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Coronavirus (COVID-19): What People With Asthma Need to Know

 

Update – Jan. 27, 2021

We added the following updates to this blog post:

  • Information on the COVID-19 vaccines
  • The importance of getting vaccines to prevent lung infections during the COVID-19 pandemic

Note: Because this is a constantly changing situation, any data in this blog post may not represent the most up-to-date information. We will update this blog when possible.


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What Are the Symptoms of COVID-19 Disease Caused by the New Coronavirus?

A coronavirus is a type of virus that often occurs in animals. Sometimes, it can spread to humans. In December 2019, a coronavirus named SARS-CoV-2 started spreading and triggered a pandemic (worldwide outbreak). This new coronavirus causes an illness known as COVID-19.

Now, some new strains (versions) of the coronavirus have started spreading. It is normal for a virus to change over time. The new versions are “variants” or “mutations.” Early information shows that the new coronavirus strains may spread more easily than the original strain of the coronavirus.

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
  • Diarrhea, nausea or vomiting

Other symptoms reported are:

  • Pinkeye
  • Painful blue or purple lesions (such as a sore or bruise) on toes (COVID toes)
  • Hives or rashes

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 or can’t wake up
  • Bluish tint on lips, face or fingernails

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. For many people, they may not have any symptoms at all but can still spread the virus.

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

Some symptoms are similar between these respiratory illnesses. 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 or a cold. Respiratory illnesses may worsen asthma, so it’s important to keep taking your asthma control 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 at home.



How Does the New Coronavirus That Causes COVID-19 Spread?

The virus is thought to mainly spread through talking, coughing, sneezing, singing or breathing. The virus will be in droplets that are expelled from the mouth or nose out into the air. These droplets can vary in size from small to large. Large droplets are heavy and quickly fall to the ground/surface below. Small droplets can linger in the air longer and spread more easily. This is called airborne transmission.

People who are within 6 feet (2 meters) of someone who is ill with COVID-19 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 linger in the air. If someone who is sick coughs on or near your face, you may get infected. People may be infected with the new 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.

This is why the CDC recommends everyone wear a cloth face mask in places where it's hard to keep a 6-foot distance from others to help stop the spread of illness. If you aren't wearing a face mask, cough/sneeze into your elbow or a tissue. If you use a tissue, throw it away. In either case, wash your hands after you cough or sneeze.

The new coronavirus may also live on surfaces. If you touch a surface with the virus on it and then touch your mouth, nose or eyes, you may get sick. But this is thought to be a less common way the coronavirus spreads.

No one has been reported to have developed COVID-19 from their pet. However, a small number of pets – dogs and cats – have developed COVID-19 from contact with people with the illness. The animals had very mild illnesses. For now, the CDC recommends you treat your pets like a member of your family. If someone in your home gets sick, keep the pets away from them. Don’t allow them to be around people outside of your home.

Who Is at Risk For Severe Illness From COVID-19?

Early information about COVID-19 advised that people with chronic lung disease, including asthma, may be at higher risk for COVID-19.1

The data to date (as of Jan. 27, 2021) show no increased risk of COVID-19 infection or severity of COVID-19 disease in people with asthma.  The CDC does list moderate-to-severe asthma as a possible risk factor for severe COVID-19 disease. But some studies have shown that asthma is not a risk factor.1,2,3

Based on existing evidence, the following people might be at the highest risk for severe illness from COVID-19:

  • People over age 65
  • People with chronic medical conditions, such as:
    • Cancer
    • Chronic kidney disease
    • Chronic obstructive pulmonary disease (COPD)
    • Immunocompromised people (weakened immune system), from a solid organ transplant
    • Obesity (body mass index [BMI] over 30
    • Serious heart conditions
    • Sickle cell disease
    • Type 2 diabetes
  • Children with congenital heart disease
  • Children with multiple medical conditions that are:
    • Neurologic
    • Genetic
    • Metabolic

Additionally, the following people might be at a higher risk for severe illness from COVID-19:

  • People who are male sex
  • People who are Black, Hispanic/Latino or American Indian/Indigenous American
  • People who smoke
  • People with chronic medical conditions, such as:
    • Cerebrovascular disease (affects blood vessels and blood supply to the brain)
    • Cystic fibrosis
    • Hypertension or high blood pressure
    • Immunocompromised state (weakened immune system) from blood or bone marrow transplant, immune deficiencies, HIV, use of systemic corticosteroids or other medicines that weaken the immune system
    • Neurologic conditions, such as dementia
    • Liver disease
    • Overweight (BMI between 25 and 30)
    • Pregnancy
    • Pulmonary fibrosis (scarred lung tissue)
    • Thalassemia (a type of blood disorder)
    • Type 1 diabetes
    • Possibly moderate-to-severe asthma (and other lung diseases), especially if not well-controlled

People with asthma should take precautions when any type of respiratory illness is spreading in their community. Flu season is here, and it’s important that people with asthma get the flu shot. It is possible to get coronavirus and flu at the same time. The flu shot is widely available now. Once you get a flu shot, it takes about two weeks for your body to build the immunity to the flu. The flu shot will not protect you from getting COVID-19.

While 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 related conditions do not increase your risk of getting COVID-19. They are important to help you keep your asthma under control. You are at greater risk for having an asthma attack if you stop taking your medicines. Continue to take these medicines as prescribed:

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

If you have any questions about asthma medicines and the coronavirus, 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 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.

The biggest risk to people with asthma is not treating asthma symptoms when needed at home. This can lead to visits to overcrowded emergency rooms with no hospital beds.

Disparities Among Black, Hispanic/Latino and Indigenous American Communities

Black, Hispanic/Latino and American Indian/Indigenous Americans are experiencing a major impact from COVID-19. Data collected in the United States and in the United Kingdom shows that people in these groups along with lower-income groups are disproportionately dying from COVID-19. This is likely due to long term disparities in care. Counties in the U.S. with a Black majority have six times the rates of deaths from COVID-19.4

To stay up to date on COVID-19 and asthma news, join our community so you will be alerted when new information is available.


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

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

1. Wear a mask.
A face mask needs to cover your nose, mouth and beard completely. Wear a mask when you leave your home or if you are caring for someone at home who is sick. Wear a mask if you have been exposed to someone with COVID-19. People with asthma should be able to wear a face mask. You may have to try different styles before you find one that fits best and is most comfortable.

The WHO recommends three layers:

  • An outer water-resistant layer (such as polyester or polyester blend)
  • A middle layer of non-woven fabric (such as polypropylene)
  • An inner layer of cotton


2. Keep a physical distance from other people.
In general, the more closely you interact with other people, and the longer that interaction, the higher the risk of coronavirus spread. Try to stay home when possible. 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.


Other tips to help you stay home more often and help reduce the spread of the coronavirus:

  • Stock up on 14 to 30 days’ worth of supplies (such as medicines)
  • Use online ordering for food deliveries
  • Switch to mail-order pharmacy, if your insurance plan covers it
  • Use touchless payment options if possible
  • Avoid non-essential travel
  • Skip indoor parties and gatherings with people who don’t live with you if there isn’t a way to maintain physical distancing of at least 6 feet

Also see the CDC’s guidelines on how to protect yourself at specific locations and in certain situations, such as shops, public places, gatherings and more.

3. Wash your hands 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. 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). Don’t touch your eyes, nose or mouth.

Before using your hand sanitizer, make sure it hasn’t been recalled for containing harmful ingredients by checking the FDA’s recall list. The FDA has recalled several hand sanitizers because they have methanol. Methanol is toxic and can make you sick if you put it on your skin. Some hand sanitizers have even been mislabeled as containing ethanol, but really contain methanol.

Not all hand sanitizers are effective at killing germs. To sanitize your hands for the new coronavirus, look for a hand sanitizer that contains:

  • At least 60% ethyl alcohol (ethanol), or
  • At least 70% isopropyl alcohol (isopropanol)

4. Avoid unnecessary travel.
As businesses begin to open back up, employees may need to travel for work. It is still recommended that all travel, domestic and international, be avoided if possible. Physical (social) distancing is still needed to stop the spread of the virus, so staying out of busy airports, train stations and bus stations will help. If you absolutely must travel, traveling in your personal car is probably safest because it’s easier to limit the number of people you are exposed to.

Remember that the biggest risk of getting any illness on a plane, train or bus comes from the people in the row in front and behind you and those right beside you. Sit in a window seat with an empty middle seat if possible. Ask to be reseated if someone in the row in front or behind or next to you appears ill. Think about bringing antiseptic wipes to wipe down your armrests, tray table, headrest and other areas you will be touching. Wear a face mask.

If you do travel internationally, you will have to get tested no more than three days before returning to the U.S. You will also have to show proof of a negative result. The CDC

In the U.S., if you travel to and from a different state, you may also need to take steps to isolate, quarantine or distance for 7 to 10 or even 14 days. Keep that in mind as you plan to travel.

If you plan to travel, check CDC travel precautions.

5. Ventilate indoor air.
Being outdoors is generally safer than indoors because there is better air circulation outside. Keep your indoor spaces well-ventilated by opening windows or doors, using fans, running air cleaners or using 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 new coronavirus. It may also affect the risk of transmission (how fast it spreads). To help reduce the spread of the virus that causes COVID-19 in your home or business, consider these steps:

  • 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. Get your vaccines.
Now that flu season has started, everyone must get the flu vaccine, especially people who are at high risk for both complications from the flu and COVID-19. First, a flu vaccine can help protect you, your loved ones, older adults near you, teachers and essential workers from getting the flu and can cut down your symptom severity if you do catch it. Second, it reduces the burden on our health care system by reducing the number of people who get the flu.

People who have certain medical conditions, are age 65 and older, or are under 6 should get the pneumococcal vaccine, if they haven’t gotten it in the past. If you have asthma, talk with your doctor to see if you should get the vaccine. The pneumococcal vaccine protects against a bacterial pneumonia (from streptococcus pneumonia), but it will not protect against the pneumonia that COVID-19 causes. You do not have to get it every year like the flu shot.

COVID-19 vaccines are now available for emergency use. Experts expect the Food and Drug Administration (FDA) to approve more COVID-19 vaccines as they complete clinical trials. The first set of vaccines are being given in phases, starting with health care workers, long-term care residents, older adults, essential workers, and people with other conditions that put them at higher risk for COVID-19. The general public will probably be able to get the shots by the spring of 2021. This is a great step toward ending the pandemic.

Most people can get the COVID-19 vaccines with no issues. Allergic and adverse reactions are rare.

Talk with your doctor before you get a COVID-19 vaccine if you have a:

  • Moderate or acute (short-term) illness
  • Current case of COVID-19
  • History of severe allergic reactions (anaphylaxis) to a vaccine (not including mRNA COVID-19 vaccines) or injectable medicine
  • History of an allergic reaction to PEG or polysorbate

You should not get the COVID-19 mRNA vaccine if you have:

  • Had a severe or immediate allergic reaction to a previous dose of an mRNA COVID-19 vaccine
  • A history of an allergy to any of the COVID-19 vaccine ingredients


pfizer covid-19 vaccine chart-v2
Click here for larger view


7. Regularly disinfect commonly touched surfaces.

Surfaces can contain viruses and bacteria that can make you sick if you touch the surface and then touch your mouth, nose or eyes. Use a disinfectant cleaner to clean commonly touched surfaces like door handles/knobs, remote controls, cell phones, steering wheels, tabletops, light switches, etc.

Products that clean, sanitize or disinfect may trigger asthma. When using these products, open windows, run exhaust fans, avoid spraying them into the air and wear gloves and a mask to protect yourself. If you can, have someone else do the cleaning while you are in another room or outside of the home. The Environmental Protection Agency (EPA) recommends the use of EPA-registered household disinfectants. When choosing a disinfectant, look for products that are non-scented. Also look for asthma-safer ingredients like hydrogen peroxide, lactic acid, citric acid and alcohol-ethyl or isopropyl alcohol.

According to the CDC’s How to Clean and Disinfect, clean surfaces first with soap and water to reduce the number of germs, then use a disinfectant to kill the germs. The things you touch a lot should be cleaned often, like tables, doorknobs, countertops, handles, toilets, etc. Follow manufacturer’s instructions for cleaning keyboards, phones and touch screens.

It may be hard to find cleaning or disinfecting products in stores right now. If you want to use products you already have at home, try these:

  • Use hydrogen peroxide (3%) full strength to kill the new coronavirus. Leave it on surfaces for 1 minute before wiping.5
  • You can make your own disinfectant with bleach. Add 1/3 cup of household bleach to one gallon of cold water in a well-ventilated area or outside. Wear gloves and a mask, and do not mix other cleaning products (especially ammonia) with bleach. Mix small batches and throw away after 24 hours. Bleach can trigger asthma and is harsh on the skin, so use with caution. Wash your hands after using the bleach solution.

Vinegar and essential oils (like tea tree oil) are not EPA-registered disinfectants and will not kill COVID-19.

8. Take care of your health.
Take your daily asthma medicines to keep your asthma under control. 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.

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

If you do get sick, call your doctor and follow your Asthma Action Plan.

During the COVID-19 pandemic, many people with asthma have wondered if they should monitor the amount of oxygen in their blood. COVID-19 has been known to sometimes reduce blood oxygen levels. But monitoring your blood oxygen levels is not a recommended part of home management of asthma.

Pulse oximeters (or “pulse ox”) are used by doctors to measure how much oxygen your blood is carrying. Some people with COVID-19 experience a drop in their oxygen saturation in their blood. Many people with COVID-19 are using pulse oximeters at home to watch their oxygen levels even though they are not as accurate as medical grade devices.

In general, peak flow readings or keeping a symptoms diary are the most common ways to manage your asthma (along with an Asthma Action Plan). A pulse ox may be added to this, but it is important to discuss this with your doctor. There are many ways home pulse oximeters can provide inaccurate readings. Normal pulse oximeter readings range from 92 to 100%, with 90% or below usually considered low, although some people have lower oxygenation levels normally. It is important to remember that the symptoms you feel should always come before pulse ox and peak flow numbers.

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

Similarly, there is no recommendation to use an at-home pulse oximeter to determine if you have COVID-19. Doctors may recommend using a pulse oximeter to keep an eye on oxygen levels for people with confirmed COVID-19 and high-risk factors. Some people with mild to moderate COVID-19 may need to use supplemental oxygen at home.

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

If you start having symptoms of COVID-19, call your doctor or your local department of health within 24 hours. Many states have various testing options, and your doctor or department of health can tell you what to do.

Many doctors have been offering 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 has expanded the coverage of telehealth services during the COVID-19 crisis.

How Can I Deal With Stress During the COVID-19 Pandemic?

Nearly everyone is experiencing stress because of the COVID-19 pandemic. Stress can affect your well-being and quality of life. It can be an asthma trigger. So it’s important that you take care of yourself during this time.

  • Find some self-care practices that work for you. Some examples are:
  • Try a hobby
  • Take breaks from the news and social media
  • Take care of your body through exercise, healthy eating and good sleep habits
  • Practice deep breathing and stretching
  • Keep in touch with friends and family

The CDC also offers more information on coping with stress.

When you have a chronic disease like asthma, taking part in a support group can have many benefits. AAFA has free online support groups for people with asthma and allergies. For support and encouragement through the COVID-19 pandemic, join the AAFA community.

Other COVID-19 Resources to Help You Stay Safe and Healthy

What People With Asthma Need to Know About Face Masks and Coverings During the COVID-19 Pandemic

The COVID-19 Vaccine: The Latest Information for People With Asthma and Allergies

Cleaning Your Hands With Soap Vs. Hand Sanitizer: What Is Best to Protect Yourself From COVID-19 and Other Illnesses?

Please Don’t Stop Taking Your Asthma Medicines Due to the Coronavirus – a guest blog post from Dr. Mitchell Grayson

Protecting Your Hands From Eczema During Coronavirus and Flu Outbreaks

Why Healthy Indoor Air Quality Is Important When Spending More Time Indoors Due to COVID-19

Managing Asthma at School During the COVID-19 Pandemic – AAFA’s COVID-19 and Asthma Toolkit for Schools

COVID-19 Guidelines for Schools and the Impact on Kids With Food Allergies

FDA Approves Generic of Proventil HFA Albuterol Inhaler to Meet Demand Due to COVID-19


Medical Review, Mitchell Grayson, MD, January 2021.

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. Thebault, R., Tran, A. B., & Williams, V. (2020, April 7). The coronavirus is infecting and killing black Americans at an alarmingly high rate. Retrieved from https://www.washingtonpost.com...post-analysis-shows/
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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I’m not sure the flu comparison is terribly helpful here. There is a flu vaccine which at least keeps some types of flu at bay, if not all. Despite the fact that we are generally familiar with coronaviruses, there is much we still don’t know about this one. For example, there seem to be indicators that people are spreading the virus while asymptomatic, but no one is sure how. If this is indeed the case, then that makes infection control much more difficult. 

I’m worried about my baby. She’s 15 months old, which means her immune system is weaker than an adult’s and her lungs are still developing. She was diagnosed with asthma after two hospitalizations for Rhino/Entero-induced bronchiolitis and a previous bout of RSV-induced bronchiolitis and flu. Fortunately we live in a quite isolated wilderness area but we are scheduled for medical appointments next week and for the foreseeable future to learn more about her asthma and also to see a speech pathologist, since all of this sickness seems to have set her back linguistically. Also, her dad works for a large company in an urban area, and if the above asymptomatic transmission is indeed true, he could bring it home without knowing it. We are of course worried about flu as well, but she has at least had her flu shot and so have we. We are following infection control protocol but I think it’s a pipe dream to think this thing won’t reach our state (New York).

The yardsale at the federal level is not helping. I have no faith in their capability to confront this. I hope our state health department is better.

Distributed via the CDC Health Alert Network
February 28, 2020, 1505 ET (3:05 PM ET)

Update and Interim Guidance on Outbreak of Coronavirus Disease 2019 (COVID-19)
Summary
The Centers for Disease Control and Prevention (CDC) continues to closely monitor and respond to the COVID-19 outbreak caused by the novel coronavirus, SARS-CoV-2.


This CDC Health Alert Network (HAN) Update provides updated guidance on evaluating and testing persons under investigation (PUIs) for COVID-19. It supersedes guidance provided in CDC’s HAN 427 distributed on February 1, 2020.
The outbreak that began in Wuhan, Hubei Province, has now spread throughout China and to 46 other countries and territories, including the United States. As of February 27, 2020, there were 78,497 reported cases in China and 3,797 cases in locations outside China. In addition to sustained transmission in China, there is evidence of community spread in several additional countries. CDC has updated travel guidance to reflect this information (https://www.cdc.gov/coronaviru...travelers/index.html).

To date, there has been limited spread of COVID-19 in the United States. As of February 26, 2020, there were a total of 61 cases within the United States, 46 of these were among repatriated persons from high-risk settings. The other 15 cases were diagnosed in the United States; 12 were persons with a history of recent travel in China and 2 were persons in close household contact with a COVID-19 patient (i.e. person-to-person spread). One patient with COVID-19 who had no travel history or links to other known cases was reported on February 26, 2020, in California. The California Department of Public Health, local health departments, clinicians, and CDC are working together to investigate this case and are identifying contacts with whom this individual interacted.

CDC, state and local health departments, other federal agencies, and other partners have been implementing measures to slow and contain transmission of COVID-19 in the United States. These measures include assessing, monitoring, and caring for travelers arriving from areas with substantial COVID-19 transmission and identifying cases and contacts of cases in the United States.

Recognizing persons at risk for COVID-19 is a critical component of identifying cases and preventing further transmission. With expanding spread of COVID-19, additional areas of geographic risk are being identified and PUI criteria are being updated to reflect this spread. To prepare for possible additional person-to-person spread of COVID-19 in the United States, CDC continues to recommend that clinicians and state and local health departments consider COVID-19 in patients with severe respiratory illness even in the absence of travel history to affected areas or known exposure to another case.

Hello @I Am Curious
I am happy to hear you weathered two different flu virus strains this year without complications! Most healthy people recover from flu without complications (and is what is being seen in coronavirus COVID-19 as well).  But when you have asthma, it can put you at higher risk because asthmatic lungs already have swelling.

When you have a respiratory infection, your immune system responds by creating more mucus and releasing substances from your cells to fight the virus or bacteria - but this also creates swelling/inflammation. When this happens in airways that are already compromised, it can make it much harder to breathe because the airways become more narrow. Imagine a straw that is filled with pudding and then trying to move air through that straw.

People at highest risk of complications from the flu:

  • Older age (our elder population is at greatest risk)
  • Asthma (especially untreated or uncontrolled asthma can mean there is more swelling in the airways to start with)
  • Other health conditions (heart disease, diabetes)
  • Being pregnant 
  • Kids under age 5, but especially those under age 2


Researchers and public health officials are still trying to determine risk factors for COVID-19.  It should be similar to other viruses in the same family. At this time, people at highest risk for COVID-19 are defined as:

  • People living in same household as someone with laboratory-confirmed COVID-19 infection and are not using home isolation techniques
  • People in or who traveled in Hubei Province, China

The definitions for medium and low risk are available here: https://www.cdc.gov/coronaviru...risk-assessment.html

I think it is helpful to know that walking past someone in public has no identifiable risk of COVID-19 infection. It appears to be that you have to have much closer contact (like living together, or being seated within 6 feet on a flight) for it to spread. 

At this time, asthma is not a risk factor for COVID-19 (although this could change). A look at 140 cases found no one with asthma: https://onlinelibrary.wiley.com/doi/10.1111/all.14238

People with asthma should continue to take the same precautions to avoid any respiratory illness - wash hands often, don't share food/drinks, try to avoid being right next to someone who is coughing/sneezing, etc. 

I can't find any information anywhere about patients with asthma (specifically) and COVID-19 mortality rates. I am a relatively healthy individual with mild but persistent allergy triggered asthma. My singulair seems to keep it under control. I've had the flu twice this season (different strains) with no complications. But, I am curious, so these are my questions:

 

  1. I've heard that the jury is still out on what exactly causes respiratory complications from viruses in people with asthma. Some say it's an overproduction of mucus that can become infected and/or cause an increased inflammatory response. Others say that inhaled steriods do little to one's general immune system, but could leave the lungs more vulnerable to pathogens. Both seem plausible to me, but I'm no doctor. What's your take, @AAFA Community Services ? (please no stock response like "always wash your hands" ... I'm already there, haha)
  2. Those at elevated risk include people with chronic respiratory diseases like asthma. I also know that, at least in Wuhan, COVID-19 killed significantly more men than women. Culturally in Wuhan, men smoke significantly more than women, though some doctors believe biological differences may be to blame. I know that published recommendations are general in nature on purpose because you can never be too safe, but do you have any statistics about how many cases included asthma patients and what those outcomes were? There are a million different respiratory diseases but us asthmatics are concerned specifically about asthma. 
Kathy P posted:

Hi @Azmtick - those are all great questions!

Many long-term controller or preventative medicine inhalers do contain an inhaled corticosteroid. These prevent and reduce airway swelling. They also reduce mucus in the lungs. They are the most effective long-term control medicines available. It's important to keep taking your controller medicine even when you don't have symptoms because they prevent asthma symptoms. Stopping your controller medicine may increase your asthma symptoms and the risk of complications if you do get the coronavirus, flu or other illness. If you are concerned about the steroid affecting your immune system, discuss that with your doctor.

Travel can expose you to germs. There are steps you can take to reduce your exposure and hopefully avoid getting sick. This article has lots of tips on traveling with asthma and allergies.

Thanks Kathy P. That's very useful advice.

Hi @Azmtick - those are all great questions!

Many long-term controller or preventative medicine inhalers do contain an inhaled corticosteroid. These prevent and reduce airway swelling. They also reduce mucus in the lungs. They are the most effective long-term control medicines available. It's important to keep taking your controller medicine even when you don't have symptoms because they prevent asthma symptoms. Stopping your controller medicine may increase your asthma symptoms and the risk of complications if you do get the coronavirus, flu or other illness. If you are concerned about the steroid affecting your immune system, discuss that with your doctor.

Travel can expose you to germs. There are steps you can take to reduce your exposure and hopefully avoid getting sick. This article has lots of tips on traveling with asthma and allergies.

I have intermittent asthma. I usually manage my symptoms (wheezing during the pollen season) with antihistamines and sometimes the Ventolin inhaler. I had an attack about a month ago and the last time before that was 10 years ago. For the most recent attack, I was prescribed Deltacortril for five days, and they certainly sorted the problem. The doctor also suggested I take a preventive inhaler to keep the asthma at bay.

However, I read on the internet that the preventive inhaler which delivers a small dose of steroids can weaken the immune system. So in light of the coronavirus outbreak, should I not take the preventive inhaler? I should add the I travel overseas regularly. 

We have updated this blog post to reflect more recent information on the 2019 new coronavirus (COVID-19). Even though coronavirus numbers have risen worldwide, people in the U.S. are still at a greater risk of getting the flu. 

Keep washing your hands and avoiding people who are sick. And don't forget to follow your Asthma Action Plan if you start feeling ill. 

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