COVID-19 and Chronic Obstructive Pulmonary Diseases (Asthma and COPD)

COVID-19, bolest uzrokovana novim koronavirusom (SARS-CoV-2), akutna je respiracijska bolest koja može uzrokovati teški akutni respiracijski sindrom, dovesti do zatajenja disanja i smrtnog ishoda. Obje bolesti su, rjeđe od očekivanog, prijavljene kao pridružene bolesti COVID-19, ali je prijavljen povećan mortalitet kod bolesnika koji su imali KOPB kao pridruženu bolest. Trenutno nisu poznati potencijalni štetni ili zaštitni učinci inhalacijskih kortikosteroida i ostalih lijekova, koji se koriste u liječenju astme i KOPB-a, na rizik inficiranja SARS-CoV-2 virusom ili pogoršanje COVID-19. Ne preporučuju se izmjene u temeljnom liječenju astme i KOPB-a i bolesnike treba liječiti sukladno aktualnim smjernicama, s ciljem postizanja maksimalne kontrole bolesti i održavanja optimalne plućne funkcije. Dok se bolesnici s astmom ne smatraju populacijom povećanog rizika u slučaju COVID-19, bolesnici s KOPB-om moraju se tretirati kao osobe povećanog rizika i kod njih treba provoditi mjere pojačane zaštite, sukladno aktualnim epidemiološkim preporukama. Primjena inhalacijske terapije predstavlja povećan rizik širenja novoga koronavirusa te se preporučuju posebne mjere za smanjivanje tog rizika. Dijagnostički postupci kod kojih se stvara aerosol trebaju se odgoditi do povoljnije epidemiološke situacije ako nisu žurni. Žurne postupke treba provoditi uz odgovarajuće zaštitne mjere, po mogućnosti nakon obavljenog testiranja na COVID-19.Coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an acute respiratory disease that can lead to respiratory failure and death. This article is focused on patients with chronic respiratory diseases, particularly chronic obstructive pulmonary disease (COPD) and asthma. Both diseases appear to be under-represented in the comorbidities reported for patients with COVID-19, but there is increased mortality among COVID-19 patients who have COPD as a comorbidity. The potential benefits or harms of inhaled corticosteroids and other treatments for people at risk of SARS-CoV-2 infection or patients with COVID-19 are unclear at present, and no changes to the treatment or management of chronic respiratory conditions, including COPD and asthma, should be considered at this stage. Asthma and COPD patients should be treated according to the latest guidelines, aiming at maximal possible control of the disease and maintaining optimal pulmonary function. While asthma patients are not seen as high-risk compared to the standard population, COPD patients should be considered high-risk and protected according to current epidemiologic recommendations. Delivering aerosolized medications to patients with COVID-19 can aggravate the spread of the new coronavirus, and special measures should be taken to minimize that risk. Aerosol producing diagnostic tests (spirometry, bronchoscopy) should be postponed in all non-urgent patients. In urgent patients it should be performed with proper protective measures and possibly after COVID-19 testing