Around the globe, we are currently facing an unprecedented situation the world has never seen before. The novel coronavirus (COVID-19) is spreading rapidly, forcing politicians, health experts, and the rest of the population to adopt new approaches. Especially people with pre-existing respiratory tract conditions such as asthma are extremely worried about contracting the coronavirus.
For this reason, we have put together up-to-date information from experts intended to answer your most pressing questions:
Are asthmatics more at risk than others of becoming infected with coronavirus?
The lung specialists from the Verband Pneumologischer Kliniken (VPK – German Association of Pneumological Clinics) say that asthmatics whose disease is well controlled are in principle at no greater risk of a coronavirus (COVID-19) infection than healthy people. According to the VPK, asthmatics whose therapy is well managed and well adjusted generally do not have an increased risk of infection. Provided, that is, that they continue to take their medication regularly.
Are people with pre-existing respiratory tract conditions at greater risk of experiencing more severe disease progression due to coronavirus (COVID-19)?
Although according to the Robert Koch Institute, severe cases frequently occur in patients without any underlying conditions, the following groups of persons have been identified as having a higher risk of developing serious symptoms:
- older persons (with the probability of serious disease progressions increasing steadily from around 50 – 60-year-olds)
- people with certain underlying conditions affecting:
- the heart (e.g. coronary heart disease),
- the lungs (e.g. asthma, chronic bronchitis),
- patients with chronic liver disease,
- patients with diabetes mellitus,
- cancer patients,
- patients with a weakened immune system (e.g. due to an illness associated with immunodeficiency or treatment with immunosuppressive drugs, such as cortisone).
Should I continue taking cortisone medicines that inhibit the immune system during the current coronavirus pandemic?
What will happen if asthmatics simply discontinue their medication?
Experts warn that suddenly discontinuing medication or changing your treatment can exacerbate asthma to the point that (otherwise avoidable) doctor’s visits or even hospital admissions become necessary. The risk to people with asthma of coming into contact with COVID-19 patients and getting infected there is significantly higher than a possible, as yet unconfirmed, risk of being more likely to catch the novel coronavirus as a result of taking immunosuppressive drugs.
When do we speak of controlled or uncontrolled asthma?
According to the Lungeninformationsdienst (Lung Information Service), a medical distinction is made between three degrees of asthma control, which form the basis for asthma therapy (adjustment):
- controlled asthma,
- partly controlled asthma,
- uncontrolled asthma.
With the help of easy-to-determine criteria, physicians are able to assess the degree of symptom control. The four questions relate to the last four weeks before the present check-up:
- Have you experienced daytime symptoms more than twice a week?
- Has your asthma caused you to wake during the night?
- Have you had to take on-demand medication more than twice a week (exception: when doing sport)?
- Has your asthma restricted you in your activities?
If none of these questions is answered with a “yes”, the asthma is considered controlled. If one or two criteria are met, the asthma is deemed partly controlled. In the case of three or four “yes” answers, we speak of uncontrolled asthma. Among children and youths, the classification is somewhat narrower. If they display daytime symptoms or need reliever medication, irrespective of how often, medical experts speak of partly controlled asthma.
Why is good asthma control important?
Being diagnosed with bronchial asthma is initially worrying for many people. According to the Deutscher Allergie- und Asthmabund (DAAB – German Allergy and Asthma Association), nowadays most children and adults with a diagnosis of asthma are able to live a perfectly normal life (including activities and sport, even competitive sports) provided that the disease is well controlled and shows a stable pattern. Asthma can be well controlled through continuous therapy supervised by a doctor and through targeted self-management. Ideally, primary-care physicians should regularly monitor whether their patients present controlled, partly controlled or uncontrolled asthma symptoms.
What’s the best way to protect myself against catching coronavirus?
General recommendations issued by the Robert Koch Institute and the Federal Ministry of Health on prevention of COVID-19:
- Observe the rules for coughing and sneezing
- Wash your hands frequently and thoroughly with soap and water (for at least 20 to 30 seconds)
- Wherever possible, maintain a minimum distance of 1.5 meters from other persons
- Don’t shake hands
- Don’t touch your face
- Wherever possible, stay at home
How can I generally protect myself against respiratory infections?
Apart from the general hygiene rules such as washing your hands and social distancing, the German Standing Vaccination Committee (STIKO) recommends vaccinations against the flu (influenza) and pneumococcus for certain groups of persons. This is based on the rationale that bacteria and viruses that cause inflammation of the bronchial tubes or lungs, or even a straightforward cold, can aggravate asthmatic symptoms. Getting vaccinated against pneumococcus and flu is therefore meaningful and appropriate – also with a view to preventing simultaneous infection with several different pathogens, which would place the organism under additional strain and exacerbate the course of the disease.