In asthma, infections can increase the frequency of attacks. Research conducted during the pandemic process reveals that asthma does not increase the risk of COVID-19, but the mortality rate associated with COVID-19 increases in patients whose asthma is not under control. The COVID-19 vaccine, which has been implemented all over the world, can be applied to asthma patients, except those who have allergic reactions to vaccines and some medications, and those with a serious allergy history. Professor of Allergy Diseases Department of Memorial Ankara Hospital. Dr. Adile Berna Dursun gave information about COVID-19 infection and vaccine administration in asthma patients.
It is known that there are approximately 335 million asthma patients all over the world and approximately 4 million in our country, and these numbers are increasing day by day. In our country, asthma is observed in 100-5 out of every 7 adults and 100-13 out of every 14 children. In other words, asthma is a public health problem that can be seen in all age groups all over the world. How the pandemic process and the COVID-19 vaccine will affect asthma patients and what should be done are among the topics that are wondered.
Different factors specific to the individual may cause asthma.
Asthma is a chronic condition that occurs due to narrowing of the airways (bronchi) due to non-microbial inflammation. In asthma, which is a disease characterized by recurrent and episodic cough, shortness of breath, wheezing or whistling sound, chest tightness / pressure sensation, any or more of these symptoms can be seen together. Different factors specific to each individual (allergens, exercise, air pollution, chemicals, cigarette smoke, cold air, stress, etc.) may play a role in the emergence of symptoms.
Pulmonary function test provides important clues for diagnosis
The medical history of the individual is the most obvious guide in the diagnosis of asthma. However, a comprehensive physical examination should be performed and a respiratory function test, which is the most important examination for the diagnosis of asthma, should be performed. Pulmonary function tests can be performed in the hospital environment or by remote access thanks to new technologies during the pandemic period.
The goal is to control the disease
The aim of asthma treatment is to control the disease. Asthma can often be brought under control by setting common goals in the treatment of asthma with the cooperation between the physician and the patient / patient's relatives and making plans accordingly. First of all, it is important to determine the triggers specific to each individual and to reduce the exposure to these triggers and, if possible, to prevent them. Reviewing diseases such as allergic rhinitis, drug allergy, nasal polyps, chronic sinusitis that may accompany asthma and arranging appropriate treatments for these diseases are another effective factor in controlling asthma. The next stage involves planning the appropriate individual drug therapy.
Asthma Covid-19 does not increase the risk of transmission
The impact of the COVID-19 virus on asthma patients and how asthma patients should take measures in this process are among the most curious issues. Since the beginning of the pandemic, there are no data on increased risk of COVID-19 in patients with asthma. However, it has been shown that the mortality rate associated with COVID-19 is increased in patients whose asthma is not under control. For this reason, patients who have difficulties in controlling asthma should pay maximum attention to coronavirus measures and apply to the health institution for treatment approaches to control asthma.
What asthma patients should do to overcome the pandemic process with the least amount of problems;
- Medications to control asthma should continue to be used regularly and absolutely should not be interrupted.
- Patients with severe asthma should continue their biological treatments and oral cortisone treatments under the control of a physician.
- A written action plan for an asthma attack (information for treatments that the patient can initiate himself in case of an attack and information for attack management) should be provided to each patient.
- Patients who cannot come to the health institution, do not want to come, or who are at risk to come can be followed up in centers with remote access technological infrastructure.
- Proper use of masks, protection of social distance and attention to hand hygiene should continue uninterruptedly. It should also be kept in mind that overuse of disinfectants can also trigger symptoms.
- Asthmatic patients should also be vaccinated for influenza (seasonal flu).
During the COVID-19 pandemic, taking all measures for asthma control effectively will lead to a decrease in deaths due to COVID-19 in asthmatic patients.
Allergic reaction is rare after vaccination
Vaccines with various characteristics have been developed for COVID-19 and these development stages are still ongoing. In this context, local (at the application site) side effects such as redness-swelling, fever and weakness are reported against the vaccines. In general, the development of allergic reactions to vaccines is rare, with less than 1 in 1 million doses. It has been reported that one of the mRNA COVID-19 vaccines, which is not currently available in our country, has been observed with one 200 dose of Pfizer-BioNTech vaccine, and one anaphylaxis (allergic shock) with a 000 dose of Moderna vaccine. It is among the data that 360 percent of cases with anaphylaxis had a history of serious allergic reactions before and 000 percent of allergic reactions with this vaccine were observed within the first 1 minutes after administration.
Those with a history of allergic reactions to the vaccine, attention!
Considering that anaphylaxis is rarely observed with COVID-19 mRNA vaccine and COVID 19 infection is a clinical condition that can result in death, vaccination can be applied to asthmatic patients, except for the following situations. However, this situation must be diagnosed by a doctor.
- Those who had anaphylaxis with the first COVID-19 vaccine administration
- Those with a previous history of severe allergic reactions with any vaccine
- Those who are allergic to laxatives, depot corticosteroids and antacid stomach medications
Those with allergic history, attention!
Regardless of the type of coronavirus vaccine, it is recommended that individuals with a history of severe allergic reactions should report this to the vaccine administration team, the vaccine should be administered in the health institution with emergency intervention facilities, and observed for at least 30 minutes after the vaccination.