The clinical manifestations of the patient with asthma and SARS-CoV-2 present a wide range, from asymptomatic to those experiencing acute respiratory failure. The use of spirometry has been restricted for diagnosis and monitoring, due to the high risk of contagion.

Un estudio de la Revista Alergia México ha demostrado que la eosinofilia y la inflamación TH2, debido a su efecto inmunológico antivírico, son factores protectores contra el COVID-19 severo al igual que los pacientes con asma leve, ya que expresan menos receptores de la enzima convertidora de angiotensina (ECA2), en comparativa con aquellos que presentan asma neutrofílica que expresan mayor proporción de estos receptores, lo que sugiere presentaciones más severas de COVID-19. El tratamiento convencional del asma modula la respuesta inmunitaria del SARS-CoV-2, por lo cual, los pacientes con asma controlados tienen manifestaciones no graves de COVID-19, aunque los mecanismos no están claros.

Throughout the pandemic, it was established that the rates of morbidity, severity of COVID-19 infection, and mortality in patients with moderate to severe asthma have not exceeded or revealed significant differences compared to the population in general, but comorbidities such as obesity, diabetes mellitus, arterial hypertension, conditions that produce inflammatory processes with a mainly Th1 cytokine profile, endothelial damage, involvement of other inflammatory pathways (complement, coagulation cascade, etc.), if they have been the entities that frame a poor prognosis, both in the evolution and in the mortality rates due to SARS-CoV-2.

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Worldwide, a variable incidence of COVID-19 has been reported in asthmatic patients with records from 5.6% in South Korea to 11% in the United States of America, however, no differences in severity and mortality have been observed in asthmatic patients hospitalized for SARS-CoV-2 (6.9%), compared to other respiratory viruses such as seasonal influenza (11%).