Summary
Bronchial asthma, being one of the significant health problems due to the high prevalence of the disease worldwide, has not received an adequate assessment concerning coronavirus disease, the most relevant today. The article focuses on research on this problem because respiratory allergy is associated with a significant decrease in the expression of ACE2 receptors, which are the entry receptor for COVID-19. The research reflected in the article aims to trace the susceptibility of patients with bronchial asthma to coronavirus disease. The observed results served as the basis for recommendations for the treatment of bronchial asthma.
Significance
The article “COVID-19 susceptibility in bronchial asthma” can be assessed as significant for society, and that is why it was selected as the object for review. Bronchial asthma itself is a significant threat to human death; constant monitoring is necessary to prevent the onset of asthma attacks. The acute problem with coronavirus today still requires attention and further research. The importance and relevance of the article are that it explores this relationship and can offer some statistics and figures “indicating low susceptibility to COVID-19” in patients with pre-existing asthma. (Green et al., 2021, 688) Thus, research makes it possible to comfort these patients and shield them from the greater fear that they suffer in such a situation. Bronchial asthma is a chronic disease, and most often, genetic causes are the main ones for the onset of the disease. However, asthma can develop under the influence of unfavorable working environment factors, and in this case, more people are at risk.
Personal Response
The article reviewed is of particular interest, as it explores the relationship between diseases and hence susceptibility, which are the most relevant at the moment. The new coronavirus infection continues to spread worldwide, and research related to it is also relevant and necessary to the current state of affairs. In addition, the situation in the world with bronchial asthma has been aggravated in recent decades. Despite the fact that the second has been studied much more than the first, asthma is a severe disease that cannot be cured entirely; coronavirus disease overlaps with asthma and can be an additional trigger for asthma patients.
It is noted that the receptors that respond to those occurring in the environment are the same, and the susceptibility of patients with bronchial asthma to COVID-19 remains a crucial topic for study. However, the study cited in the article suggests low susceptibility, which is to some extent consolation and good news for patients with asthma. Cases of coronavirus infection are more common in people who smoke, so they are more at risk compared to asthmatics. The article is not difficult to read; the information provided and the evidence base on statistics, tables, figures, and relevance are traceable and do not require any changes.
Describing the Bronchial Asthma
Etiology and Mechanism the Bronchial Asthma
Bronchial asthma is a chronic inflammation of the airways; respiratory symptoms can vary in time and intensity and appear with airway obstruction. The following internal and external etiological factors can influence the development of BA:
- genetic, hereditary, allergic, and/or dysmetabolic predisposition;
- allergens and / or non-specific agents – pollutants;
- auxiliary adverse environmental factors (Hall & Agrawal, 2017).
BA symptoms develop after contact with allergens, which are non-infectious and infectious. Pollen, household, food, epidermal, chemical, insect, medicinal, professional allergens are considered non-infectious, and fungal, bacterial, parasitic, viral ones are infectious. In addition, chemical substances, tobacco smoke, biological inducers, and neuropsychic effects can serve as allergens; this group is non-specific inducers of pollutants. Allergens are responsible for 60-85% of asthma in adults and 64-90% of asthma in children. The central mechanism of the pathogenesis of bronchial obstruction in any clinical and pathogenetic variant of asthma is congenital or acquired hyperreactivity and hypersensitivity of the bronchi. Hypersensitivity is the condition of bronchial receptors to low doses of allergens and pollutants (Semernik et al., 2017). Hyperreactivity of the bronchi is an increased, in contrast to the norm, response to allergens or non-specific agents, characterized by a decrease in the threshold of sensitivity to them.
Signs and symptoms
The following signs of bronchial asthma are noted:
- Asphyxiation can arise both during physical exertion and in complete rest and when inhaling the allergenic particles in the air.
- Shortness of breath co-occurs with cough and has a harsh character.
- An asthma attack involves an inability to breathe deeply and frequent shallow breathing.
- Wheezing accompanies the breathing of a person during an attack and is sometimes listened to even remotely.
- Orthopnea is a posture that a person reflexively assumes during an attack; this pose promotes deeper exhalation (Hou et al., 2018).
Without treatment, symptoms can progress over time; as the disease develops in the body, such disorders arise as:
- General weakness
- Cyanosis of the skin
- Difficulty breathing
- Shortness of breath
- Dry cough
- Dizziness and headache
- Susceptibility to various diseases.
Diagnostic methods
A clinical diagnosis of bronchial asthma should be established by a doctor based on patient complaints, medical history, and diagnostic methods. A specific examination for allergic pathology is carried out, while it is necessary to consider the bronchial obstruction and the degree of its reversibility. The following methods are used to assess lung function and the degree of reversibility of bronchoconstriction:
- Spirometry is an essential method of investigating the reversibility and severity of bronchial obstruction.
- Peakflowmetry is performed with a peak flow meter and is used to measure the maximum expiratory flow rate.
- Bronchoconstrictor test is currently the most common method for studying bronchial hypersensitivity at present.
- The allergological examination includes provocative tests on the skin, laboratory tests for the detection of specific IgE antibodies are also relevant.
Pathology, pathophysiology, systems affected
Bronchial asthma affects the respiratory system; it is provoked by bronchial hyperactivity, leading to shortness of breath, repeated attacks of suffocation, chest congestion, and wheezing. It manifests in the form of shortness of breath that occurs in the area of the bronchi. At the later stages of asthma, structural changes occur in the airways: fibrosis, vascular proliferation—an increase in the number of mucous glands in the submucous layer. The progression of these processes leads to an aggravation of asthma, a deterioration in lung function, and a decrease in the effectiveness of therapy.
Prognosis, treatments, might we expect a chronic phase?
Predominantly, the disease occurs in the chronic phase, and modern medicine cannot cure bronchial asthma. However, all efforts are aimed at creating a therapy that preserves the patient’s quality of life. Pharmacotherapy of the disease is divided into two groups:
- Preparations for situational use
- Preparations of constant use (Khaitov et al., 2018).
Medicines aimed at relieving seizures include anticholinergic drugs, combination drugs, theophylline. Medications for the supportive therapy of bronchial asthma include inhalation and systemic glucocorticosteroids, long-acting theophylline, anti leukotriene drugs, antibodies to immunoglobulin E. Treatment of bronchial asthma involves complexity; drugs and methods of using these substances are equally important. The drugs are administered by inhalation, parenterally, or orally. To deliver medicines through the respiratory tract, the following groups of drugs are possible:
- aerosol inhalers;
- powder inhalers;
- nebulizers.
Public health impact: who does this affect, how, why, where?
Bronchial asthma is a severe medical, social and economic problem. On average, 4-18% of the world’s population suffers from asthma of varying degrees. In childhood, the disease is diagnosed to a greater extent, predominantly in boys. The ratio of cases to boys and girls is usually equated to adolescence; in adults, women are at risk and, for the most part, suffer from bronchial asthma. According to statistics, cleanliness increases the incidence of allergies and its clinical climax – asthma (Uwaezuoke, 2018). It is noted that townspeople suffer from asthma more often than rural residents. This is since the human body cannot adequately respond to natural allergens in too clean conditions of civilization and urbanization polluted with exhaust gases.
Technological and research advancements on the horizon
Research in this area is underway, and the article cited confirms this. Many sources also note the need for further research on this problem associated with bronchial asthma. Technological and research advancements are especially relevant in evidence-based medicine, treatment, diagnosis of asthma, etiology of the disease. Fundamental questions of modern directions devoted to bronchial asthma are designed to optimize the treatment and focus on controlled clinical trials in the field.
References
Green, I., Merzon, E., Vinker, S., Golan-Cohen, A., & Magen, E. (2021). COVID-19 susceptibility in bronchial asthma. The Journal of Allergy and Clinical Immunology: In Practice, 9(2), 684-692.
Hall, S. C., & Agrawal, D. K. (2017). Vitamin D and bronchial asthma: an overview of data from the past 5 years. Clinical therapeutics, 39(5), 917-929.
Hou, C., Zhu, X., & Chang, X. (2018). Correlation of vitamin D receptor with bronchial asthma in children. Experimental and therapeutic medicine, 15(3), 2773-2776.
Khaitov, M. R., Gaisina, A. R., Shilovskiy, I. P., Smirnov, V. V., Ramenskaia, G. V., Nikonova, A. A., & Khaitov, R. M. (2018). The role of interleukin-33 in pathogenesis of bronchial asthma. New experimental data. Biochemistry, 83(1), 13-25.
Semernik, I. V., Semernik, O. E., Dem’yanenko, A. V., & Lebedenko, A. A. (2017). A method for noninvasive diagnosis of bronchial asthma based on microwave technology. Biomedical Engineering, 51(2), 124-127.
Uwaezuoke, S. N., Ayuk, A. C., & Eze, J. N. (2018). Severe bronchial asthma in children: a review of novel biomarkers used as predictors of the disease. Journal of asthma and allergy, 11, 11.