Asthma and COVID-19

Abstract

The COVID-19 pandemic has collapsed the health systems of many countries in the world and comorbidities in adults have exponentially increased their mortality; in matters of asthma, it has not been possible to establish a defining relationship in mortality. The clinical manifestations of asthmatic patients with SARS COV 2 are presented in a wide range; from asymptomatic to those who experience acute respiratory failure. The most sensitive method for the diagnosis of SARS-CoV-2 infection is RT-PCR. Antigen and serologic tests are quicker than RT-PCR, but they are less sensitive. Radiologic studies and the computed tomography of the chest assist in the diagnosis and follow-up of SARS-CoV-2 infection. The use of spirometry for diagnosis and follow-up is restricted due to the elevated risk of contagion. It has been shown that eosinophilia and TH2 inflammation, due to their antiviral immune effect, are protective factors against severe SARS-CoV-2/COVID-19. Patients with mild asthma express less angiotensin converting enzyme receptors (ACE2), and those with neutrophilic asthma express it in greater proportion, which suggests more severe presentations of COVID-19. The conventional asthma treatment modulates the SARS-CoV-2/COVID-19 immune response, which is why patients with controlled asthma have non-severe manifestations of COVID 19, however, the mechanisms are not clear.