ASTHMA PATIENTS SHOULD TAKE EXTRA CARE DURING THE CURRENT PANDEMIC DR. RAKESH KUMAR CHAUDHARY

Chronic respiratory conditions account for a massive health burden in India, at around 93 million, out of which nearly 37 million are asthmatics. As stated by WHO more than 235 million people suffer from asthma across the globe and India contributes to 11.1 per cent of the global asthma burden and about 42 per cent of related deaths making it the asthma capital of the world. Million are suffering from asthma round the globe meanwhile catastrophic Covid -19 pandemic causing a huge burden on health care system with loss of humanity in whole world and a huge economic crisis. Respiratory viral infections are the primary cause of asthma exacerbations in moderate to severe asthmatics and it can lead to pneumonia and other acute respiratory diseases in adults and children. COVID -19 viruses could be like other respiratory virus, which can exacerbate the asthma but there is no published data to support this. So not only our country but over the globe need more vigilance in asthmatics to take utmost care in the current time of pandemic.

1.Does asthma really increase the risk of contracting COVID-19 or Covid infection increase the asthma attack?

Currently there is no evidence to say that asthmatics have a higher risk of contracting COVID-19 infection. Some early reports and the CDC stated that people with moderate to severe asthma may have higher risk of becoming very sick if they contract the virus.

2.1s it advisable for asthmatics to continue using their corticosteroid inhaler in this current pandemic or not?

Patients with asthma should continue their corticosteroid inhaler unless asked to stop by medical professional or doctor. In the current pandemic, the best thing a person with asthma can do is to keep their asthma under control by their regular inhalers use. Stopping steroid inhaler will put the person at risk for developing an asthma exacerbation. In the current pandemic, treatment of an exacerbation will likely require going to the emergency department or urgent care, where the individual has a much higher risk of being exposed to someone with an infection. So, in a way, by continuing to keep asthma under control, the person with asthma is actually reducing their chance of exposure to viral infections.

3. Management if asthmatics experience worsening of his/her symptoms?

Asthmatics should follow the Asthma Action Plan as recommended by their doctor. Recent recommendation round the world is to use an MDI with a spacer to relieve acute symptoms instead of nebuliser to prevent risk of transmission of viral infection because they generate aerosols that can spread infectious droplets for several metres. But in severe attacks nebuliser can be used following good nebulisation and infection control practices as advised by your doctor.

4. What should asthmatics do if they have symptoms of fever and cough?

If any known asthmatics develop any symptoms like fever, cough, breathlessness, body aches, etc.,must immediately consult the doctor and follow all instructions.

5. Should asthmatics go for scheduled appointments or should they avoid going to medical centres, clinics or hospitals?

Better to contact your doctor through tele-consultation instead of visit to clinic or hospital to update your progress. In case of absolutely necessity please take a prior appointment and avoid any unscheduled visits.

6. Why and how inhalation therapy is a better way to control asthma even during the current situation?

Medical management to treat asthma, exacerbation or asthmatics with covid -19 infections are same. In the current pandemic, treatment of an exacerbation will likely require going to the emergency department or urgent care, which increases the chance of exposure to infectious viral. So adherence and good compliance to inhalation therapy is best way to control asthma.

Chandan Hospital and its Department of Respiratory Medicine advise following best practices for asthmatic people or who have a severe respiratory condition (asthma or COPD) in current pandemic?

– Keep your asthma under control by following your asthma action plan. – Stopping inhalers by himself due to fear of catching covid infection is dangerous will lead to exacerbation or attack. So don’t stop any medications or inhalers without consulting your doctor. – Make sure that you have 30 days of non-prescription medications and supplies on hand too in case you need to stay home for a long time. – Learn to cope with anxiety and stress in these days of uncertainties in current pandemic or take help of your doctor. – Avoid exposure of asthma triggers like dust, smoke, pollen, cold and pollution. – Eat immune boosting foods, sleep well and staying home unless absolutely urgent in order to avoid triggering episodes. – Practice social or physical distancing, avoid busy places, good hand hygiene and use face mask. – Flu and pneumococcal vaccination according to doctor advice. – Avoid unnecessary travels and tours to prevent you from catching infections.