COVID-19 and Asthma

April 17, 2020

One of the most common questions I have been asked lately is, "Am I at a higher risk of COVID-19 since I have asthma?” The good news is that you don’t have a higher risk of getting the disease. Initial data from Italy and New York indicated that asthma does not significantly increase the mortality risk. However, bigger studies do show a slight increased risk. They did not break down asthma into severity but at this time I assume, after looking at the numbers, that it is uncontrolled asthma that presents a higher risk. Well controlled asthma may only have a slight increased risk of mortality with COVID-19. Chronic Obstructive Pulmonary Disease (COPD) does increase the risk significantly. If you are a smoker, if you ever needed motivation to stop, THIS IS IT! I recommend all asthma patients to make sure their asthma is under control. A quick assessment is that you should be able to walk and talk in full sentences without taking a breath. If it is not under control please schedule a video or in-person visit. For those of you under control without a daily medication I would not recommend making any changes. There is some data that indicates that adding an inhaled steroid may cause more problems. This does NOT mean you should stop your daily inhaled steroid if you are already on this medication. Along the same lines there is a debate whether oral steroids may cause more problems. With that being said, if you are having an asthma flare we may still need to give oral steroids and this should take precedence over a potential risk of oral steroids and COVID-19.  

 

Another common issue I am seeing lately is the anxiety factor that affects breathing. Everywhere you look there is news about the severity of COVID-19 so it is a natural response to be nervous and anxious. However, being nervous and anxious often leads to irregular breathing that can mimic an asthma attack. When people are anxious we often breath with our neck and shoulder muscles with quick and shallow breaths. This often leads to us ‘blowing out’ or releasing too much carbon dioxide and this gives people a sense of dizziness. When you breath with the neck and shoulder muscles you tighten the vocal cords and don’t allow as large of an opening for the oxygen to get into the lungs.  

To combat this, I recommend diaphragmatic or ‘belly breathing.’  To do this: sit upright in a chair or stand with a straight back. Place one hand on your belly, relax your shoulders, take a long slow deep breath in through your nose. While taking this breath exaggerate your hand that is on your stomach moving outward as your belly expands while taking the deep breath. This will help you to focus on using your diaphragm to breath. Then through your mouth slowly exhale, while the hand and stomach move inward. 

 

Repeat as necessary. This is a tough time for everyone so please contact our office with any questions and stay safe!

 

Dr. McMahon

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