Dr. Matt Dougherty isn’t waiting for his pediatric asthma patients or their parents to call him in a panic, frightened that a sudden cough or wheeze is due to the novel coronavirus. He’s reaching out to them, virtually, via telemedicine.
“I look through my patient files, identify the ones in the past that I know have had problems this time of year with allergies triggering their asthma and contact them before they have symptoms,” said Dougherty, who treats children with allergies and asthma at Esse Health in St. Louis, Missouri.
“I tell my patients, let’s maximize your lung health now,” he said. “Then in case you get unlucky enough to run into coronavirus, at least we’ve come into it with the best lung condition we can.”
Asthma vs. Covid-19 symptoms
Asthma is one of the underlying health conditions that puts one at higher risk for a more severe case of Covid-19, the disease caused by the novel coronavirus.
“During an asthma attack it’s almost like breathing through a straw because that inflammation is restricting the airway,” said Dr. Lakiea Wright, who specializes in allergies and immunology at Brigham and Women’s Hospital in Boston.
“You can imagine if a virus that causes extra inflammation gets in there, then that’s going to be worse,” Wright said. “Those are the patients who might end up on ventilators to help with breathing because Covid-19 is doing a lot of damage in the lungs.”
Many of the key signs of Covid-19, such as coughing, shortness of breath and chest tightness, are also typical symptoms of asthma.
Other potential Covid-19 signs, such as sneezing, runny nose, red eyes and fatigue, can mimic allergy responses.
That’s an issue because of the 25 million Americans who have asthma, two-thirds suffer from the allergic form of the disease, in which environmental allergens such as dust, insects, pets, mold and pollen will trigger their asthma.
The number is even higher in children, Wright said: “Up to 90% of children with asthma can have allergic asthma.”
So if the signs are so similar, how can one tell them apart?
“It can be very confusing to patients,” Wright said. “I tell my patients to look for things that would be more distinguishing symptoms of Covid-19 such as fever and body aches. Allergies or asthma alone would not cause those symptoms.”
Those with allergic asthma can try antihistamines and other allergy treatments, Dougherty said. If those treatments reduce their symptoms, that’s a sign that it’s just allergies.
As for asthma, he said, anyone experiencing an asthma attack will likely have a history of asthma, and would be able to compare their symptoms to their typical asthma event.
“I would not expect a person to have a first asthma event by getting coronavirus,” he said. “And even if you did have both coronavirus and an asthmatic event at the same time, your asthma symptoms should improve by using your rescue inhaler.”
If keeping lungs as healthy as possible is the goal, how does one do that?
Know your triggers. “Asthma doesn’t just show up out of the blue. Asthma has triggers and each person’s triggers are different – cigarette smoke might be your trigger or perhaps it’s exercise,” Dougherty said.