![]() ![]() Surprisingly during this unprecedented current Coronavirus disease 2019 (Covid19) outbreak, asthmatics seem not to be overrepresented in the different studies and registries, but most are preliminary data. Moreover, coronaviruses (other than the Sars-Cov-2) are identified in 8.4% of asthma exacerbations in children and up to 20.8% in adults, ranking it second after the rhinovirus. Paradoxically, preferential respiratory tropism is clearly established for Coronaviruses as previously reported for SARS (Severe Acute Respiratory Syndrome) or MERS (Middle East Respiratory Syndrome). Whether the SARS-CoV-2 can induce exacerbations and in particular severe exacerbations of asthma is unclear at this stage, even though there are no report available in this direction. Other known factors of susceptibility are the deficient type III interferon response and genetic polymorphisms of some viral receptors, the rhinovirus CDHR3 being the most famous,. T2 airway inflammation may explain this increased viral susceptibility that can be restored by corticosteroids and biologics, and eventually azithromycin in severe asthma. It may look paradoxical that anti-inflammatory treatments and more specifically corticosteroids can prevent virally-triggered asthma exacerbations. ![]() Viral infections are the most frequent triggers of asthma exacerbations, and by the way asthmatics and in particular severe asthmatics are at risks of severe viral respiratory infections. ![]()
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