Puzzle of asthma patients’ complex resistance to virus

Experts have been left puzzled on how Covid-19 ravages people with underlying conditions but with almost less similar impact on those living with asthma. This phenomenon, which some experts have described as ‘complex’ seems to defy the expected outcomes for patients with asthma since both diseases primarily attack the respiratory system.

Asthma in the country accounts for just two per cent of Covid-19 deaths, according to Ministry of Health Covid-19 situation report dated July 16. By yesterday’s update by the ministry, so far 548 people have died from the disease among them six new deaths.

The number of confirmed cases now stands at 32,264 after 246 more people tested positive, according to data announced by Health Cabinet Secretary Mutahi Kagwe.

While it is not yet clear why less deaths are witnessed among asthmatic people - considering the novelty of Covid-19 - some experts have come up with theories to deduce this phenomenon, but in the same breath warned that asthmatic people are still susceptible to the disease.

This has been seen in the latest update dated August 14, 2020 by the Centre for Diseases Prevention and Control. “Keep your asthma under control by following your asthma action plan,” says CDC. “Continue your current medications, including any inhalers with steroids in them.”

Steroids, which are the ingredients of anti-inflammatory medicines like those used to relieve asthma, according to another paper are claimed to be the reason why less asthmatic individuals get severe Covid-19.

According to the paper, long term usage of steroids or corticosteroids may be giving asthmatic individuals some immunity. “A third possibility is that therapies used by patients with chronic respiratory disease can reduce the risk of infection or of developing symptoms leading to diagnosis,” reads the paper published on April 30, 2020 by The Lancet titled ‘Do chronic respiratory diseases or their treatment affect the risk of SARS-CoV-2 infection’.

Dr Kalubusia Kakai, an immunologist, says compared to Covid-19, asthma is more of an allergy triggered by something and not a primary infection.

“You can recover from asthma immediately; but Covid-19 will cause you difficulty breathing in the last phase of infection. That is when you require mechanical ventilation,” he said.

Both diseases also present with similar symptoms - difficulty breathing - which UK experts have acknowledged that patients might have trouble distinguishing. In an update dated July 30, 2020 published by asthma.org.uk, the experts said one way of telling Covid-19 from asthma is that you will get relief from the latter after taking steroids.

A July 2, 2020 study published by The Journal of Allergy and Clinical Immunology in the US also ruled out asthma as an increased risk of hospitalisation among Covid-19 patients.

The study found no observable difference in mortality between patients with Covid-19 who had asthma and those who did not. “We would usually expect for asthmatic patients to have worse outcomes, as viral illness often can set off asthma exacerbation,” said Dr Anju Peters, a corresponding author of the study.