Is Covid-19 responsible for asthma and COPD exacerbations?


COPD exacerbation
Asthma exacerbation

How to Cite

Çilekar, Şule, Balcı, A., & Coşgun, İbrahim G. (2022). Is Covid-19 responsible for asthma and COPD exacerbations? . HEALTH SCIENCES QUARTERLY, 2(1), 17-25.


COVID-19 is an infectious disease that is transmitted by the respiratory tract and was first identified in the Wuhan province of China. The causative agent of the disease is SARS-CoV-2. There is little known about this disease and its agent, which affected the whole world in a short time and became a pandemic. Molecular interactions between COVID-19 and chronic respiratory diseases are unknown. In this study, we examined the patients admitted to our outpatient clinic with the diagnosis of Asthma and Chronic Obstructive Pulmonary Disease (COPD) exacerbation. We investigated how much of the exacerbations during the pandemic period are caused by the COVID-19 virus and whether there have been any changes in the treatment of and approaches to exacerbations stemming from COVID-19. COVID-19 was detected in 135 of the patients. Clinically, fever, myalgia, and headache findings were significantly more common in patients with a positive COVID-19 PCR CoV 2 test in patients who were diagnosed with an attack of Asthma or exacerbation of COPD (p<0.001). The number of hospitalizations, the need for intensive care, the need for ventilation support, and the number of mortality were high in asthma and COPD patients with positiveSARS- CoV-2 tests (p<0.05 ). Based on the results of our study, patients with COPD and asthma exacerbations due to COVID-19 should be evaluated from a wider perspective. As is known, chronic diseases are poor prognostic factors for COVID-19, but asthma and COPD chronic disease are prominent among them. If there is a need for different approaches for the treatment of these patients, these approaches should be determined urgently.


Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, et al. Prevalence of comorbidities and its effects in coronavirus disease 2019 patients: A systematic review and meta-analysis. Int J Infect Dis. 2020 May 1;94:91–5

Simmons G, Reeves JD, Rennekamp AJ, Amberg SM, Piefer AJ, Bates P. Characterization of severe acute respiratory syndrome-associated coronavirus (SARS-CoV) spike glycoprotein-mediated viral entry. Proc Natl Acad Sci U S A. 2004 Mar 23;101(12):4240–5.

Peters MC, Sajuthi S, Deford P, Christenson S, Rios CL, Montgomery MT, et al. COVID-19-related genes in sputum cells in asthma: Relationship to demographic features and corticosteroids. Am J Respir Crit Care Med. 2020 Jul 1;202(1):83–90.

Izaguirre G. The Proteolytic Regulation of Virus Cell Entry by Furin and Other Proprotein Convertases. Vol. 11, Viruses. NLM (Medline); 2019.

Rokni M, Ghasemi V, Tavakoli Z. Immune responses and pathogenesis of SARS-CoV-2 during an outbreak in Iran: Comparison with SARS and MERS. Vol. 30, Reviews in Medical Virology. John Wiley and Sons Ltd; 2020.

Silva RC, Couceiro JN, Câmara FP, Valle S, Santos N. Asthma exacerbation and viral infection in adult patients, Brazil. Vol. 19, Brazilian Journal of Infectious Diseases. Elsevier Editora Ltda; 2015. p. 446–8.

Hosseini SS, Ghasemian E, Jamaati H, Tabaraie B, Amini Z, Cox K. Association between respiratory viruses and exacerbation of COPD: A case-control study. Infect Dis (Auckl). 2015;47(8):523–9.

Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurologic Manifestations of Hospitalized Patients with Coronavirus Disease 2019 in Wuhan, China. JAMA Neurol. 2020 Jun 1;77(6):683–90.

He F, Deng Y, Li W. Coronavirus disease 2019: What we know? Vol. 92, Journal of Medical Virology. John Wiley and Sons Inc.; 2020. p. 719–225.

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA - J Am Med Assoc. 2020 Mar 17;323(11):1061–1069.

Zhang J jin, Dong X, Cao Y yuan, Yuan Y dong, Yang Y bin, Yan Y qin, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy Eur J Allergy Clin Immunol. 2020 Jul 1;75(7):1730–41.

Feng Y, Ling Y, Bai T, Xie Y, Huang J, Li J, et al. COVID-19 with different severities: A multicenter study of clinical features. Am J Respir Crit Care Med. 2020 Jun 1;201(11):1380–8. 10.1164/rccm.202002-0445OC.

Yamaya M, Nishimura H, Deng X, Sugawara M, Watanabe O, Nomura K, et al. Inhibitory effects of glycopyrronium, formoterol, and budesonide on coronavirus HCoV-229E replication and cytokine production by primary cultures of human nasal and tracheal epithelial cells. Respir Investig. 2020;58(3):155–68.

Liao H, Yang Z, Yang C, Tang Y, Liu S, Guan W, et al. Impact of viral infection on acute exacerbation of asthma in out-patient clinics: A prospective study. J Thorac Dis. 2016 Mar 1;8(3):505–12.

GOLD. Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease (2020 Report). June 25, 2020

Corne JM, Marshall C, Smith S, Schreiber J, Sanderson G, Holgate ST, et al. Frequency, severity, and duration of rhinovirus infections in asthmatic and non-asthmatic individuals: A longitudinal cohort study. Lancet. 2002 Mar 9;359(9309):831–4.

Jackson DJ, Trujillo-Torralbo MB, Del-Rosario J, Bartlett NW, Edwards MR, Mallia P, et al. The influence of asthma control on the severity of virus-induced asthma exacerbations. J Allergy Clin Immunol. 2015 Aug 1;136(2):497-500.e3.

Abrams EM, Sinha I, Fernandes RM, Hawcutt DB. Pediatric asthma and COVID-19: The known, the unknown, and the controversial. Pediatr Pulmonol. 2020 Dec 1;55(12):3573–8.

Alqahtani JS, Oyelade T, Aldhahir AM, Alghamdi SM, Almehmadi M, Alqahtani AS, et al. Prevalence, severity and mortality associated with COPD and smoking in patients with COVID-19: A rapid systematic review and meta-analysis. PLoS One. 2020;15(5):1–13.

González-Rubio J, Navarro-López C, López-Nájera E, López-Nájera A, Jiménez-Díaz L, Navarro-López JD et al. A systematic review and meta-analysis of hospitalised current smokers and COVID-19. Int J Environ Res Public Health. 2020:17;7394.

Brocklebank D, Ram F, Wright J, Barry P, Cates C, Davies L, et al. Comparison of the effectiveness of inhaler devices in asthma and chronic obstructive airways disease: A systematic review of the literature. Vol. 5, Health Technology Assessment. NIHR Journals Library; 2001. 10.3310/hta5260.

Wedzicha JA, Seemungal TA. COPD exacerbations: defining their cause and prevention. Vol. 370, Lancet. Lancet; 2007. p. 786–96.

Kanne JP, Little BP, Chung JH, Elicker BM, Ketai LH. Essentials for radiologists on COVID-19: An update-radiology scientific expert panel. Vol. 296, Radiology. Radiological Society of North America Inc.; 2020. p. E113–4.

Andreassen SL, Liaaen ED, Stenfors N, Henriksen AH. Impact of pneumonia on hospitalizations due to acute exacerbations of COPD. Clin Respir J. 2014 Jan;8(1):93–9. 10.1111/crj.12043.

Rueter K, Bizzintino J, Martin AC, Zhang G, Hayden CM, Geelhoed GC et al. Symptomatic viral infection is associated with impaired response to treatment in children with acute asthma. J Pediatr. 2012 Jan;160(1):82-7. Epub 2011 Aug 19.

Whittaker A, Anson M, Harky A. Neurological Manifestations of COVID-19: A systematic review and current update. Acta Neurol Scand. 2020 Jul;142(1):14-22. 10.1111/ane.13266.

Goyal P, Choi JJ, Pinheiro LC, Schenck EJ, Chen R, Jabri A, et al. Clinical Characteristics of COVID-19 in New York City. N Engl J Med. 2020 Jun 11;382(24):2372–4.

Shaker, M. S., Oppenheimer, J., Grayson, M., Stukus, D., Hartog, N., Hsieh, E. et al. COVID-19: Pandemic Contingency Planning for the Allergy and Immunology Clinic. J Allergy Clin Immunol Pract. 2020;8(5):1477-1488.e5.

Gershon, A. S., Thiruchelvam, D., Chapman, K. R., Aaron, S. D., Stanbrook, M. B., Bourbeau, et al. Health Services Burden of Undiagnosed and Overdiagnosed COPD. Chest. 2018;153(6):1336-1346.

Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting Characteristics, Comorbidities, and Outcomes among 5700 Patients Hospitalized with COVID-19 in the New York City Area. JAMA - J Am Med Assoc. 2020 May 26;323(20):2052–9.

Labonte LE, Tan WC, Li PZ, Mancino P, Aaron SD, Benedetti A, et al. Undiagnosed chronic obstructive pulmonary disease contributes to the burden of health care use data from the CanCOLD study. Am J Respir Crit Care Med. 2016 Aug 1;194(3):285–98.

Martinez CH, Mannino DM, Jaimes FA, Curtis JL, Han MLK, Hansel NN, et al. Undiagnosed obstructive lung disease in the United States associated factors and long-term mortality. Ann Am Thorac Soc. 2015 Dec 1;12(12):1788–95. 10.1513/AnnalsATS.201506-388OC

Guan WJ, Liang WH, Zhao Y, et al. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J. 2020;55(5):2000547. Published 2020 May 14.

Li X, Xu S, Yu M, Wang K, Tao Y, Zhou Y, et al. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol. 2020 Jul 1;146(1):110–8.

Leung JM, Niikura M, Yang CWT, Sin DD. COVID-19 and COPD. Eur Respir J. 2020;56(2):1–9. 10.1183/13993003.02108-2020

Dhawale VS, Amara VR, Karpe PA, Malek V, Patel D, Tikoo K. Activation of angiotensin-converting enzyme 2 (ACE2) attenuates allergic airway inflammation in rat asthma model. Toxicol Appl Pharmacol. 2016 Sep 1;306:17–26.

Li G, He X, Zhang L, Ran Q, Wang J, Xiong A, et al. Assessing ACE2 expression patterns in lung tissues in the pathogenesis of COVID-19. J Autoimmun. 2020 Aug 1;112. 10.1016/j.jaut.2020.102463

Kermali M, Khalsa RK, Pillai K, Ismail Z, Harky A. The role of biomarkers in diagnosis of COVID-19 – A systematic review. Vol. 254, Life Sciences. Elsevier Inc.; 2020. 10.1016/j.lfs.2020.117788

Manthei DM, Schwantes EA, Mathur SK, Guadarrama AG, Kelly EA, Gern JE, et al. Nasal lavage VEGF and TNF-α levels during a natural cold predict asthma exacerbations. Clin Exp Allergy. 2014 Dec 1;44(12):1484–93.

Thomas PS, Yates DH, Barnes PJ. Tumor necrosis factor-α increases airway responsiveness and sputum neutrophilia in normal human subjects. Am J Respir Crit Care Med. 1995;152(1):76–80.

Huang AX, Lu LW, Liu WJ, Huang M. Plasma Inflammatory Cytokine IL-4, IL-8, IL-10, and TNF-α Levels Correlate with Pulmonary Function in Patients with Asthma-Chronic Obstructive Pulmonary Disease (COPD) Overlap Syndrome. Med Sci Monit. 2016;22:2800-2808. Published 2016 Aug 9.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright (c) 2022 Holistence Publications


Download data is not yet available.