Leading Doctor Offers Guidance for COPD Patients During COVID-19 Pandemic

Chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema, is a chronic lung disease that makes it hard to breathe. The disease affects millions of Americans and is the fourth leading cause of disease-related death in the U.S. People with COPD have a higher risk of more severe illness from COVID-19 due to their existing lung problems. MeiLan Han, M.D., pulmonologist and principal investigator for an American Lung Association’s Airways Clinical Research Center, offers guidance for patients with COPD.

Controlling COPD Symptoms Critical
Managing the symptoms of COPD is critical to stay healthy and avoid hospitalizations, especially during a pandemic when hospitals may be close to capacity. Dr. Han encourages patients to continue working closely with their healthcare provider to manage their symptoms through prescribed medications and treatment plans.

One common question Dr. Han reports hearing is whether patients should stop taking their regularly prescribed medications during the COVID-19 pandemic. In particular, the American Lung Association is not aware of any scientific evidence that patients with COPD should avoid using inhaled or oral corticosteroids prescribed for their COPD during the COVID-19 pandemic. People with COPD should obtain at least a 30-day supply for their prescription medications, or a 90-day supply where possible. Additionally, patients should also consider connecting with their oxygen provider to make sure oxygen deliveries will continue as usual.

Questions have also been raised about nebulized medications.  Patients with COPD can continue to use their nebulized medication as prescribed at home. There are some concerns about using nebulizers if the patient has suspected or confirmed COVID-19 as use of the nebulizer has the potential to aerosolize the virus which may then then persist in air droplets for one to two hours.

“If you have COVID-19 and are using nebulized medication, you can discuss with your healthcare provider whether there are any alternative medications that could be used. You can also try to protect the rest of the household during your treatments by using the nebulizer in a closed room, keeping the door shut and others away from the immediate area for at least two hours,” said Dr. Han.  “It is important, however, that patients discuss any potential changes in their medication regimen with their physicians first.”

Is it a COPD exacerbation or COVID-19?
COPD is a chronic disease that makes it difficult to breathe, and difficulty breathing is also a known symptom of COVID-19. So many patients may be wondering how to tell the difference between a COPD exacerbation and COVID-19. “Fever isn’t usually present with COPD exacerbations,” said Dr. Han. “But you would want to contact your doctor either way, even if it’s an exacerbation, to get advice on treatment.”

Take Proper Precautions, But Don’t Hesitate to Get Help
Patients with COPD should stay at home except for essential medical care in order to reduce their risk of coming into contact with the virus. However, if someone with COPD is experiencing COVID-19 symptoms which may include shortness of breath in addition to fever, gastrointestinal symptoms, muscle soreness, fatigue, and changes in the ability to taste and smell, it is important to seek medical care. Call your doctor to get guidance and consider telehealth as an option.

“Despite the fact that we are encouraging the general public to only seek in-person medical care if it’s urgent, I don’t want my patients to be afraid to contact me,” said Dr. Han. “You can reach out to your doctor for a virtual appointment first. Because people with COPD are more vulnerable to severe illness from COVID-19, it’s important to address any problems or unusual symptoms right away. We are still finding ways to treat patients, even if they can’t come directly into the office.”

Try to arrange for deliveries for food and everyday supplies to your house or ask friends and family members for help with shopping. If you must leave the house for other reasons, it’s important to remain at least six feet apart from other people and wear a cloth face covering. Additionally, if you live with people who are leaving and entering the home, make sure they wash their hands thoroughly and often, for at least 20 seconds with warm water and soap.

There are many healthy practices you can control that will help manage your COPD. It is important to eat healthy food, get plenty of rest and exercise daily. Quitting smoking and vaping can help to strengthen the respiratory system against COVID-19. Stay connected with friends through phone calls or virtual visits. And if you start feeling overwhelmed with feelings of loneliness, anxiety or helplessness be sure to reach out to your healthcare provider to discuss and together develop a plan to alleviate.

Dr. Han recommends the following support and resources for COPD patients and their caregivers from the American Lung Association:

• Connect to education, support and each other: The American Lung Association's Better Breathers Club program has connected people living with lung disease to education, support and each other in communities around the country for more than 40 years. Register now to join nationwide virtual meetings. Additionally, the Lung Association has a free, virtual support group and discussion community available to patients, family and caregivers.
• Quit smoking and vaping: The American Lung Association has helped hundreds of thousands of people quit smoking through Freedom From Smoking. Available online, through group clinics and a self-help workbook, Freedom From Smoking teaches the skills and techniques that have been proven to help tobacco users end their addiction and become smokefree. You can also get support for vaping with the Lung Association’s “Quit, Don’t Switch” initiative.
• Create a plan: The Lung Association has a free COPD action plan to help you monitor your symptoms with the help of your healthcare provider.
• Call the American Lung Association’s Lung HelpLine: Experienced and knowledgeable healthcare professionals and respiratory therapists are ready to assist you with questions you have about COVID-19 or any other lung health questions in over 250 languages at 1-800-LUNG-USA or submit a question online.

For more information on lung health, COPD and COVID-19, visit Lung.org. Journalists seeking to schedule an interview with a lung health expert may contact Stephanie Goldina at [email protected] or 312-801-7629.