Coronavirus: What to be aware of if you have COPD

Photo of an older man being examined by a doctor (PantherMedia / Wavebreakmedia ltd) The severity of COVID-19 mainly depends on people’s age and whether they already have other medical conditions. The symptoms are often more severe in people who have chronic obstructive pulmonary disease (COPD). Preventing an infection is especially important for them. They should continue to take their medication as usual.

Like COVID-19, COPD (chronic obstructive pulmonary disease) is a condition that affects the airways. It causes permanent damage to the lungs and narrows the airways (bronchi). People who have advanced COPD get out of breath very easily. Oxygen therapy or even artificial ventilation may be needed.

Why does COPD increase the risk of complications?

In COPD, less oxygen enters the bloodstream. This happens in COVID-19 too, if the infection attacks the lungs. So if people who have COPD are infected with COVID-19, there is a great risk that they will have trouble breathing and will need to be artificially ventilated. People with COPD are also more prone to pneumonia or lung failure.

Research has shown that people who have COPD die of COVID-19 more often than people who don’t have COPD. Studies found that about 8 out of 100 people with COPD who also had COVID-19 died. This figure only gives us a rough idea, though, because most of these studies are from China, where the care of patients differs from that in Germany and other European countries, for instance. It is not clear whether people who have COPD are also more likely to get COVID-19.

Important: Carry on using medication!

It is very important to continue using medication like inhalers to widen the airways (bronchodilators). They help to prevent acute breathing difficulties, among other things. People who don't take their COPD medication and then become infected with COVID-19 may risk having even worse breathing problems.

Some people who have COPD use a steroid inhaler every day. They should continue doing that too. A few reports have claimed that steroid inhalers can weaken the immune system so much that they increase the risk of becoming very ill if you get COVID-19. But there's no reason to believe that this is true because steroid inhalers hardly affect the immune system in the rest of the body.

Although studies suggest that steroid inhalers can generally increase the risk of pneumonia a little in people who have COPD, it's not clear whether this is also true for pneumonia due to a COVID-19 infection.

Based on current research, the advantages of steroids outweigh their possible side effects. So people can even take steroid tablets, especially because these tablets are usually only taken for a short time in COPD – to treat acute breathing problems.

It's important to have a big enough supply of COPD medications at home in case you need to go into quarantine due to a suspected or confirmed case of COVID-19.

What if you think you might have COVID-19?

The symptoms of COPD and COVID-19 are sometimes similar. Both illnesses can cause coughing and shortness of breath. But other typical symptoms of COVID-19, such as a fever and an altered sense of taste or smell, are not (or only rarely) caused by COPD. If you have typical COVID-19 symptoms, it can be a good idea to be tested for it. You can discuss this option at a test site or with your doctor.

How can you avoid infection?

It is understandable that people who have COPD are afraid of being infected with the coronavirus (SARS-CoV-2) due to the risk of getting very ill. But the risk of infection is very small, particularly in areas with low numbers of infected people. So it's usually still possible to continue going about your normal daily life if you follow the recommended safety precautions. These include keeping enough distance from others, practicing good hygiene, and avoiding groups of people. It's important to keep your risk of infection as low as possible when spending time with children and grandchildren, too.

But there might be situations where you have to be especially careful – for instance in places where a group of people are together in a small space, or if you come into contact with people who you don't know and who may even have symptoms.

Institutions like nursing homes have special safety measures in place to minimize the risk of infection.

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

In many countries, people have to wear masks in public places like shops or on public transport. A lot of people who have COPD are okay with that, but some feel uncomfortable wearing a mask. They're afraid that it will make it harder for them to breathe. But it's not clear whether wearing a mask can actually lead to breathing difficulties in people with COPD. There's not enough good scientific research in this area, and there are also no official recommendations for people who have COPD.

If you find it very difficult to wear a mask, it's best to talk to your doctor – for instance, about trying out a different type of mask or whether you could wear a face shield instead. Only for certain medical problems can doctors issue a medical certificate saying that you don't need to wear a mask.