All RTIs similar when it comes to triggering asthma exacerbations

COVID-19 is no more likely to cause asthma exacerbations than any other acute respiratory infection, new research has confirmed.

The population-based longitudinal study, involving more than 2,000 UK adults with asthma, linked relaxation of COVID-19 restrictions to a higher risk of contracting acute respiratory infections and, in turn, an increased risk of severe asthma exacerbations.

But it also showed that the relationship between acute respiratory infections (ARI) and risk of severe exacerbations were similar whether caused by COVID or other respiratory pathogens.

The findings “highlight the potential for interventions such as face covering use to reduce risk of asthma exacerbation and provide reassurance that COVID-19 is not significantly more likely to trigger asthma exacerbations than other acute respiratory infections,” the authors noted in Thorax.

For the research, a team at the Blizard Institute, Barts and The London School of Medicine and Dentistry, London, collected monthly data on face-covering use, social mixing, acute respiratory infections and severe asthma exacerbations via online questionnaires.

They found that relaxation of COVID-19 restrictions led to significantly less use of face coverings (p<0.001), a significant rise in indoor visit to public places and other households (p<0.001) and a rise in incident COVID-19 (p<0.001), non-COVID acute respiratory infections (p<0.001) and severe asthma exacerbations p=0.007).

The data confirmed that both non-COVID and COVID acute respiratory infections were independently linked with an increased risk of asthma exacerbation (adjusted odds ratios 5.75, 5.89 [before Omicron] and 5.69 [after Omicron], respectively).

“Given concerns that the omicron variant of SARS-CoV-2 may be more likely to precipitate asthma exacerbations than earlier variants, our finding that the strength of associations between COVID-19 and asthma exacerbation was not increased following emergence of the omicron variant is reassuring,” the authors said.

Nevertheless, the research showed that “relaxation of COVID-19 restrictions coincided with an increased risk of severe asthma attacks,” said Professor Adrian Martineau, lead author of the research and Clinical Professor of Respiratory Infection and Immunity at Queen Mary University of London.

“Our study was observational, so it can’t prove cause-and-effect. But our findings do raise the possibility that certain elements of the public health measures introduced during the pandemic – such as wearing facemasks – could help in reducing respiratory illnesses moving forward,” he noted.

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