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2019冠状病毒病大流行期间哮喘患者的管理:应对挑战的病理生理学考量

Management of asthma patients during the COVID-19 pandemic: pathophysiological considerations to address the challenges.

作者信息

Tabassum Tahani, Rahman Ahsab, Araf Yusha, Ullah Md Asad, Hosen Mohammad Jakir

机构信息

Biotechnology Program, Department of Mathematics and Natural Sciences, School of Data and Sciences, Brac University, Dhaka, Bangladesh.

Department of Genetic Engineering and Biotechnology, School of Life Sciences, Shahjalal University of Science and Technology, Sylhet, Bangladesh.

出版信息

Beni Suef Univ J Basic Appl Sci. 2022;11(1):20. doi: 10.1186/s43088-022-00204-4. Epub 2022 Feb 5.

Abstract

BACKGROUND

The coronavirus disease 2019 (COVID-19) has become a serious global health issue, especially for people with pre-existing health conditions. Patients dealing with asthma are presumed to be at higher risk as COVID-19 may cause severe respiratory distress.

MAIN BODY

From the initial stage of the pandemic, several clinical trials and studies have assessed the association between COVID-19 and asthma; however, no significant association was reported. This may be due to the fact that most of the asthma cases remained undiagnosed and overlapping respiratory features make it difficult to differentiate between these two diseases. The pathomechanism of the conditions and the immune response generated in response to the conditions suggest that the presence of any of the conditions is very likely to influence the presence or severity of the other condition. So far, no specific treatments are known for COVID-19; however, the use of plasma therapy and broad-spectrum antiviral drugs during the initial phase of the pandemic and widespread vaccination during the latter phase has given positive outcomes in reducing COVID-19 cases as well as disease severity.

SHORT CONCLUSION

Taking asthma as an increased risk factor for COVID-19 morbidity, this article aims to provide comprehensive insights into the risk and proper management of asthma patients during this COVID-19 pandemic. The common medications of asthma patients suppress their respiratory immune response that might facilitate cytokine storm in COVID-19 patients. Similarly, there are risks of viral-induced asthma exacerbations. Besides, different social issues such as shortage of medicines, SDOH, and delayed clinical trials put asthma patients through inconvenience. The primary focus at this point should be to reduce probable asthma attacks and severity to prevent hospitalization of asthma patients. Moreover, for better management of asthma patients maintaining an asthma action plan and healthy lifestyle, ensuring a nutritious diet, and developing self-management interventions can play a crucial role.

摘要

背景

2019年冠状病毒病(COVID-19)已成为一个严重的全球健康问题,尤其是对于那些有基础健康问题的人。由于COVID-19可能导致严重的呼吸窘迫,哮喘患者被认为风险更高。

正文

从疫情初期开始,多项临床试验和研究评估了COVID-19与哮喘之间的关联;然而,未报告有显著关联。这可能是因为大多数哮喘病例未被诊断出来,且重叠的呼吸道特征使得难以区分这两种疾病。这些病症的发病机制以及针对这些病症产生的免疫反应表明,任何一种病症的存在都很可能影响另一种病症的存在或严重程度。到目前为止,尚无针对COVID-19的特效治疗方法;然而,在疫情初期使用血浆疗法和广谱抗病毒药物,以及在后期广泛接种疫苗,在减少COVID-19病例数量和疾病严重程度方面取得了积极成果。

简短结论

本文将哮喘视为COVID-19发病的一个风险增加因素,旨在全面深入了解在此次COVID-19大流行期间哮喘患者的风险及合理管理。哮喘患者常用药物会抑制其呼吸道免疫反应,这可能会促使COVID-19患者发生细胞因子风暴。同样,存在病毒诱发哮喘加重的风险。此外,药品短缺、健康的社会决定因素以及临床试验延迟等不同社会问题给哮喘患者带来不便。此时的主要重点应是减少可能的哮喘发作及其严重程度,以防止哮喘患者住院治疗。此外,为了更好地管理哮喘患者,维持哮喘行动计划和健康的生活方式、确保营养饮食以及开展自我管理干预措施可发挥关键作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b956/8817645/238759ec6d6a/43088_2022_204_Fig1_HTML.jpg

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