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


Update – July 16, 2020

We added the following updates to this blog post:

  • Link to AAFA's COVID-19 and Asthma Toolkit for Schools
  • Link to COVID-19 guidelines for parents and schools on managing food allergies
  • Information on proper air ventilation to help reduce the spread of the new coronavirus
  • Updated symptoms
  • Updated list of who may be at risk for severe illness from COVID-19
  • New questions and answers on proton pump inhibitors and oral corticosteroid use

Other resources available include:

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.

What Is the New Coronavirus?

A coronavirus is a type of virus that often occurs in animals. Sometimes, it can spread to humans. This is rare.

In December 2019, a new illness called COVID-19 started spreading. COVID-19 is caused by the SARS-CoV-2 virus.

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 have 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 believes symptoms may appear two to 14 days after coming in contact with the virus. WHO has declared it a global pandemic (an outbreak of a new virus that spreads easily).

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.

Confused by your symptoms? @AAFANational explains what the typical symptoms are for different respiratory conditions. Information for people with asthma - #COVID19 #asthma

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Information is still changing. We will update this chart as new evidence comes out.

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

The virus is thought to mainly spread through talking, coughing or sneezing. The virus will be in droplets that are expelled from the mouth or nose out into the air. These are heavy droplets and they quickly fall to the ground/surface below.

People who are within 6 feet (2 meters) of someone who is ill with COVID-19 may be within the zone that droplets can reach. If someone who is sick coughs on or near your face, you may get infected. Studies now show that some people may have COVID-19 and not show symptoms. They may spread the virus without knowing it.

This is why the CDC now recommends everyone wear a cloth face covering 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 covering, 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 that people have coughed on. If you touch a surface with the virus on it and then touch your mouth, nose or eyes, you may get sick.

Who Is at Risk 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 7/16/20) 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 there are no published data to support that at this time.1,2,3

Based on what we know at this time, 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:
    • Chronic kidney disease
    • Chronic obstructive pulmonary disease (COPD)
    • Immunocompromised people (weakened immune system), from a solid organ transplant
    • Obesity (body mass index [BMI] of 30 or higher)
    • Serious heart conditions
    • Sickle cell disease
    • Type 2 diabetes
  • Children with congenital heart disease
  • Children with multiple medical conditions that are:
    • Neurologic
    • Genetic
    • Metabolic

Based on what we know at this time, 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
    • Pregnancy
    • 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.

It’s important for people with #asthma to know how to protect themselves from #coronavirus. @AAFANational provides answers -

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Disparities Among Black, Latinx/Hispanic and Indigenous American Communities

Communities of color are experiencing a major impact from COVID-19. Recent data collected in the United States and in the United Kingdom shows that Black, Latinx/Hispanic and Indigenous (American Indian/Alaska Native) patients 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

Physical (Social) Distancing Guidelines for People at High Risk

The CDC has released guidelines for people who may be at high risk (including people with asthma):

  • Stock up on supplies (a 14- to 30-day supply)
  • Try to find ways to have food and supplies delivered to your home
  • Limit interactions with people, and stay home as much as possible
  • Wear face masks or coverings outside the home
  • Keep a distance from others (social distancing, about 6 feet)
  • Avoid people who are sick, limit close contact and wash your hands often
  • Avoid crowds as much as possible
  • Avoid non-essential travel
  • Clean and disinfect your home and car regularly, especially items you touch often like doorknobs, light switches, cell phones, car door handles and steering wheels, etc.

Air Pollution

A Harvard study shows that people who live in areas in the U.S. with high air pollution may be more likely to die from COVID-19.5 If you live in a high-pollution area, try to reduce how much you are exposed to outdoor air pollution. Stay home as much as possible to avoid traffic. Keep your windows closed and use central air conditioning if you have it. Change or clean your air filters properly according to the manufacturer’s instructions, as well. Watch air quality reports and stay inside on days when air quality is worse.

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

The steps you take to avoid the flu and other respiratory infections will also help protect you from COVID-19:

  • Wash your hands often with soap and warm water for 20 to 30 seconds, and always after coughing or sneezing. If you don’t have access to running water, use an alcohol-based hand cleanser that is at least 60% ethyl alcohol (ethanol) or 70% isopropyl alcohol (isopropanol).
  • Don’t touch your eyes, nose or mouth.
  • Stay away from people who are sick or have been in contact with someone who is sick.
  • Don’t share makeup, food, dishes or eating utensils.
  • Wear a cloth face cover per new CDC guidelines.
  • Take your daily asthma medicines to keep your asthma under control.

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.

If you plan to travel, check CDC travel precautions.

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) – although doctors may reduce telehealth appointments as practices open back up. 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.

Should I Wear a Face Mask or Face Covering to Prevent Spreading the New Coronavirus?

Most people with asthma can wear a face mask or cloth face covering safely. It is important to find an option that is comfortable and breathable.

Evidence shows that as many as 25 to 50% of people with COVID-19 may not show symptoms, which means you can spread the virus before you know you have it.

The CDC recommends that Americans wear cloth face masks or coverings when you leave home to keep you from accidentally spreading the virus. The WHO also recommends face coverings. A face covering can catch droplets from your mouth and nose so you don't spread them to people nearby. You can use a scarf, a bandanna or a homemade fabric mask. Use material that you can machine wash and dry without damage.

To tell if a homemade face covering will be sufficient, shine a light through it. If the light shines easily through it, you may need to add more layers or use a different fabric. The WHO recommends face coverings made with three layers. Make sure your face covering blocks the light but still allows you to breathe through it.

Because of the limited supply, the CDC urges you NOT to purchase N95 masks. We need to save the supply for health care workers who already don’t have enough supplies.

You must still continue to practice physical distancing even if you wear a face covering. A face covering will not give you 100% protection from spreading or catching the new coronavirus. But it will help you and others greatly reduce the chance of spreading it, especially if you aren’t showing symptoms.

Masks may not be appropriate for children age 2 and younger. It’s best to keep kids at home where they do not need to wear a mask.

It is important to follow proper steps when using a face covering or mask. Follow these steps when using a face covering or mask:

  1. Wash your hands before putting on a face covering or mask.
  2. Fully cover your mouth, nose and beard. Make sure there are no gaps between the face covering or mask and your skin.
  3. Avoid touching the face covering or mask while using it.
  4. If your face covering or mask gets damp, replace with a clean one and wash if reusable. If it's disposable, throw it away and replace with a new one.
  5. Remove the mask from behind, trying to not touch the front. Wash washable face coverings right away. Throw away disposable masks into a closed bag or trash can.
  6. Wash your hands with hot water and soap for 20 to 30 seconds.

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What Role Does Air Ventilation Play in the Spread of the New Coronavirus?

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.

Should I Keep Appointments With My Allergist During the COVID-19 Pandemic?

Many health care providers are beginning to see patients in their offices again. As they open up, procedures may change. They may reduce the number of people in the waiting room. They may also take your temperature and ask you about symptoms. You may also be asked to wear a mask.

Your doctor may also ask you to track your peak flow readings at home instead of doing lung function tests in the office to reduce the chance of spreading the virus.

With pollen high in many parts of the U.S., regular allergy shots are an effective way to help you manage your allergy and allergic asthma symptoms. Check with your allergist's office to find out what changes they have made to how they are giving allergy shots. Continue with your allergy shot schedule unless your allergist tells you differently, practicing proper physical distancing.

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 getting enough sleep
  • 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.

What Do People With Asthma Need to Know About the New Coronavirus? Frequently Asked Questions Answered by Dr. Mitchell Grayson

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.
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.
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.
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
5. Air pollution linked with higher COVID-19 death rates. (2020, April 7). Retrieved from
6. Heneghan, C. (2018, January 30). Self-management of asthma – is there an app or pulse oximeter for that? Retrieved from
7. 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

How do you stay healthy and avoid asthma symptoms during cold and flu season? Join our community to learn more about protecting yourself from the flu and COVID-19.


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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)
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 (

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:

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:

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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