Asthma in the COVID-19 Context

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Please note that at this time, the content on this page is not being regularly updated.

Now more than ever it is important for your patients to look after their health and receive care from you as their healthcare provider. It’s essential that patients continue to seek out care that they need.

This tool has been developed to support primary care providers in navigating and providing patient care in a world where COVID-19 is the ‘new normal’, with considerations and recommendations on what’s ‘new’ and what’s ‘changed’ in the delivery of care for patients living with Asthma.  While how care is delivered has changed, efforts should be made to ensure that the quality has not. As always, when treating your patients, continue to use your clinical judgement and follow standards of care, best practices, evidence and guidelines.

Seek support:  If you need support providing the best care possible for your patients, you can consult specialists via OTN eConsult.

Key takeaway

There does not appear to be an increased risk of acquisition of COVID-19 among asthma patients, but it is possible that COVID-19 can trigger asthma exacerbations. (CTS, April 7, 2020; CPS, September 8, 2020).

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What's new, what's changed

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Management

Ensure adherence to regular asthma treatment (CTS, April 7, 2020; The Lung Association, June 2, 2020)

Discuss wearing a mask and address any concerns or anxieties the patient might have.

  • There is no evidence that wearing a facemask will exacerbate an underlying lung condition (CTS, November  30, 2020). If breathing through a mask causes a patient to feel short of breath, they should remove the mask, and if symptoms do not immediately settle, they should follow their existing strategy for relief of acute symptoms.
  • If wearing a facemask is not possible despite best efforts, patients should instead avoid or minimize circumstances where physical distancing is not possible.

Putting it into practice

Treatment

Putting it into practice

  • Inhaled maintenance therapies: Patients with asthma should restart or continue to use their prescribed inhaled maintenance therapy to improve disease control and to reduce the severity of exacerbations.
  • Corticosteroids: There is no evidence that inhaled corticosteroids increase the risk of acquiring COVID-19 or that they increase the severity of infection. Prednisone may be used to treat severe asthma exacerbations, including those caused by COVID-19 infection. Dosage should be low-to-moderate (≤ 0.5-1 mg/kg per day methylprednisolone or equivalent) and duration should be short (≤ 7 days) for exacerbations suspected to be caused by COVID-19 infection.
  • Biologics: Biologics should be continued during the COVID-19 pandemic. If biologic therapies are interrupted temporarily, it is suggested to step-up other controller therapies on an individualized basis. Where available, family physicians/primary care nurse practitioners may consider switching patients to self-administration of biologics at home.
  • Nebulized therapy: Nebulized therapy should be avoided during this pandemic. For patients who are already using nebulizers at home, they should continue to do so until they discuss switching to an alternative with their family physician/primary care nurse practitioner. Alternatives to nebulized therapy include therapy with a metered dose inhaler (MDI) with spacing device, or a dry powder inhaler.

Resources

For patients

Supports

Oxygen and respiratory services

Resources

For providers

In the event of medication shortages, consult:

These supporting materials and resources are hosted by external organizations. The accuracy and accessibility of their links are not guaranteed. CEP will make every effort to keep these links up to date.