COVID-19 and Asthma: Reflection During the Pandemic

Clin Rev Allergy Immunol. 2020 Aug;59(1):78-88. doi: 10.1007/s12016-020-08797-3.

Abstract

Coronavirus disease 2019 (COVID-19) is a global pandemic infectious disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), and abnormal, overactivated innate immunity and "cytokine storms" have been proposed as potential pathological mechanisms for rapid COVID-19 progression. Theoretically, asthmatic patients should have increased susceptibility and severity for SARS-CoV-2 infection due to a deficient antiviral immune response and the tendency for exacerbation elicited by common respiratory viruses. However, existing studies have not shown an expected prevalence of asthmatic individuals among COVID-19 patients. Certain aspects of type 2 immune response, including type 2 cytokines (IL-4, IL-13, etc.) and accumulation of eosinophils, might provide potential protective effects against COVID-19. Furthermore, conventional therapeutics for asthma, including inhaled corticosteroids, allergen immunotherapy (AIT), and anti-IgE monoclonal antibody, might also reduce the risks of asthmatics suffering infection of the virus through alleviating inflammation or enhancing antiviral defense. The interactions between COVID-19 and asthma deserve further attention and clarification.

Keywords: Allergic diseases; Asthma; COVID-19; SARS-CoV-2; Type 2 immune response.

Publication types

  • Review

MeSH terms

  • Administration, Inhalation
  • Adrenal Cortex Hormones / therapeutic use
  • Anti-Asthmatic Agents / therapeutic use
  • Asthma / epidemiology*
  • Asthma / immunology
  • Asthma / therapy
  • B-Lymphocytes / immunology
  • Betacoronavirus
  • COVID-19
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / immunology
  • Cytokines / immunology
  • Desensitization, Immunologic
  • Disease Progression
  • Eosinophils / immunology
  • Humans
  • Interleukin-13 / immunology
  • Interleukin-4 / immunology
  • Killer Cells, Natural / immunology
  • Lymphocytes / immunology
  • Macrophages / immunology
  • Natural Killer T-Cells / immunology
  • Omalizumab / therapeutic use
  • Pandemics
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / immunology
  • Protective Factors
  • Risk Factors
  • SARS-CoV-2
  • Th2 Cells / immunology

Substances

  • Adrenal Cortex Hormones
  • Anti-Asthmatic Agents
  • Cytokines
  • Interleukin-13
  • Interleukin-4
  • Omalizumab