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What is bronchial asthma?

Bronchial asthma is a chronic inflammatory respiratory disease. It is a reaction of the airways to various triggers, such as various allergens, cold air, smoke, pollution, exercise, certain medications and viruses. The result of this reaction is the contraction of the muscle fibers of the airway wall (bronchospasm), the creation of edema of their walls and the production of thick secretions within them, thus causing narrowing of their lumen and restriction of air flow through them.

What are the symptoms of bronchial asthma?

The symptoms and intensity of the symptoms of bronchial asthma vary from patient to patient, however, most patients present:

• Dyspnea (difficulty breathing)
• Intense, dry, irritating cough, sometimes productive, more often nocturnal
• Heaviness in the chest
• Chest pain
• Wheezing on exhalation
• Fatigue during exertion

What are the causes of bronchial asthma?

The causes of asthma vary, the most common are:

• Allergens, such as house dust, pollen, animal dander, food items
• Environmental pollution and smoking
• Physical or mental stress
• Chemicals (cleaning agents, medications)
• Respiratory infections
• Gastroesophageal reflux
• Weather conditions (humidity, cold air, hot air)

How is bronchial asthma diagnosed?

The diagnosis is made by the pulmonologist with the help of taking the patient’s medical history and physical examination, but also with the special tests available:

• Spirometry (before and after 15 minutes of inhaling Aerolin). This is a painless test that requires the cooperation of the patient and the doctor and measures volumes and capacities of air that the lungs exchange with the environment. This is how we study respiratory function.
• Airway hyperreactivity challenge test. It is performed in cases where spirometry is normal, but the patient’s symptoms and history are completely compatible with asthma. During this test, the airway response is assessed after inhalation of pharmaceutical substances that can cause bronchospasm.
• Allergy tests. Blood tests, with measurement of specific immunoglobulin IgE, measurement of eosinophils in the general blood, measurement of specific allergens (RAST test) and skin tests (PRICK test).

What are the ways to treat bronchial asthma?

Therapeutic treatment is prescribed by the Pulmonologist and is individualized for each patient due to the variety of symptoms, frequency of occurrence and severity of the disease.

Asthma treatment includes:

• Bronchodilator drugs. Inhaled β2 agonists and anticholinergics and theophylline tablets.
• Corticosteroids (inhaled, tablets or injectable).
• Antileukotriene montelukast.
• Monoclonal antibodies against IGE immunoglobulin administered 1-2 times a month subcutaneously and IL-5 inhibitors administered every month or two subcutaneously.

Are people with asthma among the vulnerable groups for COVID-19 disease?

It is known that viral infections can trigger an asthma attack and the same applies to COVID-19 infection, i.e. it can cause a worsening of asthma symptoms. More specifically, patients with mild asthma who are receiving their medication and are controlled do not belong to serious lung diseases, and therefore not to vulnerable groups. However, patients with asthma, with 2 exacerbations in the last year, despite the maximum use of inhaled treatment (β-stimulator and inhaled corticosteroid) belong to vulnerable groups. Patients with asthma must maintain their stable treatment, especially inhaled corticosteroids.