Asthma Management During COVID-19: Canadian Thoracic Society Position Statement

The Canadian Thoracic Society’s Position Statement on the Optimization of Asthma Management during the coronavirus disease 2019 (COVID-19) pandemic had several key insights, according to a recent summary published in CHEST.

Among the insights was a discussion of how diagnosis of asthma may play a role in the risk for infection from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), or COVID-19 severity of illness. The most recent studies suggest that patients with asthma have no greater risk of acquiring COVID-19 than the general population. However, while asthma has not been identified as an independent risk factor for severe illness or death, the Chinese Centre for Disease Control and Prevention reported a higher than average case fatality rate in patients with “chronic respiratory disease.” This study is in contrast with others that showed no link between asthma and morbidity.

When asthma treatments were evaluated in light of the COVID-19 pandemic, it was determined that patients should not change or discontinue therapy, including both biologics and inhaled steroids, without the advice of a physician. Furthermore, there is no evidence of harm caused by using corticosteroids such as prednisone to treat asthma exacerbations during the pandemic. This is because the brief course of treatment used to treat acute asthma exacerbation is not expected to compromise the immune system enough to increase chances of acquiring SARS-CoV-2.

One change noted from usual care is that patients with asthma should not use nebulizers inside of healthcare facilities because of the increased risk for aerosolization of virus particles, which may increase risk for transmission to healthcare workers.

The study authors wrote, “In general, asthma maintenance and exacerbation management should continue according to national and international guidelines during the COVID-19 pandemic, however treatment decisions should be individualized based on patient characteristics.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

Licskai C, Yang CL, Ducharme FM, et al. Key highlights from the Canadian Thoracic Society’s Position Statement on the optimization of asthma management during the COVID-19 pandemic [published online May 28, 2020]. CHEST. doi:10.1016/j.chest.2020.05.551