Asthma in the era of SARS CoV-2 virus

It is well established in international literature that respiratory viruses can trigger asthma exacerbations. However, not all viruses affect patients in the same manner and extent. The pandemic of the SARS CoV-2 virus has brought interest to study the association of this novel virus on patients with mild-moderate and severe asthma in terms of susceptibility, severity and treatment.

We performed an extensive search of current literature in the databases PubMed, Scopus and Google Scholar for original articles. We decided to include all types of articles, except for case studies, published until the end of February 2021 focusing on the effects of COVID-19 on the respiratory system and the main treatment recommendations up to date for patients with bronchial asthma.

Until now there is no clear evidence that asthmatics have a higher risk of experiencing exacerbations when infected, nor higher mortality rates than the general population. Nevertheless, our knowledge on molecular pathways behind asthma phenotypes in the past decades is growing, and it underlines the need to predict the unique response each patient may have to infection from the novel coronavirus. It is not clear yet if certain sub-populations of asthmatics are at higher risk than others.

Despite the lack of evidence for higher susceptibility and/or mortality in relation to COVID-19, all asthmatic patients, whether treated with inhaled bronchodilators/corticosteroids or even biologics, should maintain their controller therapy without making any alterations.