A retrospective study regarding the influence of COVID-19 disease on asthma

Abstract

Background During the Covid-19 pandemic patients suffering from asthma raised many concerns regarding the outcome ofthe impact of COVID-19 disease on their preexisting condition. The 2021 GINA report indicates that people with asthma do not appear to be at increased risk of a severe form of COVID-19. Method This study is a retrospective study of patients (n = 163) median age = 27.8 years, M:F = 1:1.26, with asthma evaluated using ACT (asthma control test) and VAS (visual analog scale) before and after COVID-19 disease. An ACT score over 20 points placed patients in the controlled asthma group. Results The overall evaluation for COVID-19 in our asthma patients revealed that 22.7% of the studied group had the COVID-19 disease (21.5% in the controlled asthma group and 24.5% in uncontrolled asthma group). Asthma disease history was longer in the uncontroled asthma group (128 ± 96.8 months vs. 296 ± 59.7 months, p = 0.05). Asthma treatment was conducted according to the GINA guideline, and 18.4% (30 pts) of the patients were on allergen immunotherapy treatment. Significantly more uncontrolled patients were significantly more in Step 1 and 5 of treatment (p = 0.05 and p = 0.03). During the COVID-19 pandemic, patients in the GINA step 5 of treatment experienced a worsening of asthma, often twice as severe as compared to patients with asthma in GINA step 1–4. In these patients, even mild COVID-19 disease led to worsened asthma symptoms, while severe COVID-19 led to a severe asthma impairment measured by ACT score (p = 0.03) and VAS scale (p = 0.02), with increased oral corticosteroids consumption. Conclusion Maintaining optimal asthma control should be able to reduce risk of severe outcomes after COVID-19 disease. Communication via phone with the specialist involved in their asthma care was very comforting for patients, thus confirming the necessity to include phone calls, smart phone’s application or online evaluations and counseling in long-term care of chronic diseases.

Clinical features in patients with COVID-19 treated with biologics for severe asthma

“…Accordingly, to attenuate the severity of exacerbations due to COVID-19, it is likely that clinical remission is desirable even in patients with SA who are being treated with biologics. 32 …”

Features of the course of bronchial asthma in patients who have suffered a new coronavirus infection

“…и соавт. [8], исследование которых указывает Lepretre F. и соавт. [12] отводят важную роль естественным клеткам-киллерам (NK), которые являются ключевыми участниками противовирусного иммунного ответа.…”

Natural killer cells in the lung: potential role in asthma and virus-induced exacerbation?

“…The function of NK cells has been reported in pulmonary infections particularly caused by influenza A virus (IAV), RSV, RVs and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although IAV, RSV and RV are associated with asthma development and exacerbations [72], it is still unclear if and how SARS-CoV-2 may exacerbate asthma, as there is an overlap between the symptoms of coronavirus disease 2019 (COVID-19) and asthma exacerbation [73][74][75]. Here, we will briefly examine the activation of NK cells during pulmonary infection induced by these viruses (summarised in figure 1b).…”