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Well controlled asthmatics have higher chances of severe COVID - Dr. Sheetu Singh

Well Controlled Asthmatics Have Higher Chances of Severe COVID - Dr. Sheetu Sing Visit Dr Sheetu Singh for more info - www.drsheetusingh.com

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Well controlled asthmatics have higher chances of severe COVID - Dr. Sheetu Singh

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  1. Symptoms intermittent, inflammation persistent Airway Biopsy Normal Asymptomatic Asthmatic person

  2. Well controlled asthmatics have higher chances of severe COVID and death from COVID • True • False

  3. People with asthma do not have increased risk of either COVID or severe COVID • Meta-analysis also shows that mortality in asthma is lower than in normal people • COVID related mortality higher in patients who recently took OCS or got hospitalized due to exacerbation of asthma • Thus, important to continue good asthma management GINA 2022

  4. Adults&adolescents 12+years Confirmation of diagnosis if necessary Symptomcontrol&modifiable riskfactors(seeBox2-2B) Comorbidities Inhalertechnique&adherence Patientpreferencesandgoals Personalizedasthmamanagement Assess,Adjust, Review forindividualpatientneeds ASSESS REVIEW ADJUST Symptoms Exacerbations Side-effects Lungfunction Patientsatisfaction Treatmentofmodifiableriskfactors andcomorbidities Non-pharmacologicalstrategies Asthmamedications(adjustdown/up/betweentracks) Education&skillstraining STEP5 Add-onLAMA Referforassessmentofphenotype.Consider highdosemaintenance ICS-formoterol, ±anti-IgE,anti-IL5/5R, anti-IL4R,anti-TSLP STEP4 Mediumdose maintenance ICS-formoterol STEP3 Lowdose maintenance ICS-formoterol CONTROLLERand PREFERREDRELIEVER (Track1).UsingICS-formoterol asrelieverreducestheriskof exacerbationscomparedwith usingaSABAreliever STEPS1–2 As-neededlowdoseICS-formoterol SeeGINA severe asthmaguide RELIEVER:As-neededlow-doseICS-formoterol STEP5 Add-onLAMA Referforassessmentofphenotype.Consider highdosemaintenance ICS-LABA,±anti-IgE, anti-IL5/5R,anti-IL4R, anti-TSLP STEP4 Medium/high dosemaintenance ICS-LABA STEP3 Lowdose maintenance ICS-LABA STEP2 Lowdose maintenanceICS CONTROLLERand ALTERNATIVERELIEVER (Track2).Beforeconsideringa regimenwithSABAreliever, checkifthepatientislikelytobe adherent withdailycontroller STEP1 TakeICS whenever SABAtaken RELIEVER:As-neededshort-actingbeta2-agonist GINA 2022, Box 3-5A © Global Initiative for Asthma, www.ginasthma.org GINA 2022 Addazithromycin(adults)or LTRA.Aslastresortconsider addinglowdoseOCSbut consider side-effects Othercontrolleroptionsforeither track(limitedindications,orless evidenceforefficacyorsafety) LowdoseICSwhenever SABAtaken,ordailyLTRA, oraddHDMSLIT MediumdoseICS,or addLTRA, oradd HDMSLIT AddLAMAorLTRAor HDMSLIT, orswitchto highdoseICS

  5. Follow up at 2 months 42 yrMrs. Sheela • Day time symptoms. Twice last week • Last month: 2 times sleep disturbance • Took extra inhaler one time in last week. • Could not go for walk 3 times last month. • IgE876, TEC 100 Uncontrolled Asthma

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