The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease (COVID-19) has infected over 200 million and led to the deaths of over 4.3 million people. While there are known risk factors for severe disease, asthma was initially hypothesized to be a risk factor for severe disease given the association between asthma exacerbations and respiratory viral illnesses in general. Fortunately, clinical outcomes for patients with asthma overall are similar to patients without asthma, without convincing evidence that asthma is a risk factor for severe disease. This may be explained in part by the decreasing gradient of angiotensin-converting enzyme-2 (ACE2) receptor from the upper to lower respiratory epithelium and that aeroallergen sensitized asthmatics can have up to 50% reduction in ACE2 receptor expression. Vaccination for patients with asthma is recommended for all without clear contraindications. COVID-19 specific treatment options are available depending on the severity of disease, we caution the use of systemic corticosteroids in asthmatic patients not requiring supplemental oxygen given an association with worse outcomes. Post-acute COVID-19 syndrome or long-haul COVID does not appear to be more prevalent in the asthma population, a multi-disciplinary approach to care is a reasonable option.
COVID-19 Infections and Asthma