In addition to droplet infection, aerosols are always emerging as the primary route of transmission. These are droplet nuclei that have a diameter smaller than 5 micrometers. To reduce this risk, closed rooms should always be ventilated as frequently and well as possible. Although a conclusive assessment is difficult at this time, overall, studies to date indicate that SARS-CoV-2 viruses can also be transmitted via aerosols in social settings.¹⁵

The clinical picture of COVID-19 should be known to individuals who belong to the at-risk group so that early self-recognition of symptoms is possible. In the event of contracting the viral infection, rapid contact³ to the family doctor’s office or by telephone to other advisory services is essential.

In this case, dial 116 or 117.⁴

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

Asthma and COVID-19

There are differences in the risk of infection depending on the severity of asthma. Asthmatics are normally no more at risk from coronavirus⁵ than healthy people if their asthma is well controlled. Well-adjusted means having no symptoms due to the asthma. This means, then, that only those patients who are also symptom-free are not at increased risk of infection.

However, if they have severe asthma and/or need to take cortisone tablets to control their symptoms, they may be at particular risk. For example, in such patients who have had asthma for a long time, pathological changes may have occurred in the lungs.⁶ 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, for example, if patients require the bronchodilator drug salbutamol more than twice a week or if the asthma has manifested itself due to a cold. If appropriate training is available, independent initiation of an increase in continuous therapy is possible.⁷

In patients with mild or episodic asthma, the risk of developing a severe expression of coronavirus is low6. However, in this case the regular intake of prescribed medication should not be neglected. Because well controlled asthmatics are in principle not more endangered by the coronavirus⁸ than healthy people.

In another hypothesis, asthmatics are even reported to be at lower risk due to reduced expression in the airways of the ACE-2 receptor responsible for SARS-CoV-2 uptake. This mainly affects patients with allergies and/or type 2 inflammation.⁹ If you are interested in detailed information about this risk assessment in patients with chronic respiratory and pulmonary diseases in the context of the SARS-CoV-2 pandemic, we recommend reading the following statement:

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

COPD and COVID-19

Unlike asthmatics, the lungs of COPD patients are already chronically altered by many years of smoking, for example. It may be stiffer and obstructively altered. Patients who suffer from more severe COPD and also require oxygen should stay indoors as much as possible and avoid crowds, according to recommendations. This patient group has a higher risk of developing a more severe course of coronavirus.¹⁰ For example, to minimize out-of-home contact, errands such as shopping could be done by friends or acquaintances.

If you are interested in a detailed risk assessment of patients with chronic respiratory and pulmonary disease in the context of the SARS-CoV-2 pandemic, we encourage you to read the following statement:

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