Review
A review on the effect of COVID-19 in type 2 asthma and its management

https://doi.org/10.1016/j.intimp.2020.107309Get rights and content

Highlights

  • Pulmonary inflammation due to systemic allergy leads to aggravation of asthma.

  • Conflicting relations were observed in COVID-19 and asthma.

  • Treatment regimens were assigned based on the severity of the symptoms.

  • Systemic corticosteroids decreased mortality rate in severe conditions.

  • Collectins were seen to expel SARS-CoV-2 from alveolar tracts.

Abstract

Background

COVID-19 is considered the most critical health pandemic of 21st century. Due to extremely high transmission rate, people are more susceptible to viral infection. COVID-19 patients having chronic type-2 asthma prevails a major risk as it may aggravate the disease and morbidities.

Objective

The present review mainly focuses on correlating the influence of COVID-19 in type-2 asthmatic patients. Besides, it delineates the treatment measures and drugs that can be used to manage mild, moderate, and severe symptoms of COVID-19 in asthmatic patients, thus preventing any exacerbation.

Methods

An in-depth research was carried out from different peer-reviewed articles till September 2020 from several renowned databases like PubMed, Frontier, MEDLINE, and related websites like WHO, CDC, MOHFW, and the information was analysed and written in a simplified manner.

Results

The progressive results were quite conflicting as severe cases of COVID-19 shows an increase in the level of several cytokines that can augment inflammation to the bronchial tracts, worsening the asthma attacks. Contradicting to this, certain findings reveal the decrease in the severity of COVID-19 due to the elevation of T-cells in type-2 asthmatic patients, as prominent reduction of T-cell is seen in most of the COVID-19 positive patients. This helps to counteract the balance of immune responses and hence ameliorate the disease progression.

Conclusion

Asthmatic patients must remain cautious during the COVID-19 pandemic by maintaining all the precautions to stay safe due to limited research data. Future strategies should include a better understanding of asthmatic exacerbation and its relation to COVID-19.

Keywords

COVID-19
SARS-CoV-2
Type-2 asthma
Cytokines
Inflammation
T-cells

Abbreviations

SARS-CoV-2
Severe Acute Respiratory Syndrome Coronavirus-2
COVID-19
Coronavirus Disease-19
NIH
National Institutes of Health
NSAIDs
Nonsteroidal Anti-Inflammatory Drug
ACE inhibitors
Angiotensin-Converting Enzyme Inhibitors
AHR
Airway Hyper-Responsiveness
TSLP
Thymic stromal lymphopoietin
NK Cells
Natural Killer cells
FVC
Forced Vital Capacity
PEF
Peak Expiratory Flow Rate
FEV1
Forced Expiratory Volume In The First Second
FeNO
Fractional Exhaled Nitric Oxide
STAT-6
Signal Transducer And Activator Of Transcription-6
JAK-2/STAT-5
Janus Kinase-2/Signal Transducer And Activator Of Transcription-5
M-CSF
Macrophage Colony-Stimulating Factor
POSTN
Periostin Gene
ORF
Open Reading Frames
RBD
Receptor-Binding Domain
TMPRSS2
Transmembrane Protease, Serine 2
Rdrp
RNA-Dependent RNA Polymerase
HLA
Human Leukocyte Antigen
CDC
Centres For Disease Control And Prevention
HRV
Human Rhinovirus
AERD
Aspirin-Exacerbated Respiratory Disease
FRC
Functional Residual Capacity
ERV
Expiratory Reserve Volume
TNF-α
Tumor Necrosis Factor-Alpha
ACOS
Asthma-COPD Overlap Syndrome
COPD
Chronic Obstructive Pulmonary Disease
GINA
Global Initiative For Asthma
FRU
First Referral Units
HFNC
High Flow Nasal Cannula
DPPC
Dipalmitoyl Phosphatidyl Choline
NRDS
Neonatal Respiratory Distress Syndrome
SP
Surfactant Protein
HRCT
High-Resolution Computed Tomography

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Authors with equal contribution.

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