Should routine spirometry and lung function control be performed in asthmatic patients during the COVID-19 pandemic?
The Global Initiative for Asthma guidelines state that routine spirometry should be avoided, especially in high-risk areas of COVID-19 transmission. If spirometry needs to be performed, maximum PPE should be used.133 The treatment of asthmatic patients can be monitored using personal devices measuring forced expiratory volume and peak expiratory flow. Many of these devices are equipped with remote transmission functions and thus are amenable for the telemedicine management of patients.137
Should asthma exacerbations be treated with oral corticosteroids during the COVID-19 pandemic?
There is no evidence suggesting that the current approach to treat asthmatic patients during an exacerbation should change during the COVID-19 pandemic. Moreover, there is no proof that a short course of systemic corticosteroids impacts the evolution of COVID-19. Thus, oral corticosteroids should be given as usual for the treatment of an asthma exacerbation.128,133In the few cases in which patients are treated with long-term oral corticosteroids in addition to their high dose inhaled corticosteroids this should be continued in the lowest dose possible to prevent exacerbations.133 The cause of the asthma exacerbation should be studied thoroughly to rule out potential exacerbations due to viral infections.75