lcp
We have detected you are using Internet Explorer. To provide the best and most secure experience, please use a modern browser as we do not support Internet Explorer.

The Interplay of Long COVID with COPD and Asthma: Implications for Clinical Care

22 September 2023 - Susan Helmrich

The global emergence of COVID-19, caused by the SARS-CoV-2 virus, has not only presented acute challenges for healthcare professionals worldwide but has also shone a spotlight on its lingering after-effects, colloquially termed "Long COVID". This condition, marked by prolonged symptoms like fatigue, cognitive disturbances, and dyspnea, poses a distinct concern for patients with chronic respiratory conditions like Chronic Obstructive Pulmonary Disease (COPD) and asthma. As our understanding of Long COVID evolves, it is essential to explore its implications for these already vulnerable patient groups.

 

long covid overview
Reference: https://erj.ersjournals.com/content/erj/early/2023/03/15/13993003.00409-2023/F1.large.jpg

 

1. Overlapping Symptoms - Diagnostic Challenges

Dyspnea, or shortness of breath, is a hallmark of both Long COVID and COPD/asthma. For patients with a pre-existing respiratory condition who contract COVID-19, differentiating between an exacerbation of their chronic illness and the continuation of COVID symptoms can be challenging. Healthcare providers must be vigilant in their assessments, perhaps relying more heavily on objective tests such as spirometry or imaging to discern the primary etiological factor.

2. Inflammation and Airway Hyper-responsiveness

Both COVID-19 and asthma are characterised by inflammatory processes, albeit of different origins. There's emerging evidence to suggest that Long COVID might prolong or exacerbate airway inflammation, potentially leading to increased bronchial hyper-responsiveness in asthma patients. For those with COPD, a condition marked by chronic inflammation, the added inflammatory burden of Long COVID may lead to further deterioration of lung function.

3. Treatment Modalities and Therapeutic Implications

The intersection of Long COVID with COPD and asthma may necessitate a reassessment of therapeutic strategies. For instance, a greater emphasis on anti-inflammatory agents or adjusting the dosages of bronchodilators might become necessary. Clinicians may also need to be wary of potential drug interactions if antiviral or other COVID-specific treatments are continued in the long term.

4. Rehabilitation and Pulmonary Function

For those with pre-existing respiratory conditions, pulmonary rehabilitation is a cornerstone of management. With the advent of Long COVID, the demand for specialised rehabilitation programs that cater to both the chronic condition and the lingering effects of the virus is likely to rise. Customising rehabilitation to address the unique challenges posed by the confluence of these conditions will be essential.

5. Mental Health Considerations

The psychological toll of Long COVID is gaining recognition. Given the chronic nature of COPD and asthma and the frequent limitations they impose on quality of life, the added mental health burden of prolonged COVID symptoms can't be ignored. Healthcare providers should be prepared to offer enhanced psychological support or refer patients to mental health specialists as needed.

Conclusion

Long COVID, with its myriad manifestations, is charting new territories in clinical medicine. For patients with COPD and asthma, the journey may be even more intricate. As research on Long COVID continues, it is paramount for healthcare professionals to remain updated, adaptable, and compassionate, ensuring that the best possible care is provided to those navigating these dual challenges.

Related courses

The Consult - COPD

Managing Respiratory Disease in Patients with Long COVID.

 

References

  1. Global Initiative for Chronic Obstructive Lung Disease (GOLD). (2021). Global Strategy for the Diagnosis, Management, and Prevention of COPD. 

  2. National Heart, Lung, and Blood Institute. (2020). COPD. National Institutes of Health.

  3. Australian Government Department of Health. (2020). Chronic Obstructive Pulmonary Disease (COPD). The Australian Lung Foundation.

  4. Marshall, M., Howe, A., Howsam, G., Mulholland, M., & Leach, J. (2020). COVID-19: a danger and an opportunity for the future of general practice. The British Journal of General Practice, 70(695), 270-271.

  5. Greenhalgh, T., Knight, M., A’Court, C., Buxton, M., & Husain, L. (2020). Management of post-acute COVID-19 in primary care. BMJ, 370.

  6. Australian Government Department of Health. (2021). Management and Treatment of Long COVID. Commonwealth of Australia.

Susan Helmrich
Susan Helmrich

Susan is the Head of Nursing Education for the Medcast Group.

DipAppScNsg, BN, CritCareCert, CoronaryCareCert, TraumaNsgCareCert, CertIV(TAE), MN(Ed), and GradCert(Ldrshp & Mgt).

Get Medcast Plus

Become a member and get unlimited access to 100s of hours of premium education.

Learn more
Related News
Osteoporosis in over 50s - clinical fact sheet and MCQ

Medcast Medical Education Team

Brand icon

Osteoporosis is a significant health issue, affecting millions of Australians over the age of 50. Appropriate screening for at-risk patients is the first step in reducing the risk of minimal trauma fractures. This FastTrack activity discusses the application of DXA scanning as well as pharmacological and non-pharmacological interventions for osteoporosis. Complete the quiz to receive RP and EA CPD.

10 mins READ
Recognising and responding to suicide risk in Australian veterans: a guide for GPs

Dr Catherine Eltringham

Brand icon

This article equips GPs with practical strategies to recognise and assess suicide risk in Australian veterans. It outlines tools to support your consultation and assessment, and highlights referral pathways such as Open Arms – Veterans and Families Counselling and DVA services to support early intervention and save lives in general practice.

10 mins READ
Gas trapping & breath stacking - What is your asthmatic patient telling you?

Susan Helmrich

This article explores the risks and management of dynamic hyperinflation in mechanically ventilated patients with status asthmaticus. It outlines causes such as airway obstruction and bronchospasm, and provides strategies for adjusting ventilation settings to minimise gas trapping, support cardiac function, and reduce complications like pneumothorax and systemic hypotension.

5 mins READ