (2020). The Impact of Asthma on Mortality in Patients With COVID-19. Chest. https://doi.org/10.1016/j.chest.2020.0air pol.575
4. Huang, B. Z., Chen, Z., Sidell, M. A., Eckel, S. P., Martinez, M. P., Lurmann, F., Thomas, D. C., Gilliland, F. D., & Xiang, A. H. (2021). Asthma disease Status, COPD, and COVID-19 severity in a large Multiethnic POPULATION. The Journal of Allergy and Clinical Immunology: In Practice. https://doi.org/10.1016/j.jaip.2021.07.030
5. Kampf, G., Todt, D., Pfaender, S., & Steinmann, E. (2020). Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. Journal of Hospital Infection, 104(3), 246–251. doi: 10.1016/j.jhin.2020.01.022
6. Heneghan, C. (2018, January 30). Self-management of asthma – is there an app or pulse oximeter for that? Retrieved from https://blogs.bmj.com/bmjebmsp...-app-pulse-oximeter/

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During the webinar, you’ll learn about:

• How loss of smell affects quality of life, mood, appetite, and safety
• The link between loss of smell and nasal-polyp severity
• Treatment options for nasal polyps
• If the loss of smell could better with treatment
• If treatments for nasal polyps improve sense of smell
• How different treatments like biologics and surgery help restore smell
  
  

Don’t miss this chance to take control of your health. Watch now and learn more!

Welcome to our November research update! Getting involved with research is an important way to impact asthma and allergy treatments, education, and awareness.

This month, we are highlighting clinical trials, surveys, and news on:

• Potential asthma treatments
• The impact of environment on asthma
• Moderate to severe eczema in children
• Differences in COVID-19 outcomes based on asthma type
• Study on tezepelumab for nasal polyps
• Impact of corticosteroid use in people with nasal polyps
  
  

Note: The links below will take you to external websites.

Surveys

Community Asthma Survey

If you are over 18 and have asthma, we want to hear about how the environment affects your breathing. By telling your story, you can help others understand and manage asthma better!

The Asthma and Allergy Foundation of America (AAFA) is a partner in this research and appreciates your support!

TAKE THE SURVEY

Participants Needed for Eczema Study

If you are a caregiver for a child under 18 with moderate to severe eczema, we would love to hear your opinions and perspectives. Your feedback can help impact guidelines for childhood eczema. Your child can take the survey too with your help.

Take a 15-minute online survey for a research study on using systemic (oral or injectable) medicines for eczema.

Your voice makes a difference! Each participant will be entered into a drawing for a reward.

Principal Investigator: Dr. Joy Wan (Johns Hopkins Medicine IRB00397225)

TAKE THE SURVEY

Chronic rhinosinusitis is a common medical condition that affects 5-12% of adults.¹ Around 20 to 30% of people with chronic rhinosinusitis have nasal polyps.^2,3 Nasal polyps associated with type 2 inflammation, which is also linked to asthma, allergic rhinitis (hay fever), atopic dermatitis (eczema), food allergies, eosinophilic esophagitis (EoE).⁴

Nasal polyps can have a major impact on quality of life. They can affect sleep, the ability to do daily activities, and cause anxiety and depression. They can also cause safety concerns because they can affect a person’s ability to smell.

The Asthma and Allergy Foundation of America (AAFA) studied the impacts of living with nasal polyps in a report titled, Life with Nasal Polyps: The Patient Experience and Opportunities to Improve Care in the U.S.

As part of our research, we interviewed people with nasal polyps to understand the patient experience. Below, you’ll hear from Tom, Norah, Teresa, Leo, Tamara, and Georgia* about how their experiences line up with some of the key findings of our report.

Diagnosis Can Take a Long Time

For many people, it can take months, or even years, to get a nasal polyps diagnosis. Tom, who was recently diagnosed with nasal polyps, described having symptoms for months before diagnosis.

“For some months I had some nasal congestion issues,” Tom said. “And I really wasn't too happy with the doctor's response. I ended up in the hospital [and] had an ENT say I had a head full of polyps.”

For some people, getting a formal diagnosis can take years. Georgia was diagnosed with nasal polyps after having symptoms and seeing multiple health care providers for years with no relief.

“Before my diagnosis I just had issues with allergies,” recalled Georgia. “Every season it started out with me having sinus infections real bad. So once I started getting sinus infections and I knew it was seasonal, I went to an allergist. From the allergist, I started taking allergy shots. I did that for about a year, and I felt like my allergies weren't getting any better. So then I started having issues with asthma … then it got to the point where I was going back and forth to the hospital, to the ER. Then I decided from there to go to an ENT [who diagnosed me with nasal polyps].”

Nasal Polyps Can Impact Quality of Life

Nasal polyps can have physical impacts like congestion, stuffy and runny nose, and loss of taste or smell. They can also impact mental, social, and emotional health. Teresa, who has had chronic sinus infections as a result of her nasal polyps, described the impact on social life and relationships.

“It impacts your life,” Teresa said. “You have to change plans with friends if you have a sinus infection, and they get worse and worse. You’re constantly altering your life, family events, [you] just lose your energy, and they get harder to fight.”

Leo, a college student, also detailed the impact on school and physical activities.

“I swam before,” Leo said. “I can't really do that anymore just because water goes up in [my nose] and doesn't come back out. It doesn't drain. And so I end up with a sinus infection … There have definitely been times where I’m at work or I’m in class, and I can feel a bad one coming on that I have to just buckle down and know that I’m going to go take a nap or something after.”

The impacts on smell and taste can also be dangerous in some cases. Georgia described times when she couldn’t smell spoiled food or burning in the kitchen.

“I would eat foods and not know if they were spoiled or not,” Georgia said. Like milk, you don't know it's not good, especially if you can't taste or smell it. I could even remember a point where I was in my room, I had put on dinner. And I was sitting on my bed and the alarms went off in the house, and all of a sudden I started seeing white smoke…and then I noticed my throat was feeling a little funny, because I was inhaling the smoke, but I couldn't even taste it or smell it.”

Access to Effective Treatments for Nasal Polyps Can Be Challenging

Nasal polyps can be treated with medicines and surgery. For many of the people we interviewed, getting access to these treatments was a challenge.

Norah, who has managed her nasal polyps well through budesonide nasal sprays, talked about the challenges of getting insurance to approve her prescription.

“The cost is going up,” said Norah. “I'm in the middle of a fight with Medicare. They denied me once, but you can appeal. So, I'm in the middle of an appeal process to get the tier lowered on that drug … And so now I have to ask [my asthma specialist’s] office to reapply. Otherwise, I’m looking at between $80 and $120 a month just for the budesonide because it's a tier 4 drug under Medicare. They denied it because the FDA doesn't see the need for using it that way.”

Tom, who qualified for a biologic treatment for nasal polyps, described the difficult process to get the treatment.

“Getting that prescription was an incredible odyssey all in itself,” said Tom. “Getting it approved or not approved and getting the specialty pharmacy to deliver it … And I'd have to call them every couple of weeks to go through this whole rigamarole all over again. It was not fun.”

Challenges with accessing treatments (especially newer, more expensive options) can be different for everyone. Factors like your insurance provider and plan can play a big role in accessing treatment.

Some people we interviewed also had trouble getting information about surgery.

“I wasn't offered surgery, surgery was never an option,” said Tamara. “I go to my ear nose and throat doctor, [and they say] 'Okay, you look good, you're doing okay.' Surgery was never on the table.”

For others who had surgery to remove their nasal polyps, they often had to try medicines first or do surgeries more than once. And for some people, recovery after surgery can be challenging.

Leo described his experience with surgery: “I got surgery because the drugs didn't work. And the surgery recovery, at least for a couple of [the surgeries], was a pain... two to three weeks of a lot of bleeding and junk coming out, just because of the large amount of stuff that was in there that they had to remove.”

Nasal Polyps Can Impact Quality of Life

Nasal polyps can have physical impacts like congestion, stuffy and runny nose, and loss of taste or smell. They can also impact mental, social, and emotional health. Teresa, who has had chronic sinus infections as a result of her nasal polyps, described the impact on social life and relationships.

“It impacts your life,” Teresa said. “You have to change plans with friends if you have a sinus infection, and they get worse and worse. You’re constantly altering your life, family events, [you] just lose your energy, and they get harder to fight.”

Leo, a college student, also detailed the impact on school and physical activities.

“I swam before,” Leo said. “I can't really do that anymore just because water goes up in [my nose] and doesn't come back out. It doesn't drain. And so I end up with a sinus infection … There have definitely been times where I’m at work or I’m in class, and I can feel a bad one coming on that I have to just buckle down and know that I’m going to go take a nap or something after.”

The Need for More Nasal Polyps Support and Resources

Our report highlighted a need for more support and resources for nasal polyps. Tamara, who was diagnosed at age 14, described frustrations in the education she received from her health care provider when she was first diagnosed.

“Especially when you're talking to a 14-year-old, the big thing is compliance,” said Tamara. “And if you don't explain why compliance is important, at some point, they’re going to get tired of doing things. [They] get tired of using nasal sprays and stop because they don’t understand what can happen if they don’t. And he never bothered to explain all of that. He just said, ‘You need to take it, and it may help your ear problems,’ but that was it. He never went into details.”

As such, she explained how doing her own research as a nurse practitioner helped her learn more about nasal polyps.

“Once I became a nurse, I researched it myself,” Tamara recalls. “Sometimes you have to do your own research and be your own advocate. So that’s pretty much what I did … I was able to understand things to the point where I was better able to ask questions and get the answers that I needed.”

Teresa also talked about how important it is to raise awareness about nasal polyps among health care providers.

“I just wish more local allergists were aware,” Tamara said. “For a time, I was just seeing an allergist and a pulmonologist to treat the allergy and asthma because I had dealt with other allergists, and no one was helping … So I wish there was more training in polyps and awareness of that. I don’t feel like every allergist and every ENT is aware.”

There is also a need for more education and awareness for people with nasal polyps. Norah spoke about the need for more information on day-to-day management.

“I would just love more information. Other than what I’m doing, is there anything I can do to keep these from growing back or keep them under control? I guess it would be just more ways of controlling and keeping them from coming back.”

Georgia also stressed the importance of raising awareness among caregivers and loved ones.

“They’re looking like, ‘Huh? Polyps? I’ve heard of cancerous polyps, but not nasal polyps.’ And then you got to go through the spiel and be the doctor and break down things and give people terminologies and stuff, and they’re still lost.”

The Life with Nasal Polyps report was developed independently by AAFA and made possible by support from Sanofi and Regeneron.

*Names have been changed for privacy.

References
1. Dietz de Loos, D., Lourijsen, E. S., Wildeman, M. A. M., Freling, N. J. M., Wolvers, M. D. J., Reitsma, S., & Fokkens, W. J. (2019). Prevalence of chronic rhinosinusitis in the general population based on sinus radiology and symptomatology. Journal of Allergy and Clinical Immunology, 143(3), 1207–1214. https://doi.org/10.1016/j.jaci.2018.12.986
2. Stevens, W. W., Schleimer, R. P., & Kern, R. C. (2016). Chronic Rhinosinusitis with Nasal Polyps. The Journal of Allergy and Clinical Immunology: In Practice, 4(4), 565–572. https://doi.org/10.1016/j.jaip.2016.04.012
3. Benjamin, M. R., Stevens, W. W., Li, N., Bose, S., Grammer, L. C., Kern, R. C., Tan, B. K., Conley, D. B., Smith, S. S., Welch, K. C., Schleimer, R. P., & Peters, A. T. (2019). Clinical Characteristics of Patients with Chronic Rhinosinusitis without Nasal Polyps in an Academic Setting. The Journal of Allergy and Clinical Immunology: In Practice, 7(3), 1010–1016. https://doi.org/10.1016/j.jaip.2018.10.014
4. Bachert, C., Hicks, A., Gane, S., Peters, A. T., Philippe Gevaert, Nash, S., Horowitz, J. E., Sacks, H., & Jacob-Nara, J. A. (2024). The interleukin-4/interleukin-13 pathway in type 2 inflammation in chronic rhinosinusitis with nasal polyps. Frontiers in Immunology, 15. https://doi.org/10.3389/fimmu.2024.1356298