Covid-19 and asthma concerns

COVID-19 is mainly a respiratory infection, and there are concerns regarding the effects of this virus on children and youth with asthma. But, NO EVIDENCE to date to suggest that young people with asthma are at increased risk for COVID-19 infection.

Further to this concern is that a child or youth with asthma infected with COVID-19 could experience an asthma exacerbation and serious morbidity due to combined effects on the respiratory tract [3]-[5]

In Canada –children and youth living with asthma

  • should remain on their current controller medications and take them as ordered
  • Asthma exacerbations should be aggressively treated, including the use of oral corticosteroids when needed.
  • Nebulization should be avoided, if possible, due to transmission risk.
  • Close monitoring of medication shortages is required and ongoing. Medication shortages, including shortages of asthma medications, already exist in Canada.

Other precautionary practices include:

September – peak for asthma typically the 3rd week of September or the 3rd week after school starts is when there is an increase in asthma exacerbations.

Families with concerns should discuss their child’s asthma with the physician who helps them to manage the asthma. Each family will have to decide on risk and benefit regarding school. Our focus remains on having asthma in the best control possible.

Concerns have also been raised regarding oral corticosteroid use in individuals infected by COVID-19, based on the possibility of increased viral replication [7]. Such concerns must be weighed against the general consensus that asthma exacerbations should be treated aggressively, and in accordance with current best practices [6]. The Global Initiative for Asthma guidelines recommend using oral steroids as required, and in keeping with the child’s current asthma action plan, during the COVID-19 pandemic [6][8].

-Practitioners should be aware that nebulizing medication is an aerosol-generating medical procedure (AGMP) and can increase the risk of COVID-19 transmission [10][11].

-Nebulized salbutamol should only be considered when no other option is available

Recommendation: make sure the asthma puffers are full and up to date, check the ordered medications with your doctor. Ensure your child uses the asthma medication as prescribed.

URIS program- MFNERC

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