ASTHMA AND COVID 19: EMPHASIS ON ADEQUATE ASTHMA CONTROL

Asthmatics are at an increased risk of developing exacerbations after infection by respiratory viruses such as Influenza virus (IV), Parainfluenza virus, and Human and severe acute respiratory syndrome Coronaviruses. Asthma itself, mainly when poorly controlled, is an independent risk factor for pneumonia. A subset of Asthmatics can have significant defects in their innate, humoral, and cell-mediated immunity arms, and it may explain the increased susceptibility to infections. With the current COVID 19 pandemic affecting millions of people worldwide and with mortality several times that of seasonal Flu, it was necessary to revisit this subject. The pathogenesis of SARS-CoV-2, the virus that causes COVID 19, can potentiate the development of acute asthmatic exacerbation with the potential to worsen the state of chronic airway inflammation. The relationship is evident from several studies that show asthmatics experiencing a more adverse clinical course of SARS-CoV-2 infection than non-asthmatics. Recent studies show that Dexamethasone significantly decreased mortality among admitted COVID 19 patients. However, the benefit of inhaled corticosteroids, especially in asthmatics, is still inconclusive. Hence, while we are waiting for more studies that further narrates the association between COVID 19 and Asthma, individualizing asthmatics management among clinicians is crucial to achieving adequate disease control.