The impact of COVID-19 and influenza on pediatric asthma

By: Kavita Patel, MD, Pulmonology

If you have a child with asthma, this is likely the time of year that you brace yourself for the onslaught of respiratory illnesses, which are inevitable during the cooler months. This year, with the ongoing COVID-19 pandemic and the impending Influenza season, parents have more reasons to worry than ever before.

There has been a lot of discussion about the upcoming flu season coinciding with the COVID-19 pandemic. Did you know that Australia and South America, who experience their flu season several months before we do in the U.S., have reported NO influenza cases in 2020? This believed to be largely due to lockdowns, social distancing and travel bans implemented to mitigate the spread of COVID-19 in the spring and early summer. Since June, the U.S. has loosened many of those restrictions and as a result, we have even seen an increase in COVID-19 cases. This could mean we won’t likely have the same experience this flu season.

Pediatric asthma as a risk factor

The Centers for Disease Control and Prevention (CDC) states that children with chronic lung diseases, including asthma, are at higher risk for severe infection with Influenza virus and likely could require hospitalization. The same is believed to be true about COVID-19 infections in children with asthma, though the limited data available does not illustrate that. This may in part, be due to the fact that children with chronic lung diseases and asthma are being more cautious to avoid infection and therefore are not getting sick in large proportions.

Similarities

Did you know that COVID-19 and Influenza have many similarities? Both viruses are spread primarily by respiratory droplets and share symptoms like fever, cough, sore throat, nausea/vomiting, body aches, decreased appetite, body aches, headaches and shortness of breath. This will undoubtedly make it very difficult to tell one virus from the other.

And to make this even more confusing, studies have shown that COVID-19 and flu infections can infect an individual simultaneously! 

COMPARISON OF COVID-19 and Influenza
COVID-19 Influenza
Spread mostly by respiratory droplets Spread mostly by respiratory droplets
Symptoms: cough, wheeze, fever, sore throat, nausea, body aches Symptoms: cough, wheeze, fever, sore throat, nausea, body aches
No vaccine available Vaccine available—and safe!

So what can you do to help your asthmatic child this year, especially if they are heading back to school for in-person learning?

Your goal should be to optimize asthma control:

  • Review your child’s Asthma Action Plan and make sure it is updated and current.
  • If your child is prescribed an inhaled corticosteroid, continue daily use as directed by their physician.
  • Make sure you have albuterol (rescue medication) at home and it is not expired.
  • Make sure your child is using an accurate metered dose inhaler (MDI) technique with spacer to ensure adequate medication delivery to your child’s lungs.
  • Keep an albuterol inhaler and spacer/chamber at school in the event your child needs it during school hours (individual school guidelines may vary).
  • Follow CDC guidelines to decrease spread of COVID-19 as it will also likely decrease exposure to Influenza as well (i.e. masking in public, hand washing, social distancing).
  • Anyone 6 months and older without any contraindications should get a flu vaccine each year.
  • If your child has had an allergic reaction to the influenza vaccine in the past, he/she should be evaluated by an allergist before administering another flu vaccine.
  • Egg allergy* is not a contraindication because it does not increase risk of severe allergic (anaphylactic) reaction to the inactivated influenza vaccine.

* Children with egg allergies can receive any licensed, recommended vaccine that is age appropriate.

Please contact your child’s doctor if you need to schedule a flu shot or if you need an updated Asthma Action Plan.