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Infectious Diseases

Updated 20 July 2020

Why coronavirus complications may not be as severe in asthmatics

More research is needed to answer critical questions around why asthmatic patients suffer fewer severe Covid-19 complications than those with other comorbidities.

  • Asthma appears to have less severe implications for Covid-19 patients than other comorbidities
  • Research needs to be conducted to assess the role inhaled corticosteroids could play in Covid-19
  • Age might, however, be skewing the statistics as children are more likely to suffer from asthma

Does asthma contribute to cytokine storm syndrome conditions in severely ill patients?

It is well-documented that old age and comorbidities like diabetes, obesity, heart disease and chronic obstructive pulmonary disease (COPD) have serious implications for Covid-19, but when it comes to asthma there seems to be some debate. 

READ: Asthma, allergies, Covid-19 and your child: here’s what you need to know

A review from Rutgers University scientists published in The Journal of Allergy and Clinical Immunology: In Practice asked some serious questions about asthma, and suggested that a better understanding of the interaction between asthma and the coronavirus could help us find new treatments.

In general, asthmatic episodes appear to be under control in terms of hospital admissions, although fear of infection might be keeping asthmatics away from the hospital.

One theory is that asthmatic people have become more vigilant during the pandemic, with physical distancing measures limiting their interactions with triggers like pollution and allergies. Also, the hyper-vigilance might also be fuelling stricter adherence to medication.

Corticosteroids could be good or bad

Another question raised in the review is whether the inhalation of corticosteroids – part of traditional asthma treatment – could be reducing the virulence of the virus in the lungs by limiting expression of ACE2 receptors. Alternatively, it could be increasing inflammation while making the body's immune response less effective.

"The tropism for SARS-CoV-2 to the upper airway epithelium and the use of inhaled corticosteroids provide a real-life laboratory to test whether these attributes modulate infectivity and disease progression," write the researchers.

READ: Asthma ups ventilator needs of younger adults with Covid-19

Age is also a factor to consider – asthmatic sufferers tend to be young in comparison with patients with other comorbidities, and this could be skewing the results when looking at severe Covid-19 illness linked to asthma patients.

Compared to COPD and cardiovascular diseases, asthma also has far less severe complications when it is coupled with Covid-19 infections. 

While far more research is still needed, those with controlled asthma can at least breathe a little easier as the pandemic continues.

READ: Don't cut back on asthma meds during pandemic

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