COVID-19 and Asthma, Allergy and Immune Deficiency Patients

ACAAI Statement:

The recent pandemic outbreak of Coronavirus has created much uncertainty and anxiety among many of our patients. Elderly patients, as well as patients with severe asthma, immunodeficiency and other chronic conditions where their immune system may be compromised, are most susceptible to increased morbidity and mortality from viral infections in general, and we assume similar precautions should be recommended to these individuals for Coronavirus.

We recommend all patients especially those with asthma, to remain on their medications. Specifically, asthma patients taking inhaled corticosteroids (ICS) should continue these medications as they have been shown to prevent or reduce asthma exacerbations in part by reducing ICAM-1 levels and/or acidic endosomes important for modulating airway inflammation associated with viral infections.

A recent study reported that ICS inhibit the Coronavirus strain, HCoV-229E, replication partly by inhibiting receptor expression and/or endosomal function thereby modulating infection-induced airway inflammation.  To date 80% of cases are mild and self-limited, manifesting as fever, cough and shortness of breath.

Patients with severe asthma currently on a biologic therapy, there is no information at this time that these treatments should be stopped. We assume they are at increased risk of severe illness if they catch COVID-19 infection and optimal control of their chronic condition is of utmost importance.

Detailed clinical investigation of 140 hospitalized COVID-19 cases in Wuhan China suggests eosinopenia (low eosinophil count) together with lymphopenia (low lymphocyte count) may be a potential indicator for diagnosis. Allergic diseases, asthma, and COPD were not risk factors for COVID-19 infection. The authors found that older age, high number of comorbidities, and more prominent laboratory abnormalities were associated with severe patients.

A joint statement on the current epidemics of new Coronavirus by the world's different primary immunodeficiency organizations has been published. Their recommendations for patients with primary immunodeficiencies (PID) state that there is currently no data pointing to whether PID patients are actually at higher risk of more severe disease from COVID-19. However, it is believed that PID patients might be at higher risk for this infection or a more severe course of the disease. Thus, patients with PID need to take extra care to prevent from getting this infection. Please go to the following link for more information: https://www.ceredih.fr/uploads/COVID19_WORLDWIDE_Joint_Statement_20200311_1200CET_FINAL.pdf?utm_source=College+Insider&utm_campaign=c3588448b0-EMAIL_CAMPAIGN_2020_03_12_06_37&utm_medium=email&utm_term=0_824f79a3c1-c3588448b0-43171149

Reasonable health care recommendations for asthma and immunedeficiency patients are:

-Avoid close contact (6 feet) with people who are sick.
-Avoid touching your eyes, nose, and mouth.
-Wash your hands often with soap and water for at least 20 seconds.
-Use an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water are not available.
-Use tissues to cover coughs and sneezes, then discard tissue in the trash.
-Clean/disinfect frequently touched objects and surfaces.
-IF YOU ARE SICK, STAY AT HOME!
For up-to-date information about the Coronavirus pandemic visit the CDC's coronavirus website.

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There is a ton of information on the Internet for nearly any topic you can imagine.  The trick is getting to the right website.  There is so much data available on the Web that you can spend days wandering around, jumping from one related topic to another.  It is important to know who is providing the information.  You want a reliable web site to address your allergy problems and concerns.  The following are such sites we recommend you visit.  You can surf at your own risk but please talk to your doctor about any questions you have.  We will periodically list sites that may be of interest to you.  

American College of Allergy, Asthma & Immunology: www.acaai.org 

Find an Allergist. Find relief: http://www.allergyandasthmarelief.org

American Academy of Allergy, Asthma & Immunology: http://www.aaaai.org

Choosing Wisely Videos: 
aaaai.execinc.com/videos/Choosing-Wisely-Videos.asp

The goal of Choosing Wisely, is to increase conversation among physicians and patients by helping patients choose care that is:

• Supported by evidence
• Not duplicative of other tests or procedures already received
• Free from harm
• Truly necessary

National Allergy Bureau (Nationwide pollen counts): http://www.aaaai.org/nab

Food Allergy Network: http://www.foodallergy.org

Kids with food allergies: support & allergy free recipes: www.kidswithfoodallergies.org

National Jewish Medical and Research Center, Denver: http://www.njc.org

Allergy and Asthma Network/Mothers of Asthmatics, Inc: http://www.aanma.org

American Lung Association: http://www.lungusa.org/

Asthma and Allergy Foundation of America: http://www.aafa.org

Immune deficiency foundation: http://www.primaryimmune.org

Allergy topics of Interest:

• Seasonal Allergies
• Pollen Allergy
• Ragweed Allergy
• Eye Allergy
• House Dust Allergy
• Pet Allergy
• Mold allergy
• Food Allergy
• Drug Allergy
• Insect sting Allergy
• Cockroach Allergy
• Skin allergies
• Sinusitis

Anaphylaxis and related topics

Latex Allergy

Allergy-Immunology Glossary

• Patient Education Allergy Videos
• Patient Support Organizations
   

Research Articles

Patient Newsletter

Other sites of interest include the following:
Up to date medical information for patients: http://www.uptodate.com/patients/index.html

General medical information: http://www.medscape.com

Mayo Clinic web site: http://www.mayohealth.org

Medical Organizations:

• American Board of Medical Specialties
• American Medical Association
• World Health Organization

Skin Health:

• Mayo Clinic
• WebMD