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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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Comments (129)

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We need a practical article that will be radically honest and realistic about how to survive this as immune-compromised people. What concrete steps should we take WHEN (not “if”) this virus spreads to our community? For example, I am doing the following: procuring an N95 mask to use in public when the virus becomes pervasive; filling all prescriptions I may need if I get sick (inhalers, prednisone, etc.); getting the pneumonia vaccine to prevent the secondary infection if I can; stocking  up on goods in case I need to quarantine myself from the outside world for either protection or illness; meeting with my doctors for input; and starting an elimination diet to reduce the load on my immune system PLUS getting good sleep and exercise and increasing nutrient-dense foods. LET’S GET SPECIFIC PLEASE.

That article that supposedly shows that people with asthma are at low risk had NO people with asthma in it!  They presume that since asthma rates in Wuhan are low, that people with asthma aren't at risk. How did that get past empirical review?

I Am Curious posted:

Thank you for the updates! Super helpful!

I just wanted to point out that the one study that found no to link to increased risk of complications in persons with asthma also didn't  study anyone with asthma. Ie none of the 140 had (or knew they had) asthma. I think that's an important detail. The wording of the study itself,  concerning asthma and allergic diseases, is misleading until you read the whole thing. Two patients had COPD and they both had grim outcomes. Take what you want from that, but, because of the lack of asthma specific information published, I'm thinking either not a lot of asthma patients have gotten it (doubtful considering air quality in some places), or there just hasn't been enough time to compile info. It's hard to be patient since it's very clear that healthcare workers and researchers are likely overwhelmed in the areas hardest hit, but we have to try. Get enough sleep, stay hydrated, eat nutrient rich foods, take supplements, stay active and avoid large crowds. Most importantly, get or keep your asthma under control and wash your hands. 

Thank you again for getting this information for us. Please continue to keep us posted with allergy and asthma specific information.

Absolutely agree with you on this.  That study is not particularly helpful and I’m unclear ho they came to the conclusion they did without the direct study of asthmatics.  It’s hard not to panic.

Thank you for the updates! Super helpful!

I just wanted to point out that the one study that found no to link to increased risk of complications in persons with asthma also didn't  study anyone with asthma. Ie none of the 140 had (or knew they had) asthma. I think that's an important detail. The wording of the study itself,  concerning asthma and allergic diseases, is misleading until you read the whole thing. Two patients had COPD and they both had grim outcomes. Take what you want from that, but, because of the lack of asthma specific information published, I'm thinking either not a lot of asthma patients have gotten it (doubtful considering air quality in some places), or there just hasn't been enough time to compile info. It's hard to be patient since it's very clear that healthcare workers and researchers are likely overwhelmed in the areas hardest hit, but we have to try. Get enough sleep, stay hydrated, eat nutrient rich foods, take supplements, stay active and avoid large crowds. Most importantly, get or keep your asthma under control and wash your hands. 

Thank you again for getting this information for us. Please continue to keep us posted with allergy and asthma specific information.

The title of your article is misleading; there is no information in your article specific to people suffering from asthma. Contracting coronavirus and having asthma as an underlying condition has been highly publicized as leading to critical health issues or fatalities. Your article offers nothing specific to asthma. You should consider changing the article title to: Coronavirus: What You Need to Know, since the content is general information for the public, until you actually have content for an article pertaining to coronavirus with asthma as a comorbidity. Very disappointed.

I just read an article today that stated do not take steroids for the corona virus.  It makes it worse.
1. is this true?

2. nebulizers and rescue inhalers are essentially steroidal.  Does this also apply to them?  
3. should we try to avoid using this if we contract the virus?  

Lorene posted:
Shea posted:

I just think that N95 masks can be helpful. They found the size of the corona virus and those masks block that size particle and yes it needs a tight seal but that is perfectly possible to teach people what that is. It can help. And high-risk population should know this and have time to irder and waut fir one before it gets widespread. And its possible to make enough for everyone including healthcare workers. And it doesnt need to be mandated fir everyobe, it usnt 100 percent, but it can help...   I feel it is deceptive and inappropriate and lowers trust for the CDC and WHO and surgeon general to tell the public it wont help them. Yes you have to remove it correctly. Yes you have to get the right size and not have a beard probably. Just give us the real facts and information that yes it can be helpful:

"N95 masks fulfill the filtering efficiency criteria of the National Institute for Occupational Safety and Health (NIOSH) and are approved for protection against droplet and airborne transmission of 95% of particles greater than 0.3 microns in size. N95 masks, which must be fit tested, are believed to offer protection against the contact and droplet spread of the coronavirus."

https://www.apsf.org/news-upda...oronavirus-covid-19/

https://www.google.com/amp/s/w...QFKAGwASA%253D#ampf=

https://smartairfilters.com/en...s-n95-surgical-mask/

 

Hi @Shea N95 masks may provide a layer of protection, but they may be hard to breathe through when you have asthma or an infection. They can also be hot, and often masks lead to people touching their face more in an effort to make the mask most comfortable. Wearing a mask can't hurt, but hand washing and sanitizing are going to be our best bet for protection. Thank you for sharing your thoughts. 

Lorene 

Shea - I agree with you. I live in NYC and travel to work on the subway and wearing a n95 mask would greatly decrease my chances of contracting the virus where I am in close proximity to strangers. I do understand that the CDC and WHO are trying to quell the general population from buying/wearing masks when basic hygiene would be more helpful in the long term but they are not protecting those the with the 'underlying health conditions' that they continually mention. This is a situation where you must take your own health and well-being in your own hands. I have n95 masks and carry one in my bag daily and will not hesitate to use it when I feel unsafe.  The CDC's guidelines are too broad and general and do not speak to me, an asthmatic specifically and how can they when the response about specific conditions are - not enough data! 

I am struck by how “experts” keep reassuring the general public that there is no alarm if you’re healthy and then in passing mention the elderly and those with underlying issues are at higher risk -  like we don’t need reassurance.  Very little time is spent on these groups when talking about Coronavirus.  There are countless people that fall into these categories - lung disease, heart disease, cancers, etc. It is hard not to panic or have anxiety with the 24/7 coverage.  So i wash my hands constantly and worry about someone coughing or sneezing around me- not much you can do to protect from that other than significant social distancing and isolation.

hello , i have excerice enducted asthma and i never get asthma atacks beside when i run or do a lot of sports , did not have any atacks since like 7 months im i still going to die if contact covid 19 ? or is it only for people that have uncontrolled asthma  , last time i did the flow test i scored 250 

This is going to be the "unpopular" opinion, but it is one more should consider. You will not eliminate disease with a paper mask. You cannot prevent a future asthma attack by stockpiling medication. The virus takes about two weeks to become apparent and it will definitely have killed you within the month if it is going to be your cause of death. Do what you've always done, but do it better. Be clean. Be aware of your condition. Be considerate of those around you. Most of all, be rational. Don't risk the health of your friends, family, or community to have 2 months worth of supplies and leave them with none. More people being able to take precautions means less people spreading germs.

Last edited by Ender
Candace posted:
Ellie89 posted:

I too am desperately looking for hints on what to do in the Covid-19 situation as someone with Asthma.

From what I understand, I am not more likely to contract the virus, but it is likely that it will affect me more strongly once I do. Given the fact that at this point, we're mostly talking about "when" we will all be infected, rather than "if" - shouldn't it be the logical next step to quarantine everyone who's part of the higher risk demographic?

I have a job that I could potentially do from home, however my bosses are rather reluctant to allow it. As of now, every article and every website contains slightly different information - again, even though the common ground already seems to be that the absolute majority of people will in fact be infected. As long as there is not one unified opinion on this, or even an official statement recommending people that are at a higher risk to stay home, what do I tell my bosses? Or do I just continue to get on public transport and walk around the office, all while hoping for the best? I just can't believe there's no better way to deal with this.

Thanks in advance for your replies

My husband has adult-onset asthma and controls it with daily medication, however, I am still concerned what would happen to him if he contracted coronavirus, since I've seen him battle numerous sinus infections and suffer considerably. He is a college instructor and is exposed to many people on a daily basis. I do not have asthma, but also want to avoid becoming ill so I don't infect him, so we are both on a daily vitamin regimen of immune-boosting vitamins, including D3, C, fish oil, B2, B12, and a multivitamin that includes recommended daily doses of other immune-boosting vitamins. I have taken all of these vitamins regularly, but my husband hasn't until the past week. We also eat mostly plant-based foods and avoid processed foods and excess sugar. I also asked my husband to start exercising regularly. We exercise together for motivation. I know that 100% grape juice (3 8oz. glasses/day) also boosts immunity. I learned about it when researching how to increase immunity several years ago when I was also teaching. Taking the vitamins and grape juice and exercising at least 3 days/week enabled me to avoid becoming ill when I previously contracted an illness every quarter I taught. I have never heard anyone at the CDC or WHO recommend vitamins to boost immunity, recommend maintaining regular cardiovascular exercise, or recommend a healthy diet, but based on recommendations from our family physician and reading other physicians' advice, I feel that all of these are imporant to include into our regular regimen to avoid becoming ill in the first place. I want us to do everything in our power to stay healthy. BTW - I have not yet heard that the majority of people living in the U.S. will become infected, so I hope that is not an absolute. All the best!

Hi! thanks for sharing your tips on how your and husband stay healthy. Just a precaution, people should always check with their health care provider before starting any supplements or even vitamins to make sure they will not interfere with current medications. Eating a healthy diet and exercising are great strategies to staying healthy throughout the year. Again, talking to a health care provider to ensure diet and exercise are safe is recommended. Grape juice contains a lot of sugar, so anyone with diabetes or other conditions should OK this with their doctor. ~ Lorene 

Thank you all for submitting your questions! We are working on updating our blog above with updated numbers and recommendations. We have also sent a list of questions to our Medical Scientific Council and will share the information as soon as we hear back from the council.

Stay safe and keep washing your hands!

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.

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. 

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.

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. 

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!

I have been on a weekly allergy immunotherapy since SEP2019, does that affect my immune system or does it suppress my immune system in any way that would make me susceptible to corona virus more than someone who has regular seasonal allergies?

Collin S Magnuson posted:

Albuterol inhalers, nebulizers and other asthma treatments may significantly strengthen the lungs and help symptoms of Coronavirus and fight off the infection faster. Even people without asthma could use asthma treatments to fight corona virus.

You are going to get people killed! Do not use a nebulizer. The only time you should use it is if you have asthma and you live alone. 1. It does not "fight it off" 2. A nebulizer makes the virus into an aerosol that now has extraordinarily bigger infecton radius. If you are not a pulmonologist do not give advice you will hurt people

Hi @Collin S Magnuson, asthma medicines reduce swelling inside the airways, relax muscles that tighten around the airway and reduce excess mucus that clogs the airways. They actually reduce or stop these changes in your airway from happening, but unfortunately do not strengthen them. 

Taking your medications as prescribed is key to helping your asthma stay under control even when you get an infection or virus. When people without lung disease get a respiratory infection, asthma treatments are often prescribed to open the airways. 

Lorene 

Jeni D - what we have heard about nebulizer use is that hospitals are switching from nebulizer to inhaler because if the risk of the virus becoming airborne when treating a patient sick with COVID-19. You can read the statement here - https://community.aafa.org/blo...t-people-with-asthma

It's important to keep your child's asthma as well controlled as you can. If you have concerns, please contact their doctor. The current recommendation in general is to not stop taking any of your asthma medicine - https://community.aafa.org/blo...coronavirus-covid-19

Karleeta posted:

I am new to this so I am not sure how to go about this. I am a worried mama right now. My son who is asthmatic just had to go to the ER due to breathing problems. The said it was just his asthma due to no fever. But with it coming to close to comfort near me I am worried and want to know the true symptoms. I hear so many different things that it has me so worried. My daughter is asthmatic too but so far no breathing problems right now. Please can someone give me some possible reassurance that I am doing everything right? We have plenty of antibacterial soap and lots of sanitizer. What else should I do for them?

Hi @Karleeta we completely understand your concern and fear. Fever and a dry cough are symptoms of a virus. If your son is not running a fever it very well could just be an asthma flare. I hope he is feeling better? 

The best thing you can do is to make sure both your children take their asthma medications as directed. Do they have asthma action plans? Keep them at home as much as possible, wipe down surfaces with disinfectant wipes, wash hands often and keep them from touching their faces. At the first sign of any symptom, call your doctor to ask for guidance. 

It sounds like you are doing everything you can do, including being a caring momma. Hugs to you!

Lorene