Coronavirus disease 2019 and severe asthma

Area of Science:

• Immunology
• Respiratory Medicine
• Infectious Diseases

Background:

• The interplay between asthma and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remains unclear, with ongoing debate about asthma's role as a risk factor or protective element.
• Investigating whether SARS-CoV-2 infection can trigger asthma exacerbations is also a key area of inquiry.

Approach:

• This review synthesizes existing literature to elucidate the factors influencing the relationship between asthma and SARS-CoV-2 infection.
• Analysis focuses on recent observations regarding type 2 inflammation and its potential protective effects.

Key Points:

• Type 2 inflammation in asthma may confer protection against SARS-CoV-2 infection and severe COVID-19.
• Asthma patients exhibit altered expression of ACE2 and TMPRSS2, potentially reducing infection risk and hospitalization.
• Inhaled corticosteroids and biological therapies demonstrate a safe profile during SARS-CoV-2 infection and may prevent asthma worsening.

Conclusions:

• Current asthma management strategies, including inhaled corticosteroids and biological treatments, should be continued to prevent severe exacerbations.
• Severe asthmatics undergoing biological treatment are encouraged to maintain their therapy and receive COVID-19 vaccination.