COVID-19 and lung diseases

 In Lung-blog

The coronavirus, which is currently spreading throughout the world, is causing uncertainty on many sides. It has not yet been sufficiently researched and there is currently neither a vaccine nor medication that has been proven to help against the virus. The question therefore arises as to what patients with lung disease have to be aware of at this particular time. The presence of an underlying disease can possibly lead to a much more severe course in the case of infection than in people without a previous illness.

The proposed guidelines to which the population should adhere are therefore of particular importance for patients with lung disease. They ensure that the risk of infection is kept as low as possible. The primary goal is to reduce the risk of infection. This can be achieved, among other things, by following general rules of behaviour1 , such as avoiding contact with the mouth, nose or eyes2 , especially with unwashed hands or contact with sick people. In general, it is advisable to avoid contact outside your own household as far as possible. In addition, thorough and regular hand washing2 after touching potentially contaminated surfaces is recommended.

Detailed information on how to deal with the current virus situation can be found everywhere on the Internet. However, it is extremely important to consult reputable sources. We have listed some of them for you at the end of this article. All measures of the German Federal Government can be found here:

https://www.bundesregierung.de/breg-de/themen/coronavirus/corona-massnahmen-1734724  (german)

Instructions on how to wash your hands correctly are now also easy to find. Our tip: The WHO recommends singing the song “Happy Birthday” twice to ensure sufficient duration during each washing process. Here is also a video of the University of Vienna, which explains how to wash your hands easily:

https://www.youtube.com/watch?v=HwMDo_QZkkI&fbclid=IwAR2hQheaQ1Fe33LShixQ3E8dk2Y0FZtyBD4cXPqapo9NcUxyryMOGWtpLRE (german)

In addition to droplet infection, aerosols always crystallize as the primary transmission path. These are droplet nuclei with a diameter of less than 5 micrometers. In order to reduce this risk, closed rooms should always be ventilated as frequently and well as possible. Even if a final assessment is difficult to make at this stage, the studies conducted so far indicate that SARS-CoV-2 viruses can also be transmitted via aerosols in social interactions.15

The clinical picture of COVID-19 should be known to persons belonging to the risk group, so that early self-recognition of symptoms is possible. In the case of a viral infection, rapid contact3 with the family doctor’s practice or by telephone to other advisory services is essential.

 

In this case, dial the number 116 or 117.4

 

If cases of COVID-19 are or become known in the immediate vicinity, this should not be concealed under any circumstances.

 

Asthma and COVID-19

Depending on the severity of the asthma, there are differences in the risk of infection. Asthmatics are normally no more at risk from the coronavirus5 than healthy people, if their asthma is well controlled. Well-adjusted means that they have no complaints due to asthma. This means that only those patients who are symptom-free have no increased risk of infection.

However, if you have severe asthma and/or have to take cortisone tablets to control your symptoms, you may be at particular risk. For example, patients who have been suffering from asthma for a long time may have pathological changes in the lungs6 . In this case the elasticity of the lung tissue decreases, which can lead to difficult breathing. In this case, the affected person is at greater risk of developing a more severe course of the viral infection.

This also applies to uncontrolled asthma. This may be the case if patients need the bronchodilator salbutamol more than twice a week or if the asthma has manifested itself due to a cold. If appropriate training is available, it is possible to independently initiate an increase in long-term therapy 7.

Patients with mild or episodic asthma are at low risk of developing a severe form of coronavirus6. In this case, however, regular intake of the prescribed medication should not be neglected. This is because well-adjusted asthmatics are generally no more at risk from the coronavirus than healthy people8.

In another hypothesis, it is reported that asthmatics even have a lower risk, which is due to the reduced expression of the ACE-2 receptor responsible for the uptake of SARS-CoV-2 in the airways. Patients with allergies and/or type 2 inflammation are particularly affected.9 If you are interested in more details about this risk assessment in patients with chronic respiratory and lung diseases in the context of the SARS-CoV-2 pandemic, we recommend that you read the following statement:

https://pneumologie.de/fileadmin/user_upload/COVID-19/20200527_DGP_BdP_Risikoabschaetzung_chron._LK_SARS-CoV-2_update.pdf (german)

 

COPD and COVID-19

In contrast to asthmatics, the lungs of COPD patients are already chronically altered, for example, by many years of smoking. They can be stiffer and have obstructive changes. Patients who suffer from severe COPD and also need oxygen should stay at home as much as possible and avoid crowds. This group of patients has a higher risk of developing a more serious course of the coronavirus.10 In order to minimise contact outside the home, things such as shopping with friends or acquaintances could be done.

If you are interested in a detailed risk assessment of patients with chronic respiratory and lung diseases in the context of the SARS-CoV 2 pandemic, we recommend that you read the following statement:

https://pneumologie.de/fileadmin/user_upload/COVID-19/20200527_DGP_BdP_Risikoabschaetzung_chron._LK_SARS-CoV-2_update.pdf (german)

 

Medication intake

Some drugs have an immune-suppressing effect, as the body’s own defence is dampened. Especially in the treatment of asthma they can play a central role and also have an anti-inflammatory effect.

 

Despite the immunosuppressive effect, it is strongly recommended to continue the adequate and individually adjusted antiasthmatic inhalation therapy9 and under no circumstances to discontinue the prescribed medication without consulting your own doctor.

 

Stopping the medication could make the disease worse, which could result in a visit to the doctor or even a stay in hospital. There, in turn, the probability of meeting a COVID-19 sufferer and becoming infected is significantly increased. Because of this, it is essential to continue a successful inhalation therapy for asthmatics right now.

For asthma patients who take a break from therapy in summer due to mild symptoms, it is recommended to discuss an extension of the therapy with the doctor. Under long-term therapy, the viral infection may be less severe11.

 

If you have been taking the medication of your basic therapy only irregularly so far, you should change this right now. It is the perfect time to start inhaling again regularly.

 

Our health application Kata® helps you with the correct inhalation. It shows in a simple and understandable way how to inhale correctly. In addition, the app reminds you to inhale and assesses whether you have completed the individual steps of your inhalation process in such a way that the active ingredient has been released into the lungs in the best possible way. Kata® reports in text and pictures how successful your inhalation application was and documents your inhalation therapy. The treatment and therapy successes can be significantly improved. Do not underestimate: Especially now correct inhalation is so important.

 

                                                                                                                             

 

 

Trustworthy sources

It is extremely important to get your information from the right sources. Especially with such a sensitive topic like COVID-19 the risk of false information is increased. Also the state of science is constantly changing and especially serious scientists admit that at the moment there is not a sure answer to all questions.

In the following list we have listed sources that we consider trustworthy:

 

But what do I have to pay attention to in order to distinguish serious sources from dubious sources?

Always keep in mind who is behind the information and what interests these people may have. Particular caution is required when a remedy or treatment to prevent the virus is advertised.13 Reports in which the spread or danger of the corona virus is strongly minimized are also often alarming. If recommendations are made that contradict the information provided by the health authorities, you should first check this carefully. A healthy scepticism about the information overload is therefore highly recommended.

For more information on how to distinguish trustworthy from untrustworthy sources, see the following link:
https://www.infektionsschutz.de/coronavirus/verlaessliche-informationen-erkennen.html#c12327

 

Sources:

1 https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Risikogruppen.html
2 https://www.lungeninformationsdienst.de/themenmenue/news/alle-news-im-ueberblick/aktuelles/article/coronavirus-infos-fuer-menschen-mit-lungenkrankheiten/index.html
3 https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Risikogruppen.html
4 https://www.116117.de/de/coronavirus.php
5 https://www.mein-allergie-portal.com/pollenallergie-heuschnupfen/2610-die-birke-blueht-covid-19-allergien-und-asthma.html
6 https://www.mein-allergie-portal.com/asthma/2585-coronavirus-asthma-bei-erwachsenen-wer-ist-risikopatient.html
7 https://www.mein-allergie-portal.com/allergie-und-unvertraeglichkeit-beim-kind/2578-coronavirus-und-asthma-beim-kind-was-wenn-es-unkontrolliert-ist.html
8 https://www.mein-allergie-portal.com/asthma/2566-coronavirus-und-asthma-hoeheres-risiko-fuer-asthmatiker.html
9 https://pneumologie.de/fileadmin/user_upload/COVID-19/20200527_DGP_BdP_Risikoabschaetzung_chron._LK_SARS-CoV-2_update.pdf
10 https://www.mein-allergie-portal.com/copd/2614-coronavirus-und-copd-welche-risiken-gibt-es.html
11 https://pneumologie.de/fileadmin/user_upload/Aktuelles/2020-03-16_Statement_Asthma_und_COVID-19_F.pdf
12 https://www.lungeninformationsdienst.de/aktuelles/news/alle-news-im-ueberblick/aktuelles/article/coronavirus-asthma-medikamente-wie-gewohnt-einnehmen/index.html
13 https://www.mein-allergie-portal.com/asthma/2612-corona-asthma-wie-umgehen-mit-der-sommerlichen-therapiepause.html
14 https://www.infektionsschutz.de/coronavirus/verlaessliche-informationen-erkennen.html#c12327
15 https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Steckbrief.html

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