The outbreak of novel coronavirus – a virus that causes respiratory symptoms – has a lot of Canadians with asthma worried.
Asthma is already a disease that can cause trouble breathing, and catching the virus could make things worse, experts warn.
Around 3.8 million Canadians have asthma, according to Asthma Canada.
Having asthma doesn’t put someone at greater risk of catching the novel coronavirus though.
“At this time, there’s no data to suggest that people with asthma are more likely to contract COVID-19,” said Vanessa Foran, CEO and president of Asthma Canada.
“They’re not more at risk for catching COVID-19,” agreed Dr. Shawn Aaron, a respirologist at the Ottawa Hospital and spokesperson for the Canadian Lung Association.
“The risk for actually contracting the infection is the same as anyone else.”
However, he said, “If they do get the infection, there is somewhat more risk that the infection may be severe and may tend to ultimately lead to hospitalization compared to the average person with COVID-19.”
“These people have underlying lung disease and if their lung function is already somewhat compromised because of the asthma, then they get a second hit. That is, the COVID-19 infection causes a second hit,” he said.
“People with asthma may be at a higher risk of getting very sick from COVID-19 because it can cause an asthma attack or lead to pneumonia or acute respiratory disease,” Foran said.
Viral infections, like COVID-19, can cause asthma symptoms to “flare up,” explained Dr. Susan Waserman, a professor and director of the division of clinical immunology and allergy at McMaster University. This makes it particularly important to keep asthma under control with medication and follow asthma action plans, to avoid having an asthma attack or other symptoms if you get sick.
But while people with asthma might react to viral infections, data so far shows that having asthma doesn’t appear to be a major risk factor for dying from COVID-19, she said.
“Any virus can cause an asthmatic exacerbation,” she said. “But asthmatics have not been seen to be at undue risk. The mortality has more been described in those 65 and over, those with underlying cardiovascular disease, diabetes, other comorbidities. But asthma has not emerged as a critical factor in severity, at least not yet.”
Asthma is absent from a list of the top 10 comorbidities (or additional conditions) in patients who died of COVID-19 in New York State.
A commentary published in early April in the Lancet medical journal, based on early data, found that both chronic obstructive pulmonary disease (COPD) and asthma “appear to be under-represented in the comorbidities reported for patients with COVID-19.”
The authors aren’t sure why. They guess that it might be because these respiratory diseases are underdiagnosed or underreported, they wrote, or that the immune response in patients with asthma is different, or that medications used to control asthma actually have a protective effect – but none of these things have been proven.
Right now, the best thing for people with asthma to do is to take their medication as directed, Aaron said. “If their asthma is not well-controlled and let’s say their lung function is only 70 per cent of what it should be, they’re going to be much more vulnerable if they get a COVID infection to get really sick.”
“So asthmatics during the COVID epidemic, if they want to protect themselves, should be religious about taking their medication.”
Practising physical distancing, like staying at home and maintaining a safe distance from others, is important too, as is good hand hygiene, he said, to avoid catching the virus in the first place.
Waserman also advises people with asthma to monitor their symptoms if they get sick, whether it’s with COVID-19 or any other illness.
“If you do develop symptoms, you’ve got to follow your action plan much as you would if you were to catch any other virus. You know, if there’s fever, if you’re especially short of breath, you’ve got to seek medical attention and likely get a COVID test under those circumstances.”
Questions about COVID-19? Here are some things you need to know:
Health officials caution against all international travel. Returning travellers are legally obligated to self-isolate for 14 days, beginning March 26, in case they develop symptoms and to prevent spreading the virus to others. Some provinces and territories have also implemented additional recommendations or enforcement measures to ensure those returning to the area self-isolate.
Symptoms can include fever, cough and difficulty breathing — very similar to a cold or flu. Some people can develop a more severe illness. People most at risk of this include older adults and people with severe chronic medical conditions like heart, lung or kidney disease. If you develop symptoms, contact public health authorities.
To prevent the virus from spreading, experts recommend frequent handwashing and coughing into your sleeve. They also recommend minimizing contact with others, staying home as much as possible and maintaining a distance of two metres from other people if you go out.
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