Asthmatics are at an increased risk of developing exacerbations after being infected by respiratory viruses such as influenza virus, parainfluenza virus, and human and severe acute respiratory syndrome coronaviruses (SARS-CoV). Asthma, especially when poorly controlled, is an independent risk factor for developing pneumonia. A subset of asthmatics can have significant defects in their innate, humoral, and cell-mediated immunity arms, which may explain the increased susceptibility to infections. Adequate asthma control is associated with a significant decrease in episodes of exacerbation. Because of their wide availability and potency to promote adequate asthma control, glucocorticoids, especially inhaled ones, are the cornerstone of asthma management. The current COVID-19 pandemic affects millions of people worldwide and possesses mortality several times that of seasonal influenza; therefore, it is necessary to revisit this subject. The pathogenesis of SARS-CoV-2, the virus that causes COVID-19, can potentiate the development of acute asthmatic exacerbation with the potential to worsen the state of chronic airway inflammation. The relationship is evident from several studies that show asthmatics experiencing a more adverse clinical course of SARS-CoV-2 infection than nonasthmatics. Recent studies show that dexamethasone, a potent glucocorticoid, and other inhaled corticosteroids significantly reduce morbidity and mortality among hospitalized COVID-19 patients. Hence, while we are waiting for more studies with higher level of evidence that further narrate the association between COVID-19 and asthma, we advise clinicians to try to achieve adequate disease control in asthmatics as it may reduce incidences and severity of exacerbations especially from SARS-CoV-2 infection.

中文翻译：

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哮喘和 COVID-19：强调充分控制哮喘

哮喘患者在被流感病毒、副流感病毒、人类和严重急性呼吸系统综合症冠状病毒 (SARS-CoV) 等呼吸道病毒感染后发生恶化的风险增加。哮喘，尤其是控制不佳时，是发生肺炎的独立危险因素。一部分哮喘患者的先天性、体液性和细胞介导的免疫臂可能存在显着缺陷，这可能解释了对感染的易感性增加。充分控制哮喘与哮喘发作的显着减少有关。由于糖皮质激素的广泛可用性和促进充分控制哮喘的效力，糖皮质激素，尤其是吸入性糖皮质激素，是哮喘管理的基石。当前的 COVID-19 大流行影响了全世界数百万人，其死亡率是季节性流感的数倍；因此，有必要重新审视这个问题。SARS-CoV-2（导致 COVID-19 的病毒）的发病机制可以促进急性哮喘恶化的发展，并有可能使慢性气道炎症恶化。几项研究表明，与非哮喘患者相比，哮喘患者在 SARS-CoV-2 感染的临床过程中经历了更不利的临床过程，这种关系是显而易见的。最近的研究表明，地塞米松（一种强效糖皮质激素）和其他吸入性皮质类固醇可显着降低住院 COVID-19 患者的发病率和死亡率。因此，