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

 

Update – Nov. 15, 2021

We updated this blog post to include updated information and guidance from the Asthma and Allergy Foundation of America (AAFA) and the Centers for Disease Control and Prevention (CDC).

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.


In December 2019, a new coronavirus named SARS-CoV-2 started spreading and triggered a pandemic (worldwide outbreak). This coronavirus causes an illness known as COVID-19.

The coronavirus 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, 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, or a cold:



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 5 years and older can get the COVID-19 vaccines for free with no out-of-pocket costs in the United States. There are currently three vaccines available: Pfizer-BioNTech, Moderna, and Johnson & Johnson (J&J).

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.


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.

AAFA recommends that you postpone any unnecessary travel during the COVID-19 pandemic. 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.

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. 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.

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

  • At least 60% ethyl alcohol (ethanol), or
  • At least 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, call your doctor or your local health department within 24 hours. Many states and local pharmacies have various testing options (including at-home or drive-thru tests), and your doctor or department of health can tell you what to do. In the meantime, stay home and isolate from family members so you don’t spread the coronavirus to other people.

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 expanded the coverage of telehealth services during the COVID-19 crisis.


Medical Review, Mitchell Grayson, MD, October 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.2020.04.0613. 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.5754. 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.2021.07.0305. 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/

The Asthma and Allergy Foundation of America (AAFA) is the largest and oldest nonprofit patient organization dedicated to asthma and allergies. Our online community includes public blogs. To post a comment, you will need to register or sign in.

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I find I can do best in lightweight cloth masks like the 3 ply ones at Old Navy, with a mask brace underneath it to hold it off the face some, a stick-on metal nosepiece so it doesn't leak/fog glasses (they come in packs of 100 on Amazon for cheap), and avoid strenuous activity while wearing it, I usually only wear it inside and 6 foot distance both in and outside, AND if its for long periods, I found these fan necklaces that are quiet but blow air up on you to help reduce the heat/humidity caused by the mask-- I find the heat/humidity is what bothers my asthma most and those things all help. Also -- glasses defogger wipes or the special coating on your glasses are helpful if you wear them. The main thing is to stay calm and keep breathing steady, and not be too active. Mask breaks are helpful, outside 6 feet from others. N95s are a quite a bit more difficult for me for longer periods but if others arent masking around me or its a high risk environment, I use them short term until I get out of that environment.

So yeah.. Fan necklace:

https://www.bedbathandbeyond.c...wcB&gclsrc=aw.ds

No one is regulating Indoor temp, humidity, PM 2.5, CO2, NO2 air quality levels.. Be careful make sure you obtain IAQ and Surface protection info from fellow asthma members or certified IAQ and Surface protection contractors. 

Thomas E. Martin III

You better buy a proper mask Exposure to CO2 can produce a variety of health effects. These may include headaches, dizziness, restlessness, a tingling or pins or needles feeling, difficulty breathing, sweating, tiredness, increased heart rate, elevated blood pressure, coma, asphyxia, and convulsions...
ask for 2020 certification when seeking IAQ and surface Protection...

Thomas E. Martin III

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Hello @karim. I think maybe your question got lost in the spring. There are many updates since then. Take a look at the Frequently Asked Questions at the end of the blog above. Click them to open.

Two especially for you:

Are people with asthma at higher risk of catching the new coronavirus? (Updated 7/16/20)

Are people with asthma at higher risk of more severe symptoms from COVID-19? (Updated 6/25/20)

Hang in there!  All the best.



 

Last edited by Compton

Hello, I have asthma. Should asthma people wear masks? I have to go back to school soon and we all have to wear masks. Masks bother me, because it makes it hard to breath and starts to make me have an attack. I hope, I don’t have to even thought it is a lot of exposure. Thanks

Hi @Tanner Marie Martinez here is our updated guidance on masks. I hope it helps! 

Lorene 

Lorene Alba, AE-C

Director of Education 

AAFA 

My doctor recommended using an N95 mask with a cooling feature. I don't know how hard these are to get since most need to go to medical professionals, but we just happened to have some from a purchase for another purpose 10 months ago. They make breathing MUCH easier.

Hello, I have asthma. Should asthma people wear masks? I have to go back to school soon and we all have to wear masks. Masks bother me, because it makes it hard to breath and starts to make me have an attack. I hope, I don’t have to even thought it is a lot of exposure. Thanks

Thank you. Still a bit of a struggle, but I am able to rest because my wife is taking up my slack, bless her heart. I do not think I've turned the corner because, after improving  earlier in the week, I began to get more ill again as the week has evolved. I understand that this happens with his virus, so I'm just going to take as long as I need to recover.

@Wolfbane I am so sorry to hear you have COVID-19, but thank goodness you are not as ill as you could be. 

How are you feeling after 2 weeks, do you think you've turned the corner? 

Sending healing vibes your way!

Lorene 

Lorene Alba, AE-C

Director of Education 

AAFA 

I have COVID-19 and asthma. I also have other health conditions and am over 65. I am not as ill as I expected (going on two weeks with it). I have to wonder of those of us on corticosteroids have some protection from the inflammation that is so deadly with COVID-19. I have to be on prednisone for adrenal insufficiency as well as well, so it's a bit different for me, but with the mortality rate for asthmatics with COVID-19 being below what would be expected, it gives me pause about this link.

People suffering from severe to moderate asthma are considered at high risk of getting infected from the coronavirus. The virus affects your respiratory tract, and most probably, it can trigger an asthma attack. There is also a possibility that the situation gets more critical and led to pneumonia and acute respiratory disease. Pharmaceutical companies are still working on the COVID19 mediation, and it will take a few months to be available in the market. So, the best way to avoid getting exposed to coronavirus is to stay at home, eat healthy food, maintain social distancing, and take your asthma medication on time. Ventolin inhaler helps to cope up with an asthma attack and easily available online to purchase from Alldaychemist.com.

Anthony Constantinou says, “We need to keep our preventer inhaler daily as prescribed. This will be helpful to cut risk of an asthma attack being triggered by coronavirus or any respiratory virus.”

@Maja posted:

Hi i am from Europe. And i have asthma for many years. I am very scared now because COVID19. I follow all instructions. I haven't been out of the apartment already 2 months. I live with my parents who are retired. Only my father went out for food once a week and always wore a mask. I have had a low temperature 37.2 for 14 days. It changes during the day. In the morning I don't have and in the evening increases to 37.2 when I fall asleep it is normal. I don't have other symptoms. What is happening to me?

Hi @Maja - it sounds like you're doing everything right. I'm sorry you have a fever. Calling your doctor and asking what you should do is recommended. 

Many of us are scared as well - sending hugs! Please let us know what your doctor says and keep us posted on how you are feeling. 

Lorene 

Lorene Alba, AE-C

Director of Education 

AAFA 

Hi i am from Europe. And i have asthma for many years. I am very scared now because COVID19. I follow all instructions. I haven't been out of the apartment already 2 months. I live with my parents who are retired. Only my father went out for food once a week and always wore a mask. I have had a low temperature 37.2 for 14 days. It changes during the day. In the morning I don't have and in the evening increases to 37.2 when I fall asleep it is normal. I don't have other symptoms. What is happening to me?

It seems from the information that I've read about COVID-19, the virus is highly unpredictable; symptoms and outcomes vary widely, depending on the strength of each individual's immune system, comorbidities, and age. Physicians and researchers are still uncovering many details of how the virus affects different patient populations, and they learn new information every day. They report that some with underlying conditions survive the virus, while many others die, which is why health experts have advised everyone, especially those with underlying conditions at any age, to take all precautions. As far as comparing COVID-19 to car accidents, it was interesting to read that statistics show approximately 40,000 people in the U.S. die in car accidents each year. As of today, it has been reported that more than twice that amount, over 80,000 people in the U.S., have died of COVID-19, within months. Surprisingly, we have a much greater chance of dying from COVID-19 than from perishing in a car accident. Stats also show that the current COVID-19 death rate in the U.S. has reached 6%, and an individual state's percentage is as high as 8%: https://www.worldometers.info/coronavirus/country/us/. Stay safe out there. 

Hi Karim, I have cold induced, which can also be induced by a sharp change in temperature by 35 degrees in less than 24 hours,and I don't think ive gotten more than a 200 on my flow. I also haven't had to use my nebulizer in just over a year and spent most of my morning winters in the ER. My mothers friend is one of the head nurses for the covid situation here in New Jersey, I explained how I felt weeks ago to her the other day, she confirmed that I may have in fact had it. I did not however contract pneumonia, nor was it all that bad. I took my inhaler and I was fine, tbh if i did have it, it was underwelming. Plus the death rate for not just us but anyone who has been infected across every state is 3%. Thats just higher than the number of car accidents you may see in a week at this point. Take some light asthmatic precautions and you'll be fine(as long as you are under 60).

Melissa G posted:

Savail, here is a free online asthma care course. It goes over asthma triggers, symptoms and medications. 

Melissa G posted:

Hi Islandgirl, welcome to the AAFA forums! That is a great question, have you consulted with your dr about your concern?

You can also submit your question to our "Ask The Allergist". 

Savail, you are correct, there is conflicting information on wearing masks. This is the latest recommendation from the CDC for people with asthma. Have you ever seen an allergist or pulmonologist? 

Hello..yes..I am now on maintenance and was told that it is "building" my immune system. 

Hi @Islandgirl - that's a great question and we did ask our medical experts about allergy shots:

Should I Continue to Get Allergy Shots During the COVID-19 Pandemic?

With spring pollen on the rise in 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 social distancing.

Hi @savail -  AAFA has reached out to the CDC to share concerns and questions about masks and face coverings. We will update our community as new information develops.

During pregnancy, wimen can see their asthma symptoms get better, worse or stay the same. It's sounds like yours may have gotten worse. Have you checked bin with your doctor about your increased issues? They can best guide you to a treatment plan that will keep you and the baby safe and healthy. www.aafa.org/pregnancy

Miss Melissa, no, I have not unless it was when I was a young child. I know I was diagnosed with sinus problems around threeish and that on more than one occasion, they told my mother I would always have breathing problems without some kind of surgery. I was 'prescribed' a variety of different generic OTC allergy/sinus meds from childhood all the way through high school. I didn't have issues with activity or sports at the time, and according to doctors had adjusted well, so really, the only tell was that I constantly had bags under my eyes from a young age and struggled to eat with my mouth closed.

When I started having wheezing fits in high school, we just assumed it was sinus/bronchitis related, and I dealt with it, because we didn't realize there was anything that could be done. Menthol cough drops were my best friend if I had to do any activity, and I tried to stay indoors if people were burning cedar. When I was older, if I was having trouble breathing around bedtime, I'd drink an energy drink for the one-two combo of it putting me to sleep and making it a bit easier to breathe.

And yes, I've been keeping an eye on both the CDC page that you linked and the FAQ page about cloth coverings, which just states not to if you have "breathing problems." Very helpfully vague. I appreciate your response!

Hi Islandgirl, welcome to the AAFA forums! That is a great question, have you consulted with your dr about your concern?

You can also submit your question to our "Ask The Allergist". 

Savail, you are correct, there is conflicting information on wearing masks. This is the latest recommendation from the CDC for people with asthma. Have you ever seen an allergist or pulmonologist? 

Melissa

Grace: seasonal allergies, asthma

Josh: allergic to peanuts and tree nuts, asthma

Bekah: allergic to most foods, currently eating peaches, pears, apples and bacon, asthma, g-j tube fed, portacath for hydration

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