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COVID-19 Q&A for Patients with Chronic Respiratory Conditions

Summary of Covid-19 advice for those with lung conditions:

  • Make sure you have at least two weeks’ worth of supplies at home in case you become unwell or need to self-isolate, including food, medications and household items
  • Keep away from others who are sick, when both inside and outside
  • Avoid crowds or large gatherings
  • Avoid public transportation (including for example trains, buses, cruise ships) and non-essential air travel
  • Practice regular hand hygiene by washing with warm water and soap for at least 20 seconds
  • Do not touch your mouth, nose and eyes with unwashed hands
  • Keep up with your regular healthcare treatments where feasible.
  • If Covid-19 levels are high in your locality, stay at home as much as possible
Source: European Lung Foundation (www.europeanlung.org/covid-19/)
 

Are patients with a lung disease at higher risk of getting Covid-19 than somebody who does not?

No. This disease can be caught by anyone.

However, those with underlying lung conditions, especially elderly people (aged 60 and over), are considered to be more likely to develop severe symptoms. Men in this group appear to be at slightly higher risk than women.

However, it is important to emphasise that most patients, even those with underlying respiratory disease, have had mild infections and have fully recovered.

Source: European Lung Foundation  (www.europeanlung.org/covid-19/)
 

Are there any additional measures to limit the risk of getting sick for patients with a chronic lung condition?

There are important things that everyone should do to limit their risk, but for those with underlying health conditions, it’s especially important to:

  • Maintain at least a 1-metre distance between yourself and others
  • Avoid touching your eyes, nose and mouth
  • Regularly and thoroughly clean your hands
  • Clean and disinfect surfaces frequently
  • Keep up to date with routine vaccines
  • Continue taking all regular medications and maintain usual treatments
  • Wear a mask when you leave your home – making sure it covers your nose, mouth and chin.

For those with a chronic lung condition, it is advised that you wear a medical/surgical mask rather than a fabric one. This will help keep you safe when physical distancing is difficult, especially in a crowded or poorly ventilated indoor setting.

Following this advice, as well as guidance from your local health authorities, will help keep your lungs as healthy as possible.

Sources: World Health Organisation (www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public), European Lung Foundation (www.europeanlung.org/covid-19/)
 

Should I consider self-isolating to avoid catching the virus?

Self-isolating means staying indoors as much as possible and avoiding contact with others. Advice on self-isolation varies in different countries, but the following steps apply to all those in Europe:

  • Stay at home as much as possible, including working from home if you can
  • Avoid contact with anyone who is sick, even if they have mild symptoms

You should self-isolateif:

  • You have symptoms of fever, cough or a chest infection
  • You have been in recent contact with someone who has tested positive for Covid-19

If you are in a high risk Covid-19 area, make sure you follow local guidance to keep yourself and others safe.

If you have a fever, cough and difficulty breathing, seek medical attention immediately.

Source: World Health Organisation (www.who.int/emergencies/diseases/novel-coronavirus-2019/)
 

What is physical distancing and how can it help against the spread of the virus?

Physical distancing aims to reduce physical contact between potentially infected people and healthy people, or between population groups with high rates of transmission and others with low or no level of transmission. The objective of this is to decrease or interrupt the spread of Covid-19.

‘Physical distancing’ is same thing as the widely used term ‘social distancing’, but helps to simplify the concept. As it is not about socially isolating yourself, but ensuring you:

  • Maintain at least a 1-metre distance between yourself and others to reduce your risk of infection
  • Maintain an even greater distance between yourself and others when indoors

You can perform physical distancing measures by:

  • Limiting close physical inter-personal interactions, and following the guidelines issued by your health authorities
  • Self-isolating if you have tested positive, have possible symptoms such as  a cough, fever or headache, or if you belong to a high-risk group (aged 60+ or have an underlying health condition)

Internet-based communications and phone calls are key tools for a successful physical distancing strategy.

Source: European Centre for Disease Prevention and Control (www.ecdc.europa.eu/en/covid-19/facts/)
 

Should I wear a mask to protect myself from the virus?

To limit the spread of Covid-19, many national authorities across Europe have advised that you must wear a mask or a face covering when you leave the house, especially when entering indoor spaces such using public transport or visiting supermarkets.

Even if you have a lung condition, wearing a mask or face covering should not cause any harm to your health. However, if doing so makes breathing more difficult, you should discuss specific options with your doctor.

If you absolutely cannot wear a mask or face covering but your country has made it compulsory, you should check if any exceptions for people living with a lung disease exist.

Source: European Lung Foundation (www.europeanlung.org/covid-19/)
 

I use an inhaler, can it become infected? What can I do to prevent this? Do I need a new one?

Your inhaler should only be used by you, and it should be kept clean and stored in a secure place where it cannot be handled by others. This helps avoid the inhaler becoming a source of infection. If your inhaler is kept clean and safe, you will not require a new one at any stage.

Source: European Lung Foundation (www.europeanlung.org/covid-19/covid-19-information-and-resources/covid-19-info)
 

As part of my condition, I regularly have a dry cough and fever – can I distinguish these symptoms from those of Covid-19?

Unfortunately, no. The common symptoms of Covid-19 are not unique, which is why many people being tested for the virus do not have it, with their cough or fever instead being attributed to something else.

If you have a cough and fever that is typical for you, and you are not unwell enough to need hospital treatment, you should self-isolate until the symptoms have resolved.

Source: European Lung Foundation (www.europeanlung.org/covid-19/covid-19-information-and-resources/covid-19-info)
 

Should I go ahead with scheduled appointments or should I avoid going to medical centres or hospitals?

It is important you keep receiving the treatment you need. Because of Covid-19, some medical appointments have been rescheduled, or may now take the form of a phone or video call where possible – so, check all of your upcoming appointments for any changes.

Unless you are told not to attend, you should keep all regular appointments.

Many health services have reopened their outpatient/ambulatory services, including lung function assessments – these are still available if you need them with strict measures in place to keep you and others safe.

Source: European Lung Foundation (www.europeanlung.org/covid-19/covid-19-information-and-resources/covid-19-info)

Is it possible that I could develop post-Covid-19 pulmonary fibrosis?

Acute Respiratory Distress Syndrome (ARDS) is known to cause the development of fibrosis in susceptible people that may relate to pre-existing undiagnosed fibrosis or genetic susceptibility.

Given the large number of people expected to develop ARDS as a result of Covid-19, it is likely that a substantial proportion of patients may develop post-Covid-19 fibrosis. The ILD community is currently preparing for this likely rise in referrals to services post-pandemic. If you have any immediate concerns, you should contact your doctor.

Source: American Thoracic Society (www.brit-thoracic.org.uk/media/455101/bts-management-advice-for-ild-patients-v10-23-march-2020.pdf)
 

Are there any recommendations for inhaled asthma controller medications?

It is important that people of all ages with asthma continue to use their inhaled asthma controller medication as normal. However, if your condition gets worse, follow your asthma action plan for how to change your medication and when to seek help.

Some sources have suggested that the use of oral corticosteroids should be avoided during the Covid-19 epidemic. However, patients with asthma should not stop their prescribed inhaled corticosteroid controller medication (or prescribed oral corticosteroids).  Stopping inhaled corticosteroids often leads to potentially dangerous worsening of asthma, and avoiding oral corticosteroids during severe asthma attacks may have serious consequences. Long-term oral corticosteroids are sometimes be required to treat severe asthma, and it may be dangerous to stop them suddenly. Always discuss with your doctor or nurse before stopping any  medication.

Source: Global Initiative for Asthma (https://ginasthma.org/recommendations-for-inhaled-asthma-controller-medications/)
 

Where can I get more information about Covid-19?

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