COVID-19 was linked to worse acute and long-term respiratory burden in people with obstructive pulmonary diseases, while vaccination reduced severe outcomes.
Evidence
This narrative review synthesized PubMed, Embase, and Scopus literature from January 2020 to June 2025 on COVID-19 outcomes, , vaccination, and treatment in asthma and COPD.
Caveat
The review thematically combines heterogeneous study types and notes phenotype-specific asthma effects and attenuated vaccine responses with biologic therapies, so findings are not uniform across all OPD patients.
Simplified
BACKGROUND AND AIMS: The COVID-19 pandemic has posed significant challenges for individuals with obstructive pulmonary diseases (OPDs), such as asthma and chronic obstructive pulmonary disease (COPD). Emerging evidence highlights the complex interplay between SARS-CoV-2 infection and OPDs, including increased risks of severe disease, long-term sequelae, and potential new-onset respiratory conditions. This narrative review synthesizes current knowledge on the pathophysiological mechanisms, clinical outcomes, and management strategies for COVID-19 in OPD patients, with a focus on long-term consequences and vaccination efficacy.
METHODS: A comprehensive literature search was conducted using PubMed, Embase, and Scopus (January 2020-June 2025). Inclusion criteria encompassed original studies, reviews, and meta-analyses examining COVID-19's impact on asthma or COPD, while non-English publications, animal studies, and case reports were excluded. Data were extracted and thematically synthesized to address acute outcomes, , vaccination, and therapeutic considerations.
RESULTS: Risk and Severity: COPD patients faced higher risks of severe COVID-19 (hospitalization, ICU admission, and mortality), while asthma phenotypes influenced outcomes (eosinophilic asthma conferred milder disease).Long COVID: Persistent respiratory symptoms (dyspnea and cough), fatigue, and cognitive dysfunction were prevalent in OPD patients, with new-onset asthma reported post-infection.Vaccination: mRNA vaccines significantly reduced severe outcomes in OPDs, though biologic therapies in asthma may attenuate immune responses.Treatment: Antivirals (e.g., nirmatrelvir-ritonavir) and corticosteroids were effective, but drug interactions (e.g., CYP3A4 inhibitors) required careful management.
CONCLUSION: COVID-19 exacerbates OPD-related morbidity, underscoring the need for tailored prevention (vaccination and early diagnosis) and multidisciplinary management. Future research should prioritize phenotype-specific therapeutic strategies and long-term surveillance to mitigate post-COVID sequelae in this vulnerable population.
Key numbers
0.221
Increased Mortality Risk
Relative risk of mortality in vaccinated COPD patients vs. unvaccinated.
higher
Prevalence of New-Onset Asthma
Higher prevalence observed in patients with a history of COVID-19 infection.
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