Coronavirus: What to be aware of if you have asthma

Photo of a patient being examined by a doctor (PantherMedia / Craig Robinson) The severity of COVID-19 mainly depends on people’s age and whether they already have other medical conditions. Based on what is currently known, coronavirus infections are usually not more severe in people who have asthma. It’s important to carry on taking your asthma medication as usual.

Like COVID-19, asthma is a respiratory (airway) disease. So it seems reasonable to assume that people who have asthma might be especially vulnerable to COVID-19. This does not seem to be the case in most people, though.

Does asthma increase the risk of complications?

Only a few studies have looked into whether people who have asthma are more likely to die of COVID-19 than similar people who do not have asthma are. This is what is known so far:

  • People who have mild or moderate asthma probably don't have a higher risk of dying of COVID-19, or the risk is only slightly higher.
  • People who have severe asthma or aren't treating their asthma well enough with medication could be somewhat more likely to become seriously ill if they get COVID-19. But more good research is needed to find out whether that is actually the case.
  • People with asthma have a lower risk of getting seriously ill from COVID-19 than people who have diabetes, who are very overweight, or who have a weakened immune system, for instance.

If someone who has asthma gets pneumonia and needs to be ventilated, it can be difficult because their airways are already narrowed. You may have to stay in the hospital longer because the ventilation could take longer. That's another reason to make sure that your asthma is as well controlled as possible.

What about the risks for children?

Most children with asthma won't have a higher risk of serious illness from COVID-19. So far there haven't really been any studies looking into whether it is more dangerous in children with asthma than in those who don't have asthma. But because COVID-19 only becomes severe in very few children generally, this is probably true of children with asthma as well.

Important: Continue taking your asthma medication!

It’s very important to keep on taking your asthma medication, including steroids. They are help to prevent asthma attacks. Coughing and shortness of breath may be caused by both asthma and COVID-19. There's a greater risk of these symptoms being even worse if you become infected with COVID-19 and haven't been taking your asthma medication.

There have been isolated claims that the use of steroid inhalers could weaken the immune system so much that it would increase the risk of developing more severe symptoms if you have a COVID-19 infection. But there's no evidence to support this. Steroid inhalers hardly have any influence on the immune system as a whole because the spray affects the lungs directly. Only very small amounts are absorbed by the rest of the body. There is also no research to suggest that steroid inhalers make the lungs more vulnerable, either.

It's important to carry on taking steroid tablets too. These tablets are only rarely used to treat asthma anyway, and are usually only needed for a short time.

If you have allergic asthma, there's no reason why you shouldn't continue or start allergen-specific immunotherapy (desensitization).

It is important to have enough medication on hand to keep up your asthma therapy in case you have to remain in quarantine because you have COVID-19 or it is thought you might have it.

What if you think you have COVID-19?

The symptoms of asthma and COVID-19 can be similar. Both illnesses may cause coughing and shortness of breath. The other symptoms that are typical of COVID-19 – such as fever, changes in your sense of taste or extreme tiredness – don't occur in asthma, or only rarely do. If you have these typical coronavirus symptoms, it may be a good idea to get tested for COVID-19. You can find out more by consulting a testing center or a doctor.

Do you have to wear a mask if you have asthma?

You have to wear a mask to enter certain public spaces, such as shops or buses and trains. Some people who have asthma feel nervous about wearing a mask. They think that wearing a mask could increase their risk of asthma symptoms. But it's not clear whether a mask can trigger shortness of breath in people with asthma: There is no good scientific research on this yet – and no official recommendations have been issued for people with asthma. It’s best to consult a doctor if you have major problems with wearing a mask. For certain medical conditions, doctors may give you a note confirming that you don't need to wear a mask.