Co-Morbidity Based Questions
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Frequently Asked Inpatient Questions Microchapter |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ogechukwu Hannah Nnabude, MD
Co-Morbidity Based Questions
Patients with Hypertension
Should ACE Inhibitors and ARBs be discontinued in patients on admission for COVID-19?
- Based on current studies, it is advisable to continue the current treatment of chronic disease conditions including hypertension with either ACEI or ARB during the COVID-19 pandemic,
Patients with Asthma
Should an Asthma exacerbation be managed any differently to reduce the risk of COVID-19?
The selection of therapeutic options through the guideline-recommended treatment of asthma exacerbation has not been affected by what we currently know about COVID-19. Systemic corticosteroids should be used to treat an asthma exacerbation per national asthma guidelines and current standards of care, even if it is caused by COVID-19. Short-term use of systemic corticosteroids to treat asthma exacerbation should be continued. There is currently no evidence to suggest that short-term use of systemic corticosteroids to treat asthma exacerbation increases the risk of developing severe COVID-19, whereas there is an abundance of data to support use of systemic steroids for moderate or severe asthma exacerbation. Patients with asthma but without symptoms or a diagnosis of COVID-19 should continue any required nebulizer for treatments, as recommended by national professional organizations. If healthcare providers need to be present during nebulizer use among patients who have either symptoms or a diagnosis of COVID-19, they should use recommended precautions when performing aerosol-generating procedures (AGPs). If clinicians are concerned that an asthma exacerbation is related to an underlying infection with COVID-19, clinicians can access laboratory testing for COVID-19 through a network of state and local public health laboratories across the country.
Are any changes recommended to the treatment plan of an asthma patient with COVID 19?
If patients with asthma who have symptoms or a diagnosis of COVID-19 need to use nebulizer at home, it is recommended by national professional organizations that they should use the nebulizer in a location that minimizes and preferably avoids exposure to any other members of the household, and preferably a location where the air is not recirculated into the home (like a porch, patio, or garage). Limiting the number of people in the room or location where the nebulizer is used is also recommended. Nebulizers should be used and cleaned according to the manufacturer’s instructions. If nebulizer use in a healthcare setting is necessary for patients who have either symptoms or a diagnosis of COVID-19, they must use recommended precautions when performing aerosol-generating procedures (AGPs).