The disease caused by a coronavirus of new type of 2019 (COVID-19) is caused by SARS-CoV-2, rather recently developed coronavirus which was for the first time found in Wuhan (China), in December, 2019. Sequenation of a virus assumes that it is the beta coronavirus which is closely connected with the SARS virus. By definition, a symptomatic case of COVID-19 is existence at the person of the signs and symptoms characteristic of COVID-19.
Symptomatic transfer belongs to a SARS-CoV-2 broadcast from people with symptoms. Epidemiological and virologic researches show that transfer of a virus to other people happens not only from people to disease symptoms, but also from people who are in an incubation interval and/or are virus carriers, at close contact in the airborne way, in direct contact with the infected people or at contact with the polluted objects and surfaces. Clinical and virologic trials in which repeated biological samples from patients with the confirmed diagnosis of COVID-19 were collected showed that allocation of SARS-CoV-2 is the highest in the upper airways (a nose and a throat) at early stages of a disease, before the beginning and during the first three days from the moment of emergence of symptoms. The incubation interval for COVID-19 which represents time between influence of a virus (infection) and emergence of symptoms averages 5–6 days, but can reach 14 days.
While at most of people with COVID-19 develops only easy (40%) or the moderate form of a disease (40%), approximately at 15% of patients develops the severe form of a disease demanding oxygen support; 5% have the critical form of a disease with such complications as respiratory insufficiency, an acute respiratory distress syndrome, sepsis and septic shock, a thromboembolism and/or multiorgan insufficiency, including acute injury of kidneys and injury of a myocardium. Advanced age, smoking and the accompanying noninfectious diseases, such as diabetes, arterial hypertension, heart diseases, chronic diseases of lungs and oncological diseases were noted as risk factors of a heavy course of a koronavirusny infection and death.
Thus, patients with bronchial asthma treat risk group of a heavy course of a koronavirusny infection and demand careful observation and also the thought-over therapy at treatment of a disease.
Now it is a little data on COVID-19 frequency among patients with bronchial asthma. In a number of researches communication of COVID-19 with asthma was not revealed, however researches which show that bronchial asthma occurs in sick COVID-19 rather often are published.
Death given on risk, associated with COVID-19, in the presence of the accompanying bronchial asthma, also show a little smaller importance of this pathology in comparison with others. For example, in the English population research E. Williamson and soavt. 5683 cases of death of sick COVID-19 were analysed. Along with a male, advanced age, an uncontrollable diabetes mellitus and other diseases / states, death from COVID-19 was independently associated also with heavy bronchial asthma. At the same time in article with other research of May 08, 2020 it was noted that bronchial asthma is associated with longer intubation of patients in case of a heavy current of COVID-19, but not with the increased risk of death.
One of the important points concerning features of treatment of a new koronavirusny infection in the presence at the patient of the accompanying bronchial asthma is continuation of treatment of actually bronchial asthma. At development of a severe form of a disease the patient will need hospitalization in a hospital.
Also in medical publications the question that during a pandemic of a koronavirusny infection (COVID-19) the people having bronchial asthma need to continue basic treatment by inhalation medicines for control of a course of a disease was brought up.
It was reported that some sources are advised to avoid reception of corticosteroids during coronavirus epidemic. It concerns oral corticosteroids in the absence of obvious indications to their use. Nevertheless, patients with asthma should not stop reception of the inhalation corticosteroids appointed as basic therapy, or oral corticosteroids.
The termination of use of inhalation corticosteroids often leads to deterioration in disease, and the refusal of oral corticosteroids during heavy attacks of asthma can have serious consequences.
For treatment of heavy asthma prolonged use of oral corticosteroids can sometimes be required, and sudden cancellation of these drugs can be dangerous. Therefore before interrupting intake of any drugs for asthma, the patient always needs to consult with the attending physician.
The patient has to continue to take the inhalation drugs for control of asthma and if its state worsens, it is necessary to follow the instructions specified in the individual action plan at exacerbation of bronchial asthma to learn how to adjust treatment and when to ask for medical care.