Asthma Patients: Stay on Steroids in Face of COVID-19, Say Experts

With COVID-19 infections documented in every US state and clinicians waking up to the fact that this is everywhere, there is still lack of clarity on many basic points about the management of infection.

Although most people can be expected to recover at home without complications, patients with asthma are among those at risk for serious illness, according to the Centers for Disease Control and Prevention (CDC).

And people with asthma "have concerns about the steroids in their asthma inhalers weakening their immune system," notes the Asthma and Allergy Foundation of America (AAFA) website.

But asthma specialists are stressing that patients must keep using their preventive inhalers during this pandemic.

Optimal Control of Asthma Is First Defense Against Infection 

"People with asthma need their [preventive] steroids," said Mitchell Grayson, MD, an allergist–immunologist at Nationwide Children's Hospital and chair of the medical scientific council for the AAFA. 

Michael Blaiss, MD, executive medical director of the American College of Allergy, Asthma & Immunology (ACAAI), echoed that advice.

"If a patient has asthma they need to stay on their preventive asthma medication, which in most cases would include inhaled corticosteroids," Blaiss, who is also clinical professor of pediatrics at the Medical College of Georgia in Augusta, told Medscape Medical News.

Optimally controlled asthma is the first weapon in the fight against the infection, other experts concurred.

"The last thing we want is patients stopping their asthma medicine and getting acutely ill," David Hill, MD, a pulmonary and critical care specialist in Waterbury, Connecticut, told Medscape Medical News.

"We don't want people coming to the hospital because they stopped adhering to their therapy out of fear that the therapy was going to cause a problem."

"If you have asthma and you are sick and you're bronchospastic and wheezing that's a reason to use steroids," stressed Hill, who is a spokesperson for the American Lung Association.

Concerns That Corticosteroids Worsen COVID-19

Part of the confusion is arising from reports of concerns about corticosteroid treatment in patients in general with lung involvement because of COVID-19 infection.

Advice for those in the general population infected with COVID-19 is that "corticosteroids are to be avoided" during treatment, according to the CDC as well as the World Health Organization.

This current consensus that there is no reason "to expect that patients [in general] with COVID-19 infection will benefit from corticosteroids, and they might be more likely to be harmed with such treatment," is also detailed in a Lancet commentary published last month.

This article originally appeared on Medscape.


More Articles