What You Need to Know About Asthma and COVID-19, According to Experts

Initially, experts worried that asthma could increase the severity of COVID-19 or your chances of getting it—but research is starting to say differently.

When the coronavirus pandemic first hit last year, it incited panic amongst nearly everybody, particularly those with pre-existing health conditions. Patients with asthma were no exception, as it quickly became clear that COVID-19 could lead to serious respiratory issues and after-effects.

Because asthma is a lung disease that can make breathing difficult, it made sense that asthma sufferers would want to be extra careful and cautious in avoiding the SARS-COV-2 virus. COVID-19 infections can also lead to pneumonia and acute respiratory disease, which can in turn be more serious in people with asthma.

But now, after more than a year of studying the virus, there's good news: People with asthma are no longer thought to have an increased risk of contracting COVID-19. However, there is still little data showcasing how COVID-19 infections can affect the long-term health of those with asthma, which is why experts maintain that they should still stay vigilant in avoiding transmission.

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Here's everything we know so far-and what you need to know-about the impact of COVID-19 on those with asthma.

How do the symptoms of an asthma flare-up compare to those of COVID-19?

Asthma is a treatable (but not curable) condition and will improve with use of inhalers, nebulizers and steroids, Soma Mandal, MD, a board-certified internist at Summit Medical Group in Berkeley Heights, New Jersey, tells Health. COVID-19, on the other hand, is a new infectious disease that largely manifests in respiratory issues.

Because both have a significant impact on the respiratory system, it can sometimes be difficult to distinguish symptoms of an asthma flare from symptoms of a COVID-19 infection, Samuel Gurevich, MD, a pulmonary and critical care specialist at Cleveland Clinic Florida, tells Health. Sometimes an infection (including COVID-19 but not limited to that virus) can also trigger an asthma flare-which technically means you could have both at the same time.

But one of the biggest distinctions between asthma and COVID-19 is that symptoms of an asthma flare will usually resolve with an inhaler, while COVID-19 symptoms likely won't. "Some symptoms of COVID-19 such as coughing can improve with an inhaler, but generally people with moderate to severe COVID-19 need further treatment with monoclonal antibodies, dexamethasone and Remdesivir," says Dr. Mandal.

Generally speaking, symptoms of an asthma flare or attack include:

  • Chest tightness
  • Wheezing
  • Shortness of breath
  • Coughing

According to the Centers for Disease Control and Prevention (CDC), COVID-19 symptoms can include any of the following:

  • Fever
  • Chills
  • Cough
  • Shortness of breath
  • Fatigue
  • Muscle aches
  • Loss of taste or smell
  • Headaches
  • Nausea/vomiting
  • Diarrhea
  • Nasal congestion/runny nose

It's true that some symptoms of asthma attacks also show up in COVID-19 infections, but there are more differences between the two. "While there are overlapping symptoms which can include shortness of breath and cough, asthma is more likely to present with wheeze and typically starts after exposure to a known trigger (such as pollen or smoke)," says Dr. Gurevich. "Fevers, body aches, loss of sense of taste or smell do not occur with asthma but are common [with] COVID."

If you're unsure about whether your symptoms are asthma or COVID-related, pay attention to which of the differentiating symptoms you may be experiencing and talk to your doctor before changing your treatment plan. You should also wear a mask if going out in public, as it has not been shown that mask-wearing can exacerbate asthma symptoms.

Is asthma a risk factor for COVID-19 or severe illness?

Although it was initially thought to be a risk factor for COVID-19 complications, increased hospitalization and death has fortunately not been seen in people with asthma, Dr. Mandal says, pointing to a January 2021 study in the American Journal of Respiratory and Critical Care Medicine. After analyzing 150 studies worldwide and comparing the prevalence of asthma in patients with COVID-19, researchers found that there was no clear evidence of "increased risk of COVID-19 diagnosis, hospitalization, severity, or mortality due to asthma."

The CDC, however, still lists asthma-specifically moderate-to-severe asthma-as a condition that could make you more likely to become severely ill from COVID-19.

This means you should still be mindful about keeping your asthma symptoms at bay-especially when COVID-19 is still circulating. While available data so far suggests that asthma does not make it more likely to get COVID-19 or to have a worse outcome from COVID-19, having any lung deficiency including poorly controlled asthma will leave an individual with less respiratory reserve and therefore less prepared for infections including COVID-19, Dr. Gurevich says.

"As a doctor who treats asthma regularly, I have been advising my patients to keep their asthma under control," Dr. Mandal adds. "Those patients who have uncontrolled (moderate to severe) asthma, can theoretically have worse respiratory symptoms if COVID-19 attacks their lungs."

This is based on how some asthmatics respond to other viral illnesses; for example, some asthmatics can also have asthma/ COPD overlap, Dr. Mandal says. COPD has been shown to be one of the chronic conditions that can lead to serious complications with COVID-19.

"Anecdotally, we are seeing more patients coming into the clinic after recovering from COVID with asthma-type symptoms as well as recurrence of asthma that may have been dormant for years, Dr. Gurevich adds. "There may be an alteration in the immune system due to COVID that is responsible for this and more data should be coming soon."

Should people with asthma get the COVID-19 vaccine?

While practices like washing your hands and wearing a mask in public can cut down infection risk, at this point, it's clear that increased vaccination rates are tied to a decreased risk of infections and hospitalizations and that it's the best way to beat this thing and eventually return to more of a sense of normalcy.

IInitially, it was not well known whether asthma was a strong risk factor for COVID-19 complications and experts maintained that patients with moderate to severe uncontrolled asthma have respiratory symptoms that may have been worsened by COVID-19. This was one of the reasons why they were made a priority for receiving the COVID-19 vaccine, Dr. Mandal says. While they may not necessarily have needed priority over the general public, asthma patients definitely should not be passing altogether on getting vaccinated, given the risk of increased and exacerbated asthma symptoms after COVID-19 recovery, Dr. Gurevich adds.

"While we now know that having asthma does not necessarily increase risk of COVID-19 complications, it was still a good decision to prioritize these patients until further research was conducted," Dr. Mandal says. "Unless you are allergic to one of the components of the vaccines, or you have had an actual allergic reaction to the vaccine itself, everyone should be receiving the COVID-19 vaccine at this point."

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.

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