PREDICTION AND PREVENTION OF COMPLICATIONS OF LONG COVID IN COPD AND ASTHMA
DOI:
https://doi.org/10.52692/1857-0011.2025.3-83.29Keywords:
long COVID, COPD, bronchial asthma, post-COVID syndrome, rehabilitation, vaccination, respiratory failureAbstract
Background. Patients with chronic obstructive pulmonary disease (COPD) and bronchial asthma belong to the high- risk group for severe COVID-19 and the development of long COVID.
This study aimed to assess long COVID complications in COPD and asthma patients and to substantiate preventive measures based on international data and experience of the Republic of Moldova.
Methods. A review of scientific publications from 2020–2025 was conducted, along with analysis of official reports and normative acts of Moldova, including estimates of long COVID prevalence were calculated.
Results. Pre-existing COPD and asthma increase the risk of long-term post-COVID sequelae by approximately 30– 40%. Long COVID complications predominantly include chronic dyspnea, fatigue, reduced exercise tolerance, worsened control of the underlying disease, and psycho-emotional disorders. In Moldova, tens of thousands of people are estimated to suffer from post-COVID complications, but systematic case recording is absent.
Conclusions. Implementation of key preventive measures is required: full vaccination and boosters for at-risk groups, early administration of antivirals, continuous control of COPD/asthma, as well as development of rehabilitation and monitoring programs for patients with long COVID.
References
Agondi R.et al. Worsening of asthma control after COVID-19. Frontiers in Medicine, 2022, vol. 9, article 882665. DOI: 10.3389/fmed.2022.882665.
Alqahtani J.S. et al. COVID-19 and respiratory disease: a systematic review of COPD and smoking as risk factors. Chest, 2020, vol. 158, nr. 5, pp. 1511– 1530.
Alqahtani J.S. et al. Prevalence, severity, and mortality associated with COPD and smoking in patients with COVID-19: a rapid systematic review and meta- analysis. PLOS ONE, 2020, vol. 15, nr. 5, e0233147.
Alter P. et al. Impact of the COVID-19 pandemic on the behaviour and health status of patients with COPD: results from the German COPD cohort COSYCONET. ERJ Open Research, 2021, vol. 7, nr. 1, 00542–2020. DOI: 10.1183/23120541.00242-2021.
Benítez I.D. et al. Impact of COVID-19 on COPD exacerbations and clinical course. Discover Public Health, 2024, vol. 1, articol 3, p. 12.
Centers for Disease Control and Prevention (CDC). Long COVID in adults: United States, 2022. CDC National Health Statistics Report #188, 2023. www. cdc.gov.
Chhiba K.D. et al. Prevalence and characterization of asthma in hospitalized and nonhospitalized patients with COVID-19. Journal of Allergy and Clinical
Immunology: In Practice, 2020, vol. 8, nr. 8. www.jaci-inpractice.org/article/S2213-2198(20)31328-3/fulltext.
Condraţchi D., Pisarenco S., Martîniuc C., Procopişin L., Rotaru-Lungu C. Impactul COVID-19 asupra BPOC: complicații pe termen scurt și consecințe pe termen lung. Buletinul Academiei de Ştiinţe a Moldovei. Ştiinţe Medicale, 2024, nr. 2(79), pp. 247– 252. DOI: 10.52692/1857-0011.2024.2-79.47.
Disponibilitatea preparatelor pentru tratamentul bronhopneumopatiei obstructive cronice în Republica Moldova. Medichub.ro. www.medichub.ro/reviste-de-specialitate/farmacist-ro/disponibilitatea-preparatelor-pentru-tratamentul-bronhopneumopatiei-obstructive-cronice-in-republica-moldova-id-9495-cmsid-62.
Euronews. Commission to step up action against long COVID, 2023. www.euronews.com.
European Commission. Exploring new insights and strategies for long COVID. Health EU Publication, 2023. health.ec.europa.eu.
Global Initiative for Asthma (GINA). GINA 2022 & COVID-19: scientific brief. GINA, 2022. www.mdpi.com.
Global Initiative for Chronic Obstructive Lung Disease (GOLD). GOLD report 2025: Global strategy for the diagnosis, management, and prevention of COPD. 2025. Available at: https://goldcopd.org/wp-content/uploads/2024/11/GOLD-2025-Report-v1.0- 15Nov2024_WMV.pdf
Hatipoğlu U. et al. Inhaled corticosteroids do not adversely impact outcomes in COVID-19 positive patients with COPD: an analysis of Cleveland Clinic’s COVID-19 registry. PLOS ONE, 2021, vol. 16, nr. 6, e0251717.
Hoffmann M. et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell, 2020, vol. 181, nr. 2, pp. 271–280.
Hoffmann M. et al. The interaction of SARS-CoV-2 with ACE2 receptors: pathophysiological implications. European Respiratory Journal, 2020, vol. 55, nr. 2, articol 2000528.
Hung Chun-Tse et al. Prevalence and characteristics in long COVID among adults with asthma in the United States. Journal of Asthma, 2024, vol. 61, nr. 7, pp. 736–744. pubmed.ncbi.nlm.nih.gov.
Iglesias C. et al. Reduction in hospitalised COPD exacerbations during COVID-19: a systematic review and meta-analysis. Respiratory Medicine, 2020, vol. 175, articol 106205.
International Primary Care Respiratory Group. What do we know about the effect of long COVID and its impact on asthma? www.ipcrg.org/resources/search-resources/what-do-we-know-about-the-effect-of-long-covid-and-its-impact-on-asthma.
Kim Y.J. et al. Impact of COPD on COVID-19 prognosis: a nationwide population-based study in South Korea. Journal of Korean Medical Science, 2020, vol. 35, nr. 37, articol e345.
Liu Shuang et al. Prevalence of Comorbid Asthma and Related Outcomes in COVID-19: A Systematic Review and Meta-Analysis. The journal of allergy and clinical immunology. In practice vol. 9,2 (2021): 693-701.
Libby P., Lüscher T. COVID-19 is, in the end, an endothelial disease. European Heart Journal, 2020, vol. 41, nr. 32, pp. 3038–3044.
Long COVID – 3 years in. GMDP Academy, 2023. www.gmdpacademy.org/news/long-covid-3-years-in/.
Melinte O.E. et al. Assessment of some risk factors and biological predictors in the post COVID-19 syndrome in asthmatic patients. Journal of Personalized Medicine, 2024, vol. 14, nr. 1, articol 21. DOI: 10.3390/jpm14010021.
Ministerul Sănătății al Republicii Moldova. Protocolul clinic național „Infecția cu coronavirus de tip nou (COVID-19)”, – ediția VI (aprobat prin Ordinul MS nr.1002 din 29.10.2021) (abrogat)
Ministerul Sănătății al Republicii Moldova. Ghid Reabilitarea medicală a pacienților cu infecția COVID-19, ediția II, ordinul MSMPS nr. 614 din 30.06.2021.
Ministerul Sănătății al Republicii Moldova. Protocolul clinic național “Infecția cu coronavirus de tip nou (COVID-19)”, ediția IX, ordinul MS nr. 594 din 05.07.2024.
Ministerul Sănătății al Republicii Moldova. Reabilitarea post-COVID-19 și dezvoltarea deprinderilor de autoîngrijiri. Buletin MSM, 29 septembrie 2020.
Moscovciuc A., Condraţchi, D., Şincarenco I., Procopişin L., Simionica I. Comorbiditatea COVID-19
– BPOC: particularități și evoluție. Buletinul Academiei de Ştiinţe a Moldovei. Ştiinţe Medicale, 2024, nr. 2(79), pp. 242–246. DOI: 10.52692/1857-
2024.2-79.46.
Rajabi H., Mortazavi, D., Konyalilar, N. et al. Forthcoming complications in recovered COVID-19 patients with COPD and asthma; possible therapeutic opportunities. Cell Commun Signal 20, 173 (2022). https://doi.org/10.1186/s12964-022-00982-5
Singh D. et al. Characteristics and prognosis of COVID-19 in patients with COPD. The Lancet Respiratory Medicine, 2021, vol. 9, nr. 4, pp. 330–
bulmed.md.
Siviero P. et al. The experience of COPD patients in lockdown due to the COVID-19 pandemic. International Journal of COPD, 2020, vol. 15, pp. 2247–2254. bulmed.md.
Sosnowski K. et al. Short and long-term impact of COVID-19 infection on previous respiratory diseases. Journal of Respiratory Medicine, 2021, vol. 118, pp. 132–139. bulmed.md.
Statista. Total COVID-19 cases in the Republic of Moldova. www.statista.com/statistics/1127181/republic-of-moldova-covid-19- cases/#:~:text=Statista%20www.statista.com%20
%20Total%20COVID
Sunjaya A.P., Allida S.M., Di Tanna G.L., Jenkins
C.R. Asthma and COVID-19 risk: a systematic review and meta-analysis. Eur Respir J. 2022 Mar 31;59(3):2101209. doi: 10.1183/13993003.01209-2021.
Terry P., Heidel R.E., Wilson A.Q., Dhand R. Risk of long COVID in patients with pre-existing chronic respiratory diseases: a systematic review and meta-analysis. BMJ Open Respiratory Research, 2025, vol. 12, nr. 1, art. e002528. DOI: 10.1136/ bmjresp-2024-002528. pmc.ncbi.nlm.nih.gov.
Long COVID: 3 years in. The Lancet, 2023, vol. 401, nr. 10379, p. 795. DOI: 10.1016/S0140- 6736(23)00493-2.
Vaccines Europe. Long COVID — understanding and combatting an increasing burden. Vaccines Europe Blog, 2023. https://www.vaccineseurope.eu/media-hub/blogs/long-covid-understanding-and-combatting-an-increasing-burden/#:~:text=,Economic%20 Effects%20in%20the%20EU
Varga Z. et al. Endothelial cell infection and endotheliitis in COVID-19. The Lancet, 2020, vol. 395, nr. 10234, pp. 1417–1418. bulmed.md.
Wikipedia. COVID-19 pandemic in Moldova. Wikipedia. en.wikipedia. o r g / w i k i / C O V I D - 1 9 _ p a n d e m i c _ i n _ Moldova#:~:text=LocationRepublic%20of%20 Moldova%20%20First,3.
Wolff Doreen et al. Allergic diseases as risk factors for long-COVID symptoms: systematic review of prospective cohort studies. Clinical and Experimental
Allergy, 2023, vol. 53, nr. 11, pp. 1162–1176. DOI: 10.1111/cea.14391. pubmed.ncbi.nlm.nih.gov.
World Health Organization. Post COVID-19 condition (long COVID). WHO Fact Sheet, 26 februarie 2025. www.who.int.
Xie Pan et al. Clinical characteristics and effects of inhaled corticosteroid in patients with post COVID-19 chronic cough during the Omicron variant outbreak. BMC Pulmonary Medicine, 2024, vol. 24, art. 156. DOI: 10.1186/s12890-024-02773-9. pubmed.ncbi. nlm.nih.gov.
Yohannes A.M. COPD patients in a COVID-19 society: depression and anxiety. Expert Review of Respiratory Medicine, 2021, vol. 15, nr. 8, pp. 993– 1000. bulmed.md.
Zhao Q. et al. The impact of COPD and smoking history on the severity of COVID‐19: a systematic review and meta‐analysis. Journal of Medical Virology, 2020, vol. 92, nr. 10, pp. 1915–1921.
Ziua Mondială a Astmului: Iată câți moldoveni sunt afectați de această maladie. Sputnik Moldova, 5 mai 2020. md.sputniknews.com/20200505/Ziua-Mondiala-a-Astmului-moldovenii-sunt-afectati-de- aceasta-maladie-30133314.html.
Ziua Mondială a Astmului: În Moldova sunt peste
000 de astmatici. Știri.md. stiri.md/article/social/ziua-mondiala-a-astmului-in-moldova-sunt-peste- 160-000-de-astmatici.
Worldometers. Coronavirus cases: Moldova. https://www.worldometers.info/coronavirus/country/moldova/#:~:text=Coronavirus%20Cases%3A.
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