Many asthmatics fear an increased risk of infection or a severe course of the disease due to their previous exposure. Still, you shouldn’t just stop taking your cortisone sprays.
Older people or people with previous illnesses apply in the current one COVID-19 pandemic as a special risk group. And since the aggressive SARS-CoV-2 virus primarily affects the lungs, many asthma patients are afraid of an increased risk of infection and of a possibly severe course.
Additional uncertainty was caused by indications that medication frequently used by asthma patients additionally increases the risk of infection.
Continue using cortisone sprays?
Most often, cortisone sprays are used in asthma therapy or cortisone tablets if the course of the disease is severe because they have an anti-inflammatory effect and dampen the asthmatic hypersensitivity of the bronchi. So they regulate the body’s immune defense downwards, so the active substance has an immunosuppressive effect.
German pulmonologists and experts now want to counter this uncertainty with a joint statement. According to this, the risk of correctly adjusted asthma patients is not increased as long as they continue to take their medication regularly and do not stop taking it themselves without consulting the doctor. In the event of worsening, the cortisone dose should be adjusted accordingly according to the instructions of the attending pulmonologist.
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This assessment is in contrast to recommendations that view therapy with these inhalable corticosteroids (ICS) critically. For example, the chief virologist at the Charité in Berlin, Professor Christian Drosten, cautiously recommended that asthma patients should clarify with the doctor treating them whether the asthma medication based on cortisone should be replaced by a medication that interferes less with the immune system.
Since such a connection has not yet been scientifically proven, the experts of the German Society for Pneumology and Respiratory Medicine (DGP) continue to adhere to inhalation therapy.
The sudden discontinuation of medication or a change in therapy could be much more dangerous than an increased risk of infection with SARS-CoV-2, which is still to be proven, warn the lung experts.
They see older people with severe asthma and patients who regularly take cortisone tablets at greater risk. Anyone who has only occasionally used cortisone sprays as an asthma patient should now do this regularly so that the airways remain open and the patient does not have to deal with coughing or shortness of breath. If the cortisone spray does not help, you should consult your doctor.
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Are additional protective measures useful?
In principle, people with chronic respiratory diseases are less able to fight viruses themselves, since the lung mucosa is weakened by the existing disease. According to the pulmonologist and professor at the Munich University Clinic Rainald Fischer, asthma patients are not at so great a risk, since their bronchial mucosa usually only has an allergic inflammation and usually does not develop pneumonia.
Fischer also pointed out that wearing a face mask, such as one more effective FFP3 mask with filter function, can be uncomfortable, especially for lung patients, as this makes breathing somewhat difficult.
Since viruses and bacteria can also ignite the lungs and bronchial tubes independently of the new SARS-CoV-2 coronavirus, many doctors also believe that vaccination against flu and pneumococci is also useful for asthmatics.
And in general, asthmatics and other people with respiratory diseases should pay particular attention to general hygiene measures and a sufficient safety distance from other people of at least 1.5 meters.
Author: Alexander Freund