Management of Acute Asthma in the post COVID era

Paediatric Asthma Workshop
MANAGEMENT OF ACUTE ASTHMA IN THE POST COVID ERA

Anis Siham Zainal Abidin
Sunway Medical Centre, Subang Jaya, Selangor, Malaysia

The COVID-19 pandemic has had a profound impact on various aspects of human health, including the management of chronic respiratory conditions such as asthma. The increase in respiratory infections during and after the pandemic has been linked to exacerbations in asthma symptoms, particularly among individuals who experienced acute COVID-19, as many report ongoing respiratory issues like cough and shortness of breath after recovery. Moreover, the variability in symptom duration and severity, including persistent respiratory symptoms, suggests a significant correlation between COVID-19 and the worsening of asthma control, even in patients who initially presented with mild illness during the infection phase (Mendelson et al., 2020). Furthermore, research indicates that a notable proportion of individuals recovering from COVID-19 may develop long-term respiratory complications, which can lead to increased asthma-related morbidity and require adjustments in management strategies to accommodate the fluctuating severity of symptoms experienced by these patients (Mendelson et al., 2020)(Mehandru & Mérad, 2022)(Rivas-Vazquez et al., 2022). 

The underlying pathophysiology of the connection between COVID-19 and acute asthma exacerbations is multifactorial and not yet fully understood. Several studies highlight the role of persistent airway inflammation and altered immune responses that may predispose individuals to asthma exacerbations following COVID-19, suggesting that these respiratory complications could stem from both direct viral effects and secondary inflammatory processes (Mehandru & Mérad, 2022). In addition, the presence of preexisting conditions, such as congenital heart or bronchopulmonary dysplasia, may further complicate the clinical picture for post-COVID patients by increasing their susceptibility to respiratory infections and subsequent asthma. Moreover, the psychological stressors associated with the pandemic, including anxiety and uncertainty regarding health, may contribute to the exacerbation of asthma symptoms through mechanisms that alter respiratory function and trigger attacks, underscoring the need for a holistic approach in managing affected individuals. (Jones et al., 2006) (Mantovani et al., 2022) (Raman et al., 2021) 

To effectively address the challenges posed by acute asthma in the post-COVID era, healthcare providers must adopt a multidisciplinary approach that considers the unique complexities of each patient's presentation.