We live in the Information Age. Nowadays, however, it can be information overload with an abundance of inaccuracies regularly masquerading as facts. Dr. Juanita Mora, an allergist/immunologist in Chicago, joins us to bust several myths about asthma and COPD management that have been circulating in response to the coronavirus disease (COVID-19). After all, the spread of myths can lead to dangerous decision-making that may affect you and your family.
Stop taking oral, inhaled and/or intranasal corticosteroids due to increased COVID-19 risk since they immunosuppress patients.
Control is the most important thing for your asthma and allergic rhinitis. If you use inhaled corticosteroids, or intranasal steroids, there’s probably not a risk to developing a weakened immune system. If you use oral corticosteroids, there’s a slight increase of a suppressed immune system. If you’re in an asthma flare, your healthcare provider can help you decide which medications are the right choice to help you breathe. Do not stop or avoid taking your medication without discussing with your healthcare provider.
Children with asthma are not at risk because COVID-19 only affects older people.
We must remember that COVID-19 is a respiratory disease. Children (and adults) with moderate to severe persistent asthma or any underlying chronic lung disease may be at higher risk for complications from COVID-19. However, individuals with asthma or other lung diseases are not at higher risk of contracting the virus.
If you have asthma, you should wear a disposable mask when in public areas to help limit COVID-19 exposure.
Current guidance from the CDC says that commercially-available masks – like N-95s and surgical masks – should be reserved for people who are already sick and healthcare workers that interact with those patients.
But up to one in four individuals infected with COVID-19 might have no symptoms or very mild symptoms, and may be unknowingly spreading the virus. The use of a cloth face covering – whether that is a handmade cloth mask, bandana or scarf – can help slow the spread of COVID-19. These types of masks are not intended to protect the wearer, but to protect against the unintended transmission – in case you are an asymptomatic carrier of the coronavirus. If you have respiratory symptoms (e.g., fever, sneezing, cough, shortness of breath), you should stay home unless directed by your healthcare provider to see medical care and then you should wear a mask to prevent spreading your droplets to others.
Smoking and/or vaping does not increase your risk of getting sick with COVID-19.
Cigarette smoking and vaping are linked to lung inflammation and lowered immune function. Both potentially heighten the risk for a more severe response if exposed to COVID-19.
Albuterol or quick relief rescue inhalers can cause the immune system to be suppressed and result in patients with asthma being more susceptible to COVID-19.
These medications are bronchodilators and not corticosteroids. They relax the muscles in your airways when you’re having symptoms. You can and should continue to use your rescue inhaler as needed for asthma symptoms. The most important thing is to have your asthma well-controlled so that if infection does occur, your lungs are better able to handle the virus.
Anti-inflammatory medications (other than inhaled corticosteroids and controller medications) worsen COVID-19 symptoms.
The Food and Drug Administration (FDA) has issued a statement regarding the use of nonsteroidal anti-inflammatory drugs (NSAIDs) for patients with COVID-19. According to the agency, there’s not enough scientific evidence to link the use of NSAIDs to worsening symptoms of COVID-19. Therefore, NSAIDs can still be used even for patients with COVID-19 to treat symptoms, such as fever and muscle aches, if no alternatives seem available. For this reason, if you’re concerned, discuss options with your healthcare provider.
Using nasal sprays may push the COVID-19 virus further up your nose.
Nasal sprays are often used to treat symptoms related to common colds/viruses, including congestion and runny nose. Spring allergy season has begun in many parts of the country – these medications can assist in control of symptoms and, therefore, help prevent asthma flares. Continue to take your prescribed medications and contact your healthcare provider to discuss before discontinuing or avoiding.
Exercise puts patients with asthma and COPD at higher risk of COVID-19.
Healthy habits that help decrease COVID-19 infection risk include exercising, eating well, getting enough sleep, smoking cessation (electronic cigarettes or vaping as well), and getting your yearly flu shot.
Air Pollution can increase susceptibility to COVID-19 infection.
An emerging body of research is showing that people exposed to air pollution may be more vulnerable to severe symptoms of COVID-19. A study from Harvard found that even small, long-term exposures to particle pollution can increase an individual’s risk of death from COVID-19 by 8%. This is especially hard hitting in communities of color, who are more likely to live in counties with higher levels of air pollution –including particle pollution.
Severe illness and death from COVID-19 is equally affecting all populations.
Numerous states and cities have reported higher rates of severe complications and death from COVID-19 among African Americans and Latino Communities. These alarming headlines reflect the persistent inequalities in resource allocation, access to healthcare and other health stressors that communities of color experience. It also highlights the underlying racial disparity in the burden of lung disease among African Americans, who experience higher rates of asthma and lung cancer. Individuals with these chronic medical conditions – while not more likely to contract COVID-19 – could have more severe symptoms if they do become sick.
Children/Adults with asthma or underlying chronic lung disease should not return to the classroom or work environment until a vaccine is released.
If your asthma or chronic lung disease is well-controlled and safety measures are in place for social distancing, masks and frequent hand-washing stations along with temperature checks- parents may consider sending their kids back to school and adults returning to work. I recommend you follow the guidance from your local health experts, and in consultation with your doctor and come up with a plan to address concerns and recommendations for your family.
Juanita Mora, M.D., is an allergist/immunologist in Chicago with a strong interest in asthma care and breaking down barriers to asthma care in underserved communities. Dr. Mora's work with the American Lung Association deals closely with patient management and relations as well as doing asthma education in the community and to healthcare workers through American Lung Association workshops and health fairs. Read More.
Blog last updated: July 23, 2020