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Posted By: Mary Knudtson, DNSc, NP, FAAN
May 05, 2020
The early data on mortality from COVID-19 infections are showing that asthma is not one of the top risk factors. The top ten COVID-19 comorbidities (in rank order) were hypertension, diabetes, hyperlipidemia, coronary artery disease, dementia, renal disease, atrial fibrillation, COPD, cancer, and stroke. In New York, state officials have said asthma was a comorbid risk factor in about 5% of the COVID-19 deaths.
What health care providers do agree on, is that all patients with asthma need to be doing their best to get—and keep—their asthma in good control. The current asthma guidelines in the US are dated; new ones are slated to come out later this year. However, there are global guidelines for asthma that are current.
Many patients are anxious about COVID-19 and would like to do everything they can to reduce their risk of contracting it and getting seriously ill or dying from it. As clinicians, we have an opportunity to use telehealth visits to help our patients understand the disease, learn how to monitor their symptoms, and identify when they need help.
Many of the key signs of COVID-19—such as coughing, shortness of breath, and chest tightness—are also typical symptoms of asthma. We can help patients by teaching them how to identify and control their triggers; knowing what triggers their asthma can help them to avoid it. We can also teach them to keep a record of their triggers, symptoms, and flares. Asthmatics should use peak flow meters to monitor how well their airways are staying open and regularly record their results. If they know their baseline, they will be able to identify when they are worsening earlier in the course of a flare. They should also assess how often they're reaching for their rescue medications, and how often they're waking up at night with a cough or a wheeze. Additionally, they should record their temperature daily during the pandemic. It is important to tell our patients that they should know where their medications are and check the expiration dates. It is also imperative that patients know how to use each of their inhalers correctly. If they have an asthma action plan, using it may alert them to worsening symptoms and help them know when to call for help.
We have an opportunity to help patients stay out of the office and ER by getting and keeping their asthma in good control, reducing their chances of coming into contact with the virus, and overall promoting their health.
- Global Initiative for Asthma. Reports. ginasthma.org/reports/. Accessed May 5, 2020.
- National Heart, Lung, and Blood Institute. Guidelines for the diagnosis and management of asthma (EPR-3). www.nhlbi.nih.gov/health-topics/guidelines-for-diagnosis-management-of-asthma. Accessed May 5, 2020.