Coronavirus: How high is the risk for asthmatics?

The elderly or people with previous respiratory diseases are part of the risk group for the current COVID-19 pandemic. And because the aggressive SARS-CoV-2 virus primarily affects the lungs, many asthma patients fear an increased risk of infection and a potentially more serious development of the disease.

Uncertainty has also been raised by indications that medications frequently used by asthmatics further increase the risk of infection.

Can cortisone sprays continue to be used?

Cortisone sprays are the most widely used in asthma therapy, or cortisone pills in severe cases, because they have an anti-inflammatory effect and reduce asthmatic hypersensitivity of the bronchi. This lowers the body's immune defense, so that the active substance has an immunosuppressive effect.

German pulmonologists and experts want to counter this uncertainty with a joint statement. According to they declared, the risk does not increase in the asthma patients who take treatment while they continue taking their medication regularly and do not stop taking it without consulting their doctor. In case of worsening, the cortisone dose should be adjusted according to the instructions of the treating pulmonologist.

Other evaluations

This evaluation contrasts with positions that criticize treatment with inhalable corticosteroids. For example, the virologist at the Charité hospital in Berlin, Christian Drosten, carefully recommends that asthma patients consult their pulmonologist if the cortisone-based asthma medication could be replaced with one that does not interfere so strongly with the immune system.

However, as such a relationship has not yet been scientifically proven, experts from the German Society of Pulmonology and Respiratory Medicine (DGP) continue to support inhalation therapy.

Experts warn that a sudden interruption of medication or a change in therapy could be much more dangerous than the high risk of SARS-CoV-2 infection, which has not yet been proven.

Especially older people with severe asthma and patients who regularly take cortisone pills would be at greater risk, they say. Asthmatic patients who have so far only used cortisone sprays occasionally should start doing so regularly so that the airways remain open and the patient does not have to fight cough or shortness of breath. If cortisone spray does not help, the treating physician should be consulted.