“People with chronic conditions such as diabetes, heart disease and lung disease are slightly at a higher risk to suffer from serious COVID-19 illness as compared to healthy people.”
Ever since this information started circulating in groups and spread wide and far people with pre-existing health conditions started to panic. And more so were the people with respiratory conditions such as asthma, chronic bronchitis and chronic pulmonary obstructive disorder (COPD).
So to help you get the right information on COVID-19 and its impact on respiratory health, we spoke to Dr. Samir Garde, Pulmonologist and Lung Specialist, Global Hospital, Mumbai and here is what he has to say.
1. Are people with asthma/other respiratory health conditions at higher risk of catching COVID-19?
Answer: People with asthma do not have a higher risk of getting COVID-19 infection as compared to healthy people. The reason being, if asthmatics follow proper treatment (which includes use of inhalers and medicines such as bronchodilators and corticosteroids), the inflammation in the airways is taken care of.
According to Dr Samir, those with chronic pulmonary obstructive diseases (COPD) have a high tendency to suffer from a severe infection, if they get infected with the coronavirus. This is because people with COPD already have weak lungs so lower respiratory infection caused by COVID-19 can further damage the lungs.
Other respiratory conditions such as interstitial lung disease (also known as lung fibrosis) can increase your risk of coronavirus infection. In this condition, the oxygen carrying capacity of the lung is affected which compromises the gas exchange in the lungs. So if a person with lung fibrosis gets infected with COVID-19, then it can lead to severe infection and may also turn lethal.
2. Do people with respiratory problems have poor disease outcomes when it comes to COVID-19?
Answer: There is no sufficient data to answer this question as of now. The data on the number of deaths due to coronavirus in India does not give any analysis on the comorbidities (if any). To get these details it may take another 2-3 months.
However, if we can extrapolate the data of COPD patients who suffered from H1N1 or other viral pneumonia over the years (COVID-19 is a viral infection and may follow the same set of patterns).
3. Should I stop using nasal spray (as it may push the virus further up the nose)?
Answer: Nasal spray is recommended for asthmatics with allergic rhinitis and sinusitis and not for every individual suffering from respiratory condition. There is no scientific evidence to prove that using a nasal spray can push up the virus deep into the respiratory tract and up the risk of infection.
4. Is there any long-term damage to the lungs after having COVID-19?
Answer: Well, this is too early to comment if COVID-19 can cause long-term lung damage. It is only a week or two that the people with coronavirus infection have started recovering and discharged from hospitals. It may require data for around 2-3 months to understand if there is any long term damage to the lungs. Moreover, it can also depend on the severity and condition of the person at the time of infection.
5. People with asthma suffer from cough and difficulty in breathing. How to distinguish between these symptoms and those of COVID-19?
Answer: In any infection, fever is a classic symptom. So in people with asthma who suffer from runny nose, cough or throat irritation but no fever, it is less likely that the patient is having any infection. Also, headache and severe body ache are some of the common symptoms seen in COVID-19 patients. But if you have any of these symptoms, get in touch with a doctor who may recommend a swab test based on your condition and treat accordingly.
Also, as most people are spending time indoors either cleaning or dusting or due to indoor pollution, there is a high chance that people with respiratory problems might have a cough or runny nose. So if a person doesn’t have fever/headache/bodyache is not there, then there is no need to worry.
6. If I use a nebulizer at home, am I at risk of COVID-19 infection (risk of the virus spreading through air)?
Answer: A COPD patient taking a nebuliser at home routinely can continue nebulization. The only care he/she needs to take is that the nebulization kit which has been used should be cleaned and replaced regularly. Ideally, the kit should be cleaned at least every week by keeping it in hot water for 30 minutes and drying under the sun. Thereafter, the kit must be replaced (or disposed of) every month with a new one.
However, if a COPD patient is tested positive for COVID-19, then the precautions for using nebulizer might differ. This is because it is believed that the use of nebulization in these people can generate more droplets which can be spread to other people. In such cases, it is recommended to use a metered-dose inhaler with a spacer where droplet generation is comparatively less and thus, the risk of spreading the infection.
7. Do anti-allergic medications such as antihistamines (recommended in asthmatics/allergy) suppress the immune system and up the risk of viral infection?
Answer: People with runny nose or sore throat can use antiallergic medications as per the doctor’s prescription. There is no harm in doing so as this can only help in relieving the symptoms (and preventing worsening of the condition). Also, use of anti-allergic medications for a week or 10 days won’t suppress the immune system and won’t be of any problem.
8. Should I increase my normal dosage of medication to protect myself from COVID-19? Is stocking up medications a good idea (If yes for how long)?
Answer: Not really. People with asthma or COPD who are on inhalers tend to be stable on a certain dose. Just because there is a scare of COVID-19, there is no need to increase the dose as doing so won’t offer any protection.
It is recommended to stock at least a month’s dose of medications (such as inhalers or any specific drugs) to be on a safer side. Do consult your doctor in case of change of medications or severity of symptoms for proper treatment of the condition.
9. I use an inhaler, can it become infected? What can I do to prevent it? Should I get a new inhaler or just clean my current one?
Answer: If an asthmatic has coronavirus infection and he is using an inhaler then obviously he has to make sure that the inhaler is not shared (limited to himself only) and continue using that till the inhaler gets over. However, he should make sure to dispose of it off properly and buy a new inhaler.
10. How different is the treatment for COVID-19 for asthmatics as compared to those without any comorbid condition?
Answer: There is no difference in the treatment of COVID-19 for people with respiratory problems and those without any comorbid condition. However, people with asthma/respiratory conditions need to follow their treatment module in addition to the treatment of COVID-19.
Also, unlike popular belief, there is no truth to the statement that the symptoms of COVID-19 in people with asthma are mild as compared to the general population which can prolong the diagnosis of the condition and nor does it worsen COVID-19 symptoms.
Bottomline: These are some of the common questions that people with respiratory health conditions and COVID-19. If you or anyone in your family suffers from a respiratory problem and wants to know anything more about COVID-19 and respiratory health, ask us in the comments section and we shall get it answered from the expert. Till then, stay alert and do not panic.
(The article is reviewed by Dr. Swati Mishra, Medical Editor)