I Have Asthma, So What Is My COVID-19 Risk?

There is still so much we are learning every day about COVID-19. 'Who is most affected?', 'What treatment options might we be able to use?', and 'How can we best protect ourselves?' are all areas of interest. Since the beginning of the pandemic, experts have suggested that older individuals and those with underlying conditions may be at a higher risk of getting COVID-19 or of having more severe cases of the illness. Some of the underlying conditions thought to potentially increase risk include autoimmune conditions, heart disease, diabetes, and lung conditions, such as COPD and asthma.1

Currently, the Centers for Disease Control and Prevention still suggest that those with moderate to severe asthma may be at higher risk for severe illness, but recent information may help slightly ease concern.1

Looking at cases in New York

The New York State Department of Health has been regularly releasing data about the COVID-19 pandemic state-wide. This includes information on the number of cases, the number of tests being administered, and deaths from COVID-19. The information on deaths from COVID-19 has been broken down by other factors, such as race, ethnicity, age, sex, and other co-occurring conditions.2

Interestingly, of the top 10 comorbid or co-occurring conditions in those who have passed from COVID-19, asthma is missing. The top 10 includes high blood pressure, diabetes, heart disease, kidney disease, cancer, and more, but asthma does not make the list. COPD is currently listed as the eighth most common comorbid condition.2

Does this mean asthma is not a risk factor for COVID-19?

It is too early to tell whether or not asthma increases a person’s risk of severe COVID-19, and we need to avoid jumping to conclusions based on limited data. However, these results are interesting and may provide some hope. Other experts have weighed in on asthma and COVID-19, using the limited data we have now as well as past data from previous similar outbreaks (like SARS). Both for the fatalities in New York so far and for fatalities from SARS, the proportion of people dying from COVID-19 who also had asthma may be close to, if not less than, the percentage of people with asthma in the general population.2,3 This suggests that asthma may not provide any additional risk, however, much more study is needed.

The reasons why asthmatics may not be as high risk as previously thought may be due to a variety of factors. If there is a protective factor at play, it may be related to asthma treatment options or to the immune response related to asthma. It could also be related to factors we have yet to consider. As we move forward, experts need to find ways to accurately estimate the number of people with COVID-19 and asthma, and look at trends to determine what is happening in this population.3

It is also important to remember that conditions like diabetes and high blood pressure are much more common in the population. The fact that they dominate lists about comorbidities and COVID-19 may be related to how common they are. It may not be that they are more likely to lead to severe COVID-19 compared to less common conditions like asthma, but that they are just more common in the population. All of these factors are important to consider as we learn more about COVID-19.

COVID-19 risk in children with asthma

Unlike adults, one of the most common co-occurring conditions in children with COVID-19 so far is asthma.4 While this may seem frightening, it is important to remember that asthma is more common in children than adults.5 Also, children are less likely to have other comorbid conditions that adults have, like high blood pressure, diabetes, and heart disease. Because of this, their co-occurring conditions will be shifted toward issues in childhood, like asthma. It may or may not be that asthma increases their risk of COVID-19. It could be that asthma is just more common in this population.

Overall, there is still so much to learn about COVID-19 and other conditions, including asthma. We can be hopeful about these trends, however, there is still a lot of work to be done. Practicing good infection prevention, like handwashing, physical distancing, eating well, and staying active are still some of the best ways to prevent the spread of COVID-19.4

This article was written on April 21, 2020. Further developments in what we know about the Coronavirus are continuously emerging.

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