Treating Asthma in the Age of the Coronavirus

Michael E. Wechsler, MD

As the coronavirus (COVID-19) continues to spread globally, pulmonologists and allergists are especially important as many of the symptoms of coronavirus might intensify the upper respiratory symptoms asthma patients often suffer from.

“Everyone can be affected, but patients with underlying respiratory disease are more susceptible to having more severe disease, it can exacerbate the underlying disease more severely,” Michael E. Wechsler, MD, a professor of medicine and a pulmonologist at National Jewish Health, said in an interview with HCPLive®. “These patients are more likely to get sick, more likely to require urgent care visits and hospitalizations.”

While a lot about COVID-19 is unknown, Wechsler said the initial data show it may increase the symptoms asthma patients face, similar to what the flu often does.

However, some of the medicines used to treat asthma might be particularly worrisome in regard to the coronavirus.

“In asthma we are particularly cautious because 1 of the main treatments for an asthma exacerbation is use of corticosteroids,” Wechsler said. “The issue is that there are concerns that for coronavirus, utilization of corticosteroids can have deleterious effects. So, that can make things even worse.”

Wechsler said he balances the up-to-date information regarding the coronavirus with what is known about asthma and the individual patient when prescribing corticosteroids or an alternative.

One of the byproducts of the COVID-19 pandemic is patient anxiety. Wechsler said his advice for patients is to follow the well-known guidelines of avoiding crowds and frequent hand washes and they should contact their individual doctor to get tested and receive individualized care.

“I'm telling everyone, take all their symptoms seriously right now, whether they have asthma or whether they don't have asthma, whether they have respiratory symptoms or where they don't have respiratory symptoms,” Wechsler said. “They need to consult their physicians and care needs to be individualized for every patient.”

One of the issues is there are not an abundant number of COVID-19 tests available and they are generally being earmarked for the patients with more severe symptoms.

However, many asthma patients have the severe respiratory symptoms, which is why Wechsler has been an advocate for more testing kits becoming available.

With the unknown in place regarding the disease, how it impacts patients, and what can be done to curtail its damage, doctors in all different fields are being asked to collaborate on research and data.

Wechsler said this collaboration is crucial for the medical community to help prevent as many deaths from the coronavirus as possible.

“I think the vast majority of clinicians are taking this very seriously,” he said. “I think that we all recognize that we need to collaborate if we're going to work on this, both physicians and researchers, nurses and doctors and physician assistants and nurse practitioners, and then there's all the ancillary staff at all the hospitals that are that plays such an integral role.”