Asthma and COPD – therapeutic challenges in the COVID-19 Review article
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Abstract
Viral infections, including coronaviruses, exacerbate asthma and COPD. Recent studies, however, show that asthma is not a risk factor for severe COVID-19, and SARS-CoV-2 does not exacerbate asthma. There was no evidence of increased symptom severity, risk of death, frequency of mechanical ventilation and intubation, length of stay, readmission, or mortality from COVID-19 in patients with asthma. Patients with COPD are more susceptible to coronavirus infection and a more severe course of infection, which may be due to increased expression of ACE2 (SARS-CoV-2 receptor) in bronchial epithelium and lung tissue in COPD patients and the association of higher levels of ACE2 expression with lower lung function. Among hospitalized patients, the occurrence of COPD is significantly correlated with a greater severity of COVID-19 symptoms, which leads to a worse prognosis. The coexistence of COVID-19 with other chronic respiratory diseases, such as asthma and COPD, is a real therapeutic challenge. However, despite initial concerns, routines and treatments for asthma and COPD did not change during the pandemic. In asthma, we follow the GINA guidelines, and in COPD, the GOLD recommendations. It is recommended not to modify treatment plans prescribed by physicians and that patients continue on inhalation therapy. The mainstay of treatment is inhaled glucocorticosteroids. Currently, in everyday practice, telemedical visit is a good solution for controlling the course of asthma and COPD, maintaining treatment, and modifying the procedure. Unfortunately, we are not able to control the technique of inhaling medication during the telemedical visit. The solution to this problem may be the Forspiro® inhaler, which has a unique mechanism of correct inhalation technique. Its features, such as: simple, compact design enabling intuitive use, minimal number of steps when used, feedback for the patient about the correct inhalation process, can greatly facilitate the therapy used alone, at home by the patient.
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Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
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