COVID-19 and Pediatric Asthma: What Patients and Parents Need to Know

If you have a child with asthma, the COVID-19 pandemic may be causing some additional concern and worry. The Centers for Disease Control and Prevention (CDC) states that patients with moderate to severe asthma could be at greater risk for more severe disease. COVID-19 can affect the respiratory tract, cause an asthma attack and possibly lead to pneumonia and respiratory disease.

At this time, there isn’t any published data to support this determination, but it’s important to remember that we are dealing with an evolving pandemic and learning new information every day.

Right now, there is no vaccine to prevent contracting COVID-19 nor is there a specific treatment. There are several ongoing efforts to develop a vaccine and multiple research studies looking at drugs that can treat the disease, but the best thing we can do is to prevent the illness.

Many parents of children with asthma are wondering what they should be doing differently right now. Following your child’s asthma action plan will help you keep their asthma under control. Make sure you have access to your child’s asthma action plan – if you don’t, please contact your doctor’s office.

Systemic steroids given through intravenous route are contra-indicated for treating COVID-19 as it can increase the shedding of SARS-CoV2. However, it is recommended to continue the inhaled steroids prescribed to control your child’s asthma especially in the wake of the ongoing pandemic.

Stopping a controller medication without discussing with your child’s physician can put them at risk for developing an asthma exacerbation. In the current pandemic, treatment of an exacerbation will likely require a hospital encounter to the emergency room or urgent care, where your child has much higher risk of being exposed to someone with COVID-19. Continuing your child’s controllers as prescribed will reduce the chances of developing an asthma exacerbation and exposure to COVID-19. 

Another thing you can do is ensure your child’s prescription medications (controller and rescue inhalers) are refilled in a timely manner. Contact your health care provider to provide refills if needed.  Additionally, appropriate Metered Dose Inhaler (MDI) technique with spacer is essential to ensure appropriate medication delivery to your child’s lungs and airways. Click here for a useful video to review appropriate MDI technique.

Other preventative measures you can take for your child right now include:

• Avoiding asthma triggers such as tobacco smoke, respiratory infections, dust mites, outdoor air pollution, pets, or mold.
• Encouraging your child to wash hands often with soap and water or by using an alcohol-based hand sanitizer.
• Avoiding crowds and people who are sick as well as all non-essential travel.
• If someone in your home is sick, have them stay away from the rest of the household to reduce the risk of spreading the virus in your home.
• If possible, have someone who doesn’t have asthma do the cleaning and disinfecting. Avoid disinfectants that can cause an asthma attack.

Common presenting symptoms of COVID-19 are fever, cough, shortness of breath or difficulty breathing. Less common presenting symptoms are malaise, sore throat, loss of taste or smell, vomiting and diarrhea. These symptoms can be similar to many other common respiratory illnesses.

When your asthmatic child starts with symptoms of cough or wheezing, follow the asthma action plan and administer quick relief medications (albuterol/levalbuterol) as per the American Academy of Pediatrics (AAP). Indications to take your child to emergency room include administering quick relief medications frequently as per red zone of AAP for 9-12 hours or longer, breathing very hard/fast, quick relief medications not providing relief and/or lips or fingertips turning blue.

As the COVID-19 pandemic continues to evolve, please reach out to your child’s doctor if you have any questions about your child’s asthma treatment.