Many asthmatics fear an increased risk of infection by the novel coronavirus or a severe course of COVID-19 due to their condition. Nevertheless, they should not simply discontinue use of their cortisone sprays.
Image: picture-alliance/VisualEyze/J. Salvarredy
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Elderly people or people with previous illnesses are considered a special risk group in the current COVID-19 pandemic. And since the aggressive SARS-CoV-2 virus primarily affects the lungs, many asthma patients are afraid they might have an increased risk of infection and of a potentially severe course of the disease.
Additional uncertainty has been caused by indications that the immunosuppressive drugs frequently used by asthma patients, such as cortisone sprays, may further increase the risk of infection because they downregulate the body's own immune system.
Should patients continue to use cortisone sprays?
Cortisone sprays, or cortisone tablets in severe cases, are frequently used in asthma therapy because they have an anti-inflammatory effect and reduce the asthmatic hypersensitivity of the bronchial tubes. In this way, they regulate the body's own immune defense downward, giving the active substance an immunosuppressive effect.
However, German lung physicians and experts have now issued a joint statement to reassure asthma patients on this score. They say the risk of infection for correctly adjusted asthma patients is not increased as long as they continue to take their medication regularly and do not stop taking it without consulting their doctor. Even in the event of deterioration, the cortisone dose should be adjusted only according to the instructions of the treating pulmonologist, they say.
Different assessments
This assessment contrasts with recommendations that are critical of therapy with inhalable steroids (ICS). For example, the chief virologist of the Berlin Charite, Christian Drosten, has cautiously recommended that asthma patients should clarify with their treating physician whether their cortisone-based asthma medication should be replaced by one that does not interfere as much with the immune system.
However, since a connection between such cortisone-based medications and increased infection risk has not yet been scientifically proven, the experts of the German Society for Pneumology and Respiratory Medicine (DGP) continue to support inhalation therapy.
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They say that a sudden discontinuation of the medication or a change in therapy could be considerably more dangerous than any increased risk of infection with SARS-CoV-2.
The DGP specialists regard older people with severe asthma and patients who regularly take cortisone tablets as being more at risk. Asthma patients who have so far used cortisone sprays only occasionally should now take them more regularly, they say, so that the airways remain open and patients do not have to struggle with coughing or shortness of breath. If the cortisone spray does not help, the doctor treating the patient should be consulted.
It can be true that people with chronic respiratory diseases are less able to fight viruses themselves because the lung mucosa is weakened. However, according to the lung specialist Rainald Fischer, asthma patients are not as severely endangered as some because their bronchial mucosa usually shows only allergic inflammation and does not develop pneumonia, as a rule.
Fischer also pointed out, however, that wearing a mask, such as one of the more effective FFP3 masks with filter function, can be unpleasant for lung patients in particular, as it makes breathing somewhat more difficult.
Since other viruses and bacteria can also inflame the lungs and bronchial tubes independently of the new coronavirus SARS-CoV-2, many doctors also consider influenza and pneumococcal vaccinations to be useful for asthmatics.
In general, asthmatics and other people with respiratory diseases should pay particular attention to recommended hygiene measures and maintain a sufficient safety distance of at least 1.5 meters (5 feet) from other people.
Pollen calling
Starting to feel your nose twitch? Hayfever sufferers will notice quicker than most when pollen season starts, but that doesn't mean everyone else shouldn't learn a thing or two about this remarkable process of nature.
Image: picture-alliance/dpa/P. Pleul
Buzzin'
A bee, packed with pollen, prepares to buzz into a blooming sunflower in a field in Frankfurt (Oder), Germany. Pollinators are animals that move pollen from the male anther of a flower to the female stigma of a flower, helping to fertilize it. The most widely recognized pollinators are the various species of bees, although many other insects and animals, including some bats and birds, pollinate.
Image: picture-alliance/dpa/P. Pleul
Spruced up
Little islands of pollen cover a car roof in Stuttgart, Germany. The pollen count for the coniferous spruce tree has been very high recently. "This year, there were ideal flight conditions," said Christina Endler of the German Weather Service. "It was dry, there was a lot of sunshine and light wind." Adding to the bounty is the fact that a cold winter was followed by an unusually warm spring.
Image: picture-alliance/dpa/S. Gollnow
Walnuts for pollination
Every walnut tree has both male and female parts, meaning they are monoecious, to use the biological term. Not dependent on pollinators, the pollen is largely spread by wind, from the male to the female parts. All walnut varieties are self-fertile, meaning the pollen can, in theory, travel from the male to the female parts of the same tree. Cross pollination has a higher chance of success though.
Image: Imago/Westend61
Blowin' in the wind
What looks like yellow fog here is in fact pollen from coniferous forests being blown around the Niedersonthofener Lake, in Bavaria, Germany. As a general rule, meteorologists say that the warmer the winter is, the sooner the pollen season begins. Also, according to a study by allergist Leonard Bielory, pollen counts could double by the year 2040 due to climate change.
Image: picture-alliance/dpa/K.-J. Hildenbrand
That old chestnut
Chestnut trees (pictured here) produce both welcome shade in summer and the well-known nuts, most commonly associated with roasting on open fires in the depths of winter. These deciduous trees cannot self-pollinate. They rely on wind and insects to move the pollen from one tree to the next.
Image: Imago/blickwinkel
Every blooming thing
The spread of pollen in the springtime can be quite a sight. The expression "the forest is blooming" refers to the phenomenon of the pollen of conifers, usually spruce trees (those typically found in many German forests), filling the air to the extent that visibility is affected. Your best chance of experiencing this phenomenon is when the weather is especially dry.
Image: picture-alliance/A. Litzlbauer
Making a beeline for it
Think you get a lot done in a day? It is commonly estimated that a single honey bee can land on 5,000 flowers in one day. Pollen sticks to them as they do so and it is then brought to other flowers, allowing fertilization to occur. Are they nature's greatest matchmakers? Maybe, but if they are it is inadvertent; pollinators are usually looking for something for themselves, such as nectar.
Image: Imago/Roland Mühlanger
Bless you!
When rough winds do shake the darling buds - and pollen - of May, hayfever sufferers know all about it. Allergic rhinitis is the medical name for hayfever, and it occurs when a person's immune system overreacts to the presence of pollen and attacks it mistakenly, as if it were a parasite. As a result, the person sneezes, in a misguided attempt to "expel" something that is actually quite harmless.
Image: picture-alliance/dpa/K.-J. Hildenbrand
Like an oilslick
German observers will have noticed masses of yellow pollen accumulating in recent days and weeks, with much of it coming from pine and spruce trees. The high volume has been even greater as a result of the particularly dry spell of recent weather. In this picture, taken in North Rhine-Westphalia, western Germany, pollen residue is seen on the street.
Image: Imago/Rene Traut
The summer wind, came blowing in...
We all like to see a nice blooming corn field like the one pictured here, but we ought to be prepared for increasing amounts of pollen as the planet continues to heat up. According to the aforementioned Bielory study, in the year 2000, pollen counts (measurement of the number of grains of pollen in a cubic meter of air) averaged 8,455. By 2040, these counts are anticipated to reach 21,735.
