When the COVID-19 outbreak began, experts warned asthmatics to be especially careful. Since the coronavirus usually infects the lungs and causes breathing problems, these patients were considered particularly vulnerable patients.
But, according to the Daily Mail, studies have shown that during the pandemic, only 14 percent of people hospitalized with COVID in the UK suffered from asthma. What’s more, these patients were more likely to survive than others if they were infected with the coronavirus.
And now it turns out that in the past 18 months, the number of asthmatics who had an attack severe enough to require a visit from a physician was less than in the previous four years.
“During the pandemic, primary health care attendance during exacerbations dropped significantly,” said study lead author Dr. Syed Shah, Research Fellow at the University of Edinburgh Asthma Research Center.
Dr. Shah and his team analyzed the medical records of more than 100,000 asthma patients and found a 20 percent decrease in the number of visits to a physician for asthma attacks. However, the number of seizures severe enough to warrant hospitalization has not changed.
This phenomenon is not limited to the UK, the Daily Mail notes. Something similar is happening in the United States, where another major study found that the number of asthma attacks experienced at home was down 40 percent from previous years.
So what’s going on? The explanations put forward so far include people’s inability to get to a personal meeting or even a reluctance to visit a doctor for fear of contracting COVID-19. Another explanation suggests that asthma medications provide some protection against the virus. There is also a theory that pandemic precautions – masks, distancing, isolation – reduced the risk of exposure to other viruses known to cause asthmatic attacks.
To be sure, fear of the coronavirus prevented people from seeing a doctor. “Many of our patients told us they were afraid to seek help during a pandemic for fear of contracting the coronavirus,” says a spokesman for Asthma UK and the British Lung Foundation Partnership. Others, meanwhile, simply could not get a face-to-face meeting with their therapist.
But Professor Elliot Israel, an American lung specialist, has a different theory that the number of people seeking help for asthma is decreasing. He believes that experts may have paid too much attention to advising patients to avoid substances that trigger allergic asthma attacks, such as pollen, cleaning products or pollution, when other illnesses may be more serious.
“These things can provoke an attack, but the ability of other viruses to trigger these attacks is now more important,” says the expert.
During the pandemic, people took precautions that reduced their risk of contracting viral infections, and as a result, the incidence of these infections dropped dramatically overall.
Typically, about 50,000 people die from influenza in the United States every year. Last year, however, between 1,000 and 2,000 people died from the flu, he says. The new data sparked a debate among experts.
“We cannot assume that because doctors see fewer patients with asthma attacks, people do not have them,” said a spokesman for Asthma UK and the British Lung Foundation Partnership. “We know that 66.7% of people who have had an asthma attack dealt with it at home.”
In response, Professor Israel notes that his study, which involved 1,000 people with asthma, was designed specifically to report on what was happening in their homes. “They sent in weekly reports on how they were feeling, what medications they were taking, and whether they had a seizure,” he says. “When the reports came in, it was clear that the number of attacks had dropped.”
His theory is supported by Dr. Lauren Cohn, lung specialist and assistant professor of medicine at Yale University. “During the pandemic, my patients had fewer exacerbations than in previous years,” she says. “We think it has to do with wearing a mask and having limited contact with people at work and at school.”
So what else can you cut down? Professor Jeffrey Chupp, director of the Center for Asthma and Respiratory Diseases at Yale University, found that asthmatics, who make up about 10% of COVID-19 patients in the United States, are more likely to survive coronavirus infection. “Perhaps some of the medications used for asthma have helped reduce the inflammation caused by COVID-19,” he told Good Health.
This is because the inhalers that people with asthma use to relieve symptoms of an attack contain low doses of steroids that reduce inflammation, he said. It is also possible that the drug suppresses ACE2 receptors found in cells throughout the body that the virus uses to get inside, making it difficult for it to access, suggests Professor Israel.
Dr. Shah has a different, more traditional theory: “There is a lot of evidence that asthma is improved when environmental triggers such as pollen, air pollution, cleaning agents are properly managed.”
Air quality has certainly improved temporarily in cities around the world during the quarantine. One report states that due to the reduction in emissions from industry and transport in 2020, 65% of the analyzed cities in the world experienced better air quality compared to 2019.
“Cleaner air during the pandemic certainly helped, and as a preventive measure, more asthma patients received inhalers and were encouraged to use them in the event of an exacerbation of the disease,” says Dr. Shah. “So the pandemic could be causing the number of outbreaks to decrease because people are more careful.”
But Professor Israel disagrees. “I had to rethink my long-standing assumption that most asthma is caused by allergens in the home and office. This is not consistent with the fact that the number of attacks did not increase, but decreased when people were isolated in homes that are a rich source of allergens. This is why it makes sense to pay more attention to viruses. “
The fact that the number of people admitted to the hospital did not decrease suggests that those who did not see their therapist had milder seizures.
Ironically, a stronger viral link could mean asthma sufferers may need to take longer physical precautions against the effects of the pandemic.
“This is a rapidly evolving situation, and we are all trying to sort out different aspects,” says Professor Israel. – The lifting of restrictions means that an increase in the number of all viral infections is likely. Precautions such as masks may need to be kept longer to keep viruses out. They are pretty low tech at the moment. I suspect that this technology will improve significantly soon. “
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