Optimization of therapy of patients with bronchial asthma in conditions of coronavirus infection

Abstract

There is suffering with bronchial asthma (BA) all over the world. This pathology is one of the most common diseases of respiratory system. In 2019, the coronavirus infection (COVID-19) pandemic spread all over the world. COVID-19 has made a big difference in the lives of the entire population. Patients with BA appeared to be especially the «weakest» cohort. At the beginning of the pandemic, it was considered that patients with asthma were most susceptible to COVID-19 infection and severe infection. Currently, it is known that BA does not affect on the COVID-19 severity. It is considering opinion that the predominance of cytokines of Th-2 immune response type and the eosinophils overproduction can somehow counteract to accumulation of pro-inflammatory cytokines, preventing development of a «cytokine storm» in COVID-19 disease, which explains the low percentage of infection in patients with BA. During the pandemic, there were 35 patients with BA under observation. As a baseline therapy, patients took a fixed combination of formoterol/budesonide (Formisonide-native) in the metered-dose powder inhaler; delivery method was carried out using “Inhaler CDM” in a single dose of 4.5/160 μg. Daily inhaled glucocorticosteroids (ICS) doses choice was corresponded to asthma severity. Medium ICS doses were taken by 17 patients (48.6%), high doses were taken by 18 patients (51.4%). Special properties of budesonide and formoterol make it possible to use their combination in the treatment of asthma both as baseline therapy and for attacks relief («therapy on demand»). Formisonide-native has advantages: the dose is strictly fixed, the patient has visual control and confidence in the delivered dose, which increases the patient’s compliance with therapy, especially in a pandemic. Also, during the period of COVID-19, patients with BA need to have followed-up regular medical care in the form of on-line consultations through modern messengers, to be trained to control the disease and implement the basic therapy dosage regimen.

Keywords

• bronchial asthma
• covid-19
• budesonide
• formoterol
• glucocorticosteroids
• baseline therapy