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COVID-19 in Chronic Lung Disease: What You Need to Know

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and novel coronavirus disease (COVID-19) have been of major concern to the healthcare community at large, but particularly to clinicians who specialize in infectious disease and pulmonary and critical care medicine.

We spoke with Charles Dela Cruz, MD, PhD, of Yale University School of Medicine in New Haven, Connecticut, regarding the risks posed by COVID-19 to patients living with chronic lung disease, as well as precautions both patients and healthcare providers can take to prevent the spread of the SARS-CoV-2 virus and its potential subsequent complications.

Dr Dela Cruz is an associate professor in the Pulmonary, Critical Care and Sleep Medicine Department and the founding director of the Center for Pulmonary Infection Research and Treatment (CPIRT), both at Yale University.

Given the evidence we have so far, what level of risk does COVID-19 pose to patients with chronic lung conditions?

Patients with impaired or compromised lung conditions (eg, COPD, asthma, idiopathic pulmonary fibrosis, and cystic fibrosis) are at particular risk for COVID-19 with worse outcomes. Emerging data also suggest that patients who are elderly or have other comorbid conditions are at higher risk for more severe disease.

What are some practical steps and precautions that clinicians who treat patients with chronic lung disease can take?

Clinicians taking care of patients with chronic lung disease should help educate those patients about COVID-19 including the practice of hand washing with soap and water, avoiding touching eyes/nose/mouth, covering coughs or sneezes with tissue paper, and cleaning and disinfecting frequently touched objects and surfaces. If patients develop symptoms, they should call their doctor and discuss the next steps on the phone.

Should patients receiving mechanical ventilation in intensive care units be managed any differently in response to COVID-19?

Most patients who are already in the ICU receiving mechanical ventilation are being treated similar to patients with COVID-19, aside from additional precautions implemented to prevent viral spread with the use of additional personal protective equipment, negative pressure rooms, and limiting access to infected patients. In some circumstances, experimental antivirals may be used for coronavirus.

For the latest information, please visit the following resources: Centers for Disease Control and Prevention Coronavirus Disease 2019 (COVID-19) or the World Health Organization Coronavirus disease (COVID-19) outbreak.

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