COVID & asthma: are we at risk, or are we protected?

[EmmaF91]

Hi all!

I know that everyone’s going to be worried given current news, however I thought this would help as things are constantly changing at can be confusing. Back in March everything was unclear so the world was working on assumptions. Covid affects lungs, asthma affects lungs, therefore COVID will affect asthma. However, the majority or research since then has suggested that a controlled asthmatic (regardless of severity) has the same level of risk as a non-asthmatics with the same characteristics. So a 55yo, white man, who is overweight and has controlled asthma has the same risk as another 55yo, overweight white man who doesn’t have asthma. In fact like for like, there is a small study that suggests that controlled asthma may be a protective characteristic (ie decreases risk of severe complications/death). I’m assuming it’s the ICS we take which helps with this but 🤷‍♀️😅

This being said, there is not a lot of research on uncontrolled asthma and covid risk. There has been some suggestion that maybe those with non-eosinophilic/non-allergic asthma may be at increased risk, however they tend to be the ones more likely to be uncontrolled at the severe end so 🤷‍♀️ (please read lysistratas reply for more info on this!). The only age group where asthma may have been a factor was the 18-49 group I think. And I don’t think there has been much research into asthma and covid in children, but I can imagine that if they are controlled it’s the same as in adults (hopefully).

Hopefully this post explains the evolving thinking of who is at risk. Keep taking your meds, keep fighting to get controlled if you currently aren’t (ie are using salb more than 3 times a week)

If you have other characteristics that concern you (diabetes, weight issues, ethnicity etc) it’s worth discussing it with your health team (GP/consultant etc), but for the majority of asthmatics evidence seems to suggest that covid is not the risk we once thought it would be. Be sensible, stay safe, take your meds, and talk to someone if you have concerns! And of course if you’ve been told to stay in, stay in!

Here’s one of the articles I’ve read, that links to others; aaaai.org/conditions-and-tr...

If you want to find out your COVID risk age here’s the one I’ve used in the past; alama.org.uk/covid-19-medic...

If you’re concerned or need advice about your asthma the AUK helpline nurses are great and can be reached on 0300 2225800 M-F 9-5. Alternatively their WhatsApp service is 07378 606728. Their post covid helpline is 0300 2225942.

[JustR]

Thanks for posting..interesting read as I’ve just experienced my husband recently testing positive for Covid but my result was negative.

Looking back my asthma flare could have actually have been my symptoms, plus other mild Covid symptoms but could have tested too late. My consultant and GP have both commented that my symptoms could have been masked by my steroids?

I have severe asthma and if it was Covid then I managed to get through it.

I now need to find somewhere to get an antibody test done!

[Lysistrata Administrator Community Ambassador]

Thanks for posting! I think a lot of the official information on this is still from back in the spring, and it's good to have a summary of the more recent evidence. I know even before now my consultant (tertiary specialist centre) didn't feel that asthmatics were at the risk they claimed back then.

Specifically re the non-allergic/non-eosinophilic asthma being higher risk: since this is my type of asthma I looked into it more and it does seem to be very speculative. After finding what appears to be the paper mentioning it they do say that. They also haven't controlled for the fact that this type of asthma is more common among people who are older and more likely to be obese - both of which are risk factors in COVID, so it may be nothing to do with the asthma.

I tried another risk calculator aimed at academics/medics and it changed dramatically based on my postcode. I can understand why they do this (the risks are worse for people who are in deprivation, which has a specific index to measure it, and my borough has some very deprived areas and a high death rate in the spring as a result), but at the same time, it doesn't add much to my personal risk because I am privileged and don't have those factors. I'm adding this really as a reminder that these calculators can only ever show an overall risk for a population and your own situation may vary.

Also, as someone working in a scientific area, I would point out that the media overall do not do a good job of understanding and reporting scientific papers. I have compared the original to the report in some cases and they often seem to misread and pick the worst case then misrepresent it.

[twinkly29]

Another thank you for posting this - you can explain this (well and most things 😂) better than I can!

[Hidden]

I guess things are also compounded by variants in the virus strains.

So some reactions are likely to be more mild depending on the strain contracted.

Supposedly the Spanish variant, which we now have additionally here, is more severe, and the one in India less so.

Whether this is applied to guidance isn’t clear and whether it’s given under the more severe strains I presume should be the one, or maybe it’s the more common variant.

[EmmaF91 Community Ambassador in reply to Hidden]

This would have been worked off of the prevalent strains earlier this year

[nmcv13]

Thank you so much for posting this; really helpful and reassuring. I’ll continue to try my best to avoid getting it but thanks again.

[jlb54]

Is anyone worried about the news reports saying that hospitals might be closed to non-Covid patients by Christmas? My asthma is quite controlled by quite worrying what could happen if I have an attack

[twinkly29 in reply to jlb54]

No because most of what the media reports turns out to be complete drivel so I suspect this will be too.

[Paradigm]

I know that the criteria for Severe Asthmatics and steroid takers needing to shield has changed so that you need to be more severe. Over 20mgs of prednisolone long term now. I can't see anything about clinician judgement any more either.

So, now I wouldn't be added to the list.

I'm still concerned due to it being impossible to socially distance at my work. I'm also concerned about the general risk of increased illness rather than just death, I suppose there's a lot of worry. I don't think I'll ask to be shielded again.

According to that, I have a low risk of becoming seriously ill. I am suspicious as both colds and flus impact on my asthma, but as it says - it is a different virus.

[EmmaF91 Community Ambassador in reply to Paradigm]

Not sure what you do work wise, but the current thing is that everyone should work from home unless they really cannot work any other way. So if you were working from home last time you should be this time.

Other things are the concerns, and I’ve not found any research I to who is most susceptible to long COVID yet, which is also a concern. But as the article (and people on here mainly show) their asthma at the time of infection was not massively impacted, even when colds and flu usually do!

[Paradigm in reply to EmmaF91]

I was furloughed last time. I work in customer service in a coffee shop. Really wishing I had a job where I could WFH; unfortunately I took the wrong degree! My other job is as a carer for severely disabled child. So, no distancing there either! I trust it would be flagged if anyone in contact with him had it, though. The students, less so.

[Snowdrop27]

Thankyou for that detailed reply. From what I have understood from your post is that I am not at any more of a risk than an ordinary healthy person of my age. That means a low risk. As for myself I am not worried about it. I just wanted to know what tbe most recent imformation.

I take all the precautions that we are all told to do by following the lockdown rules.

I work with children through an agency which means I can be in contact with many different children on a daily or weekly basis. I have so much as a sniffle since January last year. I believe that because children are washing their hands regularly as well as the staff I have seen very few cold or bugs.

At the moment I am on flexible furlough as the opportunity of work in primary schools and nurseries has been few and far between. Last week I only work 3 days and this week one.

Once again thankyou for your reply.

[EmmaF91 Community Ambassador in reply to Snowdrop27]

It’s one of those things that they are still looking at. But if controlled asthma isn’t covered by group 6 than this is likely the reason why. Hopefully once AUK know for sure what is going on they’ll have their own post explaining the thought process if it’s no, or explaining the guide has again been updated if it’s a yes. They still aren’t sure what’s going on, and most of what I have is anecdotal from nurses/docs I have spoken too.

🤞🏻🤞🏻 there will be an official update soon as this was 3-4 months ago that I wrote this which was when there was a lot of people very worried about the end of lockdown and kids going back to school etc