The announcement of a potential danger of non-steroidal anti-inflammatory drugs on the aggravation of the Covid-19 infection worries allergy sufferers and asthmatics treated with corticosteroids by oral route. Should they continue their treatment? How to differentiate an allergy to pollen from the coronavirus? What precautions should be taken in full containment? Answers with Dr Albanne Branellec, allergist in Paris.
[Mis à jour le mardi 31 mars à 9h40] The alert was given by the health authorities: taking NSAIDs (ibuprofen) and corticosteroids may be an aggravating factor in Covid-19 infection. The Director General of Health, Professor Jérôme Salomon and Prime Minister Olivier Véran confirmed this information. Allergy sufferers and asthmatics, already considered as patients at risk due to an underlying respiratory pathology, have asked themselves massively the question of whether or not they should continue their treatment with a corticosteroid inhaler. “It is actually known that NSAIDs and corticosteroids facilitate the development of viral infections, Confirms Dr. Branellec. However, in the treatment of asthma, corticosteroids are inhaled and not taken orally. They settle on the thickness of the bronchus and are absorbed by the bronchus: it is very local. “
Corticosteroids taken generally are not associated with worsening COVID infections 19
The problem with these corticosteroid treatments mainly arises when taken orally and therefore not inhaled. “The recommendations are very clear on this subject, and all asthma and allergy specialists agree that inhaler treatments should be continued.“insists the allergist.”Unlike nonsteroidal anti-inflammatory drugs, corticosteroids in general are not associated with worsening COVID 19 “infections , would like to reestablish the Asthma and Allergy Association in a press release dated March 30, 2020. It is therefore important to keep the same attitude as usual towards asthma attacks and exacerbations, and treat them with a few days of corticosteroids by general route. The priority is to stabilize respiratory state, to the extent that a asthma unstable underlying is a real risk factor for complication of any viral infection, including Covid-19. This also makes it possible to avoid hospitalizations more than ever in this epidemic context (risk of contamination and lack of space in intensive care).
- Corticosteroids by general route are: Solupred®, Celestene®, Prednisolone®, Prednisone®.
- Corticosteroids in tablets (orally) for a few days should be taken if your asthma is destabilized as usual. But given the coronavirus epidemic it is important and essential to contact your doctor.
- “We recommend thediscontinuation of corticosteroids by the nasal route, because they are not essential“Adds Dr. Branellec.
“Inhaler treatments should be continued”
Spring arrives, with it the pollens of plane trees, birches and oak, the source of many allergies. Allergy sufferers have an increased sensitivity to viral respiratory infections, making them more fragile patients. “More than ever, pollen allergic patients must continue their basic therapy at the moment. Inhalers of course, but also oral antihistamines, which limit the release of histamine in the body. It is indeed this histamine that promotes inflammatory mechanisms “ insists Dr. Branellec. In case of allergic manifestations (rhinitis, watery eyes, sneezing attacks) at the arrival of sunny days, it is therefore important to make an appointment with an allergist in order to be prescribed an appropriate treatment. During the confinement period, most specialists offer online teleconsultations by appointment.
The “Information Coronavirus COVID-19 0 800 130 000” telephone platform (free) answers non-medical questions.
15 (SAMU) is made up of regulatory doctors who answer purely medical questions, and are the only ones likely to trigger medical treatment if necessary.
The dry cough or respiratory problems associated with asthma are actually quite similar to those of the first symptoms of Covid infection19. “Jhave a lot of patients who worry about getting the virus as soon as they start coughing or have trouble breathing. What sets things apart is the flu syndrome (pain, body aches) and the presence of fever“specifies Dr. Branellec. “The fever witnesses an infection, allergy causes fatigue but never fever or muscle pain. “
In this period of confinement and the arrival of spring, should allergy sufferers to pollen for example refrain from ventilating their apartment? “Not at all, good ventilation is essential. However, avoid airing in the middle of the day, but do it early in the morning (before 8 a.m.) and late evening (after 10 p.m.) “ specifies the allergist. Indeed, pollens rise in the middle of the day and risk contaminating the interior of the apartment. As for the numerous owners of cats or dogs who are allergic to it, they will have to be all the more vigilant during this period of confinement. The main recommendations are:
- ventilate their apartment as much as possible,
- vacuum regularly to remove hair,
- prohibit the animal from entering the bedroom. “If the asthma is not contained and persists, it would be more reasonable to send your animal elsewhere during this confinement period, or even to give it“adds the specialist.
- well continue their background treatment.
Thanks to Dr Albanne Branellec, allergist in Paris.