Understanding and Managing Severe Asthma in the Context of COVID-19

Abstract

Bárbara Kong-Cardoso,1 Amélia Ribeiro,2 Rita Aguiar,1 Helena Pité,1 Mário Morais-Almeida1 1Allergy Center, CUF Descobertas Hospital and CUF Tejo Hospital, Lisbon, Portugal; 2Pneumology Department, Centro Hospitalar Barreiro Montijo, Barreiro, PortugalCorrespondence: Bárbara Kong-CardosoCUF Descobertas Hospital and CUF Tejo Hospital, Lisbon, PortugalEmail [email protected]: Coronavirus disease 2019 (COVID-19) continues to spread across the world. Since the beginning of the pandemic, the question of whether asthma is a risk factor for getting the infection or for poor outcomes motivated a great debate. In the field of severe asthma and its treatment during COVID-19 pandemic, several issues are also pending. A literature review focused on the management of severe asthma patients in the context of COVID-19 is performed. The available evidence suggests that severe asthma patients do not have an increased risk of poor COVID-19 outcomes and that it is safe to treat asthmatic patients with inhaled corticosteroids (ICS) and biologics during the pandemic, even though some studies indicate that high doses of ICS may predispose to COVID-19. The chronic use of oral corticosteroid (OCS) might be associated with poor COVID-19 outcomes, although there is no complete agreement. There is very limited evidence concerning the use of triple therapy for asthma in the context of this pandemic. Ultimately, severe asthma patients should maintain their medication during the COVID-19 pandemic, including biologic agents. More studies are needed to address the role of asthma medications and asthma’s different phenotypes on the incidence and course of COVID-19.Keywords: allergy, biologics, corticosteroids, COVID-19, SARS-CoV-2, severe asthma

Keywords

• allergy
• biologics
• corticosteroids
• covid-19
• sars-cov-2
• severe asthma