Contracting COVID-19 while managing a chronic respiratory condition, such as asthma or COPD, raises concerns about ongoing medical treatments. People who rely on inhalers need to know how a viral infection affects their medication regimen and the safety of their devices. The primary focus during any acute respiratory illness is maintaining lung function, which includes continuing all prescribed therapies. Managing your existing condition properly is even more important when the lungs are stressed by the SARS-CoV-2 virus.
The Necessity of Continuing Inhaler Treatment
Continue to use your prescribed inhalers and other respiratory medications exactly as directed, even after testing positive for COVID-19. Stopping regular treatment without consulting a healthcare professional is dangerous. For asthma patients, discontinuing an inhaled corticosteroid (ICS) can more than double the risk of a severe asthma flare-up, regardless of a viral infection.
Controller inhalers, such as those containing inhaled corticosteroids, work to reduce chronic inflammation within the airways. This anti-inflammatory action is particularly important when the lungs are battling an infection like COVID-19, which is known to cause significant inflammation. The benefits of keeping airways open and reducing inflammation with these daily maintenance drugs outweigh any concern about mild immunosuppression. Maintaining control of your underlying condition provides a better defense against the virus triggering a serious complication.
Controller medications are taken daily to prevent symptoms, while rescue inhalers, typically containing a short-acting bronchodilator like albuterol, are used only when symptoms occur. Since COVID-19 is a respiratory virus, it can cause airway tightening and inflammation, meaning you might need to use your rescue inhaler more frequently than usual.
Increased use of your quick-relief medicine is a direct sign that the virus is impacting your respiratory health and may require an adjustment to your treatment plan. You should consult your doctor if you notice you are relying on your rescue inhaler more often. For continuity of care, ensure you have at least a 30-day, or ideally a 90-day, supply of all necessary respiratory medications.
Hygiene Protocols for Inhaler Use During Illness
Pay special attention to the hygiene of all respiratory devices to prevent the spread of the virus to others in the household. Inhalers and any attached spacers or chambers should never be shared, especially when someone is symptomatic with COVID-19. After each use, clean the outside surface of the metered-dose inhaler (MDI) and its spacer with a disinfectant wipe containing at least 70% alcohol.
A pressurized MDI used with a spacer is preferred over a nebulizer during an acute respiratory infection. Nebulizers create a fine mist that generates aerosols, potentially spreading viral particles over a wider area. If you must use a nebulizer, do so in a location that minimizes exposure to others, such as a well-ventilated room or outside on a porch or patio.
The nebulizer equipment, including the cup, mask, or mouthpiece, requires meticulous cleaning.
Daily Cleaning
After each treatment, the parts should be disassembled, rinsed thoroughly with warm water, shaken free of excess water, and allowed to air dry completely.
Weekly Disinfection
Additionally, the nebulizer components should be washed once a week using warm, soapy water and then disinfected by soaking them in a solution of one-part white vinegar to three-parts water for about 20 minutes. Allowing all components to air dry fully before storage is required to prevent bacterial or fungal growth.
Monitoring Respiratory Symptoms and When to Seek Urgent Care
Managing a respiratory condition while infected with COVID-19 requires proactive symptom monitoring. An increase in the need for your quick-relief inhaler is a significant indicator of worsening lung function. Contact your healthcare provider for guidance if you find yourself needing to use your rescue inhaler more than every four hours, or more than a few times per week.
Pay close attention to changes in your breathing pattern, which may signal a decline in your condition. Signs of severe breathing difficulty require immediate medical attention. These include:
- An inability to speak in full sentences.
- A feeling of tightness or crushing in the chest.
- Wheezing that does not improve after using your rescue inhaler.
- A sudden or sustained drop in oxygen saturation levels, measured with a pulse oximeter.
If you have a pre-existing written asthma or COPD action plan, refer to the steps outlined for when symptoms worsen. Any deviation from your normal breathing that causes significant alarm should prompt contact with a medical professional. Seek emergency care immediately if you experience severe shortness of breath, confusion, or bluish lips or face, as these indicate a respiratory emergency.