General


  • I have a lung condition; am I at more risk of getting COVID-19 than somebody who does not have a lung condition?

    No – the infection can be caught by anyone. However, people with underlying lung conditions might be more likely to show symptoms of the infection or to have a more severe infection than others. So far, most people that get COVID-19 have a mild viral illness, but some people develop a chest infection/pneumonia. The severity of COVID-19 infection can be greater if you have an underlying lung condition and so you should make every effort to avoid becoming infected.

  • Please can you provide detailed information about who is at high risk from a respiratory standpoint?

    Any severe respiratory condition is likely to place you at higher risk of complications, in particular:

    • Severe COPD
    • Severe asthma (meaning regularly requiring steroids for exacerbations, or taking a biological treatment or long-term corticosteroids)
    • Bronchiectasis, particularly if you experience frequent chest infections
    • Cystic fibrosis
    • Any other pulmonary condition where you are severely disabled by breathlessness (unable to leave the house due to breathlessness for example) or requiring long-term oxygen treatment
    • Lung cancer if currently active and being treated with chemotherapy or radiotherapy

     

    There are hundreds of different lung conditions and so it is not possible to list them all. Remember that being “high risk” means you have a slightly higher risk of complications of COVID-19 infection than other people, but you are still mostly likely, if you contract the virus, to have a mild illness or no symptoms at all.

  • Are there any additional measures that I should take to limit my risk of getting sick as I have a lung condition?

    Follow the advice from your country’s health authorities – this will be slightly different in each country depending on how many cases there are in your country.

    There are things that everyone should do to limit their risk. If you have a lung condition, the following are important.

    • Avoid contact with anyone who is sick.
    • Ask sick friends or relatives not to visit you and keep a distance of at least 2 metres from others who are not from your household and particularly anyone that may have symptoms such as cough.
    • Do not touch your mouth, nose or eyes with unwashed hands unless unavoidable.
    • Wash your hands thoroughly after touching surfaces that may be contaminated. Wash your hands with warm water and soap for 20 seconds.
    • Make sure you take all of your regular medications and keep up with your usual treatments to keep your lungs as healthy as possible.

     

  • Should I consider self-isolating to avoid catching the virus?

    Self-isolating means staying indoors as much as possible and avoiding contact with others. The advice on self-isolation is different in different countries at the moment, but the following are sensible steps that apply to all countries in Europe:

    • If you have symptoms of fever, cough or a chest infection you should self-isolate and get a COVID-19 test if it is available in your country.
    • If you do not have symptoms, avoid contact with anyone who is sick, even if they “just have a mild cold”.
    • Stay at home as much as possible, including working from home if this is feasible.

     

    If you are in an area with a high number of COVID-19 cases, you may be asked to do a more strict isolation.

  • Am I safe outside of the house provided I avoid crowded areas e.g. can I go to the park or walk outside?

    Yes. The virus is caught from people that have the infection and so there is no problem in going outside by yourself. It is important to avoid contact with anyone who might be ill. In some countries you may be asked to wear a face covering outside. 

    The rules for meeting other people outside or events where a large number of people are together are different around Europe so you should follow the guidance where you live. In some places the rules get relaxed when COVID-19 cases go down and are tightened again when they begin to increase. You should check what the guidance is before deciding to attend an event or to meet other people outdoors.

    In general, the virus spreads more easily indoors than outdoors and so if you have to meet others for essential reasons, it is better to do this outdoors where possible. 

  • As part of my condition, I regularly have a dry cough and fever – is there a way to distinguish these symptoms with those of COVID-19?

    No. There is nothing unique about the symptoms of COVID-19 and this is why most people who are tested for the virus do not have it. Their cough and fever are actually caused by something else.

    If you have a cough that is typical for you and it has not changed you do not need to do anything differently from normal and do not need to isolate. If your cough changes or you develop new symptoms along with your cough, you should self-isolate and if testing for COVID-19 is available in your country, arrange a COVID-19 test. 

  • Are people with respiratory disease more likely to die of COVID-19 than those without?

    Yes, older age and the presence of underlying conditions – including lung conditions – have been shown to be risk factors for death. Nevertheless, it is important to emphasise that most patients, even those with underlying respiratory disease, have had mild infections and have fully recovered.

  • Should I wear a mask to protect myself from the virus?

    The guidelines for masks or face coverings vary across Europe. You should wear a face covering if this is recommended by your local authority. There is no medical reason that means you cannot wear a face covering if you have a respiratory condition.

    You may find that it makes it feel a little harder to breathe. If this is the case you can try to adapt to the face covering slowly at home or try a different material such as a scarf. You can read more information about wearing face coverings and masks, including the different types of masks and face coverings, here.

  • Can I catch COVID-19 from my pet?

    Cats and dogs have been found to have the virus but there is currently no evidence that humans can catch the disease from common household animals such as cats and dogs. At the moment cats and dogs have not been shown to experience severe symptoms.

  • My neighbours often smoke in their garden and the smoke comes into my house if the windows are open. Can COVID-19 be transmitted through exhaled smoke?

    There is no evidence that COVID-19 can be transmitted through smoke, but passive smoke exposure can still be harmful to people with lung conditions in other ways. It might be worth closing the windows if your neighbours are smoking.

  • The news says that the worst affected by COVID-19 are the older age population and ‘people with pre-existing conditions’. Are ‘people with pre-existing conditions’ also older or does this refer to people of any age?

    Most people dying from COVID-19 have been aged over 80 years and have had advanced heart and lung conditions. They have had a combination of older age and severe pre-existing conditions. Most older people and most people with pre-existing conditions have had a mild viral illness and have fully recovered. Younger people with underlying conditions are more likely to suffer complications than younger people without underlying conditions. That is why it is important to be more cautious if you have underlying health problems, even if you are young.

  • I had the flu vaccine this year. Am I protected from this virus?

    The flu vaccination only protects against the flu (influenza virus) and does not protect against COVID-19, although it is still important to have your flu vaccine so you do not get the flu.

    Vaccines are now available for COVID-19 and more are being researched. Many countries across Europe are now giving vaccines to their citizens. Each country will have slightly different criteria for who will be vaccinated first. Generally, people who are most vulnerable are being vaccinated first. It is fine to receive both the flu and COVID-19 vaccines.

  • What is being done to protect the vulnerable population (elderly, people with health conditions)?

    To protect older people and those with underlying health conditions, most European countries have adopted “social distancing” and self-isolation procedures. This means asking people to stay at home more than usual, practicing good hand hygiene and keeping their distance in public to reduce transmission.

  • Should I inhale hot water vapour to prevent COVID-19?

    There is no reason to believe hot water vapour would be either helpful or harmful for COVID-19.

  • What breathing exercises should I be doing if I get COVID-19?

    There are no specific breathing exercises to do if you get COVID-19. If you have a lung condition such as bronchiectasis where you need to regularly clear your chest then you should keep doing your regular breathing or airway clearance exercises.

  • How do you know when someone is no longer contagious for COVID-19? Should you isolate if a family member is returning home from hospital with COVID-19?

    The hospital should advise you and the family member about this when they are discharged from hospital. In general, once symptoms have stopped and it has been 10 days since the start of symptoms, patients are unlikely to be infectious. If the hospital advises you that the patient is still infectious when they come home, they should also advise on how to isolate within the home, which includes trying to maintain a distance of 2 metres apart in the home and not sharing beds or bathrooms if possible. Research has shown it is very rare for people to be infectious beyond 10 days from the onset of symptoms.

  • I’m in a high-risk group. What should I do now that social distancing laws are being relaxed?

    As the rules are being relaxed there has been specific guidance for high-risk groups. This varies from country to country, but it might be that rules have been relaxed for younger people and those without high-risk conditions first.

    Socially distancing and wearing face coverings is now in place in most countries and it is still very important to continue with handwashing and avoid touching your face with unwashed hands.

  • I am due to have a spirometry test - is there a risk of transmission?

    Many countries have stopped doing spirometry tests at the moment to reduce the risks to staff of being exposed to the virus during the test.

    You are not at risk of catching the virus from a spirometry test. Spirometry equipment has always been dealt with in a very hygienic way and measures to avoid transmission of the virus are being practiced in spirometry labs everywhere. The main risk of catching the virus is from other people, and therefore the biggest risk is when travelling to the test and coming back from the test. Remember to practice social distancing – staying 2 metres apart from others at all times.

  • Does the dry cough turn into a phlegmy cough?

    In most cases, no. The cough is usually dry throughout COVID-19, but about 1 in 5 patients seem to develop a phlegmy cough. This is more common if you have COPD or bronchiectasis. If the sputum is green it suggests you may need an antibiotic and you should discuss this with your doctor.

  • As social distancing is relaxing in some places and people return to work, should people who are high risk stay away from family members who have been out even with face coverings/masks on?

    In every country the advice will be slightly different and so you should follow the local guidance as far as possible. In general, as long as COVID-19 is circulating in the community, you should limit exposure to as small a group of people as possible to reduce the risk of infection.

  • Are there any lung conditions that might mean people will have less severe COVID-19?

    Probably not. There has been some speculation from experts that we have not seen as many patients with asthma, bronchiectasis or cystic fibrosis getting severe COVID-19 as we perhaps expected at the start of the pandemic. This has not, however, been confirmed by subsequent research and so it is likely the risk is the same for all underlying conditions.

  • Could anxiety cause similar symptoms to COVID-19, such as chest pains?

    Always discuss problems such as chest pains with a healthcare professional, because although they can be caused by anxiety, there are also potentially serious health problems that can cause chest pain.

    Anxiety is a very difficult problem and can cause issues such as breathlessness and chest pains as well as other symptoms which could be mistaken for COVID-19. It is understandable that many people are anxious at the moment. If you do develop symptoms, it is important not to dismiss them as being caused by anxiety, but to assume until proven otherwise that they could be caused by COVID-19. This means self-isolating if you have symptoms that could be caused by COVID-19 and seeking medical attention for testing or treatment if you have more severe symptoms.

    If you are struggling with your mental health during this difficult time, we have developed a factsheet about managing your mental health with a lung condition which you can access here.

Work


Travel


  • My partner has to travel by plane for treatment for his condition. What can we do to keep him safe?

    Travel for people with underlying conditions should be limited as much as possible and restricted only to essential trips. In this case, if the trip is essential, you should follow the steps outlined at the top of this page, including practicing good hand hygiene during every part of the trip. Airlines and airports have introduced extensive new measures to reduce risk when travelling.

  • Should I avoid using public transport? What is the best type of transport to use?

    For patients with underlying lung conditions, we suggest limiting journeys as much as possible. Public transport, such as bus and train journeys, may be necessary, in which case the best way to reduce the risk of transmission is to wash your hands thoroughly before and after the journey; avoid touching your face, nose and eyes, and try to maintain a distance of more than 2 metres from other passengers if possible.

    Public transport with the fewest passengers or that limits your contact with potentially sick people is the best, but we recognise that some journeys are unavoidable.

    In most countries, there is now a recommendation to wear a face covering on public transport.

Children


  • Should I be worried about sending my child to school?

    Many countries in Europe closed schools in response to the outbreak. In many places they are now re-opening schools. You should follow your local guidance about sending children to school.

    Children can contract COVID-19, but most frequently have a mild viral illness. The risk to your child and any risk to you as a person with lung disease should be discussed with your school before a decision to take your child out of school is made.

    In the event that more widespread transmission and large outbreaks are detected in the country, schools in specific regions may be advised to close.

  • My child has a lung condition; what should I be doing to protect them?

    If they are old enough, ensure they have been taught about how to wash their hands properly and to avoid touching their mouth, nose and eyes with unwashed hands. Consider social distancing measures, such as reducing out of school activities and avoiding events where they will be in contact with a large number of people.

    Most importantly, the disease is generally mild in children, but could cause problems in children if their lung condition is not under good control. Make sure they are taking all of their regular medications, such as preventor inhalers for asthma, to reduce the risk of complications if they do get the infection.

  • I have children and I have a lung condition; what should I do to ensure that I am still safe?

    Both you and your children should practice good handwashing with soap and water for 20 seconds regularly through the day and particularly after your child has come home from school (if applicable) and before meals. Both you and your children should avoid contact with anyone who is sick or who has been in contact with people potentially infected with COVID-19.

  • My child routinely has obstructive bronchitis. Should we keep her in isolation?

    It is difficult to comment without more information. If anyone, including a child, is in a high risk group for COVID-19 they should follow the advice at the top of this Q&A regarding social distancing, hand hygiene and limiting contact with people outside their household. Staying in complete isolation was recommended in many countries early in the pandemic and is called “shielding”. This is difficult to do over a prolonged period of time and so we recommend following local government advice in your country.

Ventilation


  • I am worried about shortages of ventilators. Would you recommend any that I can use at home?

    Ventilation should only be provided by a trained specialist and is not something that you should acquire yourself without specialist supervision.

  • What preventative measures should I take if I use oxygen at home or if I use a nebuliser?

    If you use oxygen at home, this usually indicates that you have quite a severe underlying lung condition and so you should take steps to reduce your risk of getting COVID-19. These include:

    • Avoid contact with anyone who is sick. Ask sick friends or relatives not to visit you and keep a distance of at least 2 metres from anyone sick that you encounter in public.
    • Avoid touching your mouth, nose or eyes with unwashed hands.
    • Wash your hands thoroughly after touching surfaces that may be contaminated. Wash your hands with warm water and soap for 20 seconds.
    • Make sure you take all of your regular medications and keep up with your usual treatments to keep your lungs as healthy as possible.
  • I have obstructive sleep apnoea and use continuous positive airway pressure (CPAP). Is there anything that I should be aware of regarding the impact of COVID-19?

    You should continue to use your treatment as normal. We do not know whether CPAP makes the virus spread more easily within a household. You may wish to distance yourself from vulnerable household members by changing bedrooms.

  • I have several conditions and use CPAP overnight. I’m worried that if I get hospitalized, because of my other conditions, ventilation may be prioritized for someone who is healthier. What should I do?

    Please be reassured that the vast majority of people who get COVID-19 infection do not require ventilation. Most people experience a mild viral illness (similar to a cold) and recover fully. This includes people that have underlying conditions.

    Hospitals in Europe are receiving extra ventilators and additional trained staff to ensure as many patients as possible can receive ventilation if it is required.

    The most important thing you can do is to make every effort to avoid getting the virus. This means following strict social distancing measures. For now, you should reduce contact with people outside your household as much as possible and practice strict hygiene measures in addition to:

    • Avoiding contact with someone who is displaying symptoms of coronavirus (COVID-19). These symptoms include high temperature and/or a new and continuous cough
    • Avoiding non-essential use of public transport when possible
    • Working from home where possible. Your employer should support you to do this.
    • Avoiding large and small gatherings in public spaces, noting that bars, restaurants, leisure centres and similar venues are likely to be shut as infections spread easily in closed spaces where people gather together.
    • Avoiding gatherings with friends and family. Keep in touch using remote technology such as phone, internet, and social media. Use telephone or online services to contact your GP or other essential services.
  • I use non-invasive ventilation (NIV). What should I do if I get infected?

    Most patients with COVID-19 experience only mild symptoms, including fever and coughing. This will not be different for patients using NIV. Depending on the medical reasons for needing NIV you may be more likely to develop severe symptoms, including dyspnea (shortness of breath) or hypoxemia (low levels of oxygen in the blood). Contact your doctor early if symptoms get worse.

    If you are diagnosed with COVID-19 you may be more likely to infect other people while using NIV, especially via any air leak from the device. The high flow generated by the ventilator may distribute virus particles in the area around you. Discuss additional protective measures with you doctor. For example you may wish to distance yourself from vulnerable household members by changing bedrooms if you use NIV overnight, to reduce the risk of spreading infection.

  • I use continuous positive airway pressure (CPAP). What should I do if I get infected?

    Most patients with COVID-19 experience only mild symptoms, including fever and coughing. This will not be different for patients using CPAP.

    We do not know whether CPAP makes the virus spread more easily within a household. You may wish to distance yourself from vulnerable household members by changing bedrooms.

  • I use invasive ventilation. What should I do if I get infected?

    Most patients with COVID-19 experience only mild symptoms, including fever and coughing. This will not be different for patients using invasive mechanical ventilation. Depending on the medical reasons for you needing invasive ventilation, you may be more likely to develop severe symptoms, including dyspnea (shortness of breath) or hypoxemia (low levels of oxygen in the blood). Contact your doctor early if your symptoms get worse.

    If you are diagnosed with COVID-19 you may be more likely to infect other people while using mechanical ventilation, especially via any air leak around a tracheostomy. The high flow generated by the ventilator may distribute virus particles in the area around you. Discuss additional protective measures with you doctor.

  • Could CPAP machines be re-purposed as ventilators and if so is there a donation service I could give to?

    No, your CPAP machine could not be repurposed for use in a hospital. It is important you carry on using your normal treatments during the coronavirus pandemic, including your CPAP.

Medications


Medical Appointments


Specific Respiratory Conditions


Asthma

Bronchiectasis

  • Is there anything specific I should know about COVID-19 and my condition?

    People with bronchiectasis might be at higher risk of complications if they get COVID-19, so here are a few suggestions to reduce your risk of getting the infection and the risk of complications if you do:

    • Avoid contact with anyone who is sick. Ask sick friends or relatives not to visit you and keep a distance of at least 2 metres from anyone sick that you encounter in public.
    • Do not touch your mouth, nose or eyes with unwashed hands unless unavoidable.
    • Wash your hands thoroughly after touching surfaces that may be contaminated. Wash your hands with warm water and soap for 20 seconds.
    • Make sure you take all of your regular medications and keep up with your usual treatments to keep your lungs as healthy as possible.
    • Specifically for bronchiectasis, ensure you do your airway clearance exercises regularly- this clears mucus from the lungs and reduces the risk of a flare-up (exacerbation).
    • If you develop a fever and cough, but feel well, try to increase the frequency of your airway clearance and take paracetamol to reduce fever. If you become more unwell, seek medical advice. If you have a home supply of antibiotics, as many patients with bronchiectasis do, only take this if your sputum (phlegm) increases in amount or becomes discoloured. Antibiotics will not work against a virus, but would treat a bacterial infection.
  • I have bronchiectasis. Should I be self-isolating? And I am I more at risk of severe illness?

    Bronchiectasis is a very diverse condition and ranges from severe to mild, and so it is not possible to give one recommendation that covers everyone. In general, if you have severe bronchiectasis, meaning that you have frequent chest infections or take preventative antibiotics, you should follow the advice in your country for people at high risk. This may include measures such as working from home where you can and avoiding unnecessary contact with people outside your household.

    Patients with mild bronchiectasis, where you have only a mild cough and do not suffer frequent chest infections, may not need to take extra precautions but should still follow all hygiene and public health advice.

    We do not know if bronchiectasis patients are more likely to have complications, but it is better to be careful.

  • Are people with bronchiectasis getting over COVID-19?

    Yes, most people with bronchiectasis who have had COVID-19 have had mild symptoms and have fully recovered. There is a slight increased risk of severe disease with COVID-19 in bronchiectasis.

Cancer

Chronic Obstructive Pulmonary Disease (COPD)

  • I have COPD- how will COVID-19 affect me?

    About 50% of people who contract COVID-19 will experience no symptoms at all. Some people will experience a mild cold with running nose, sore muscles, fever and a cough. Others develop a more “flu-like” illness with worse fever, sore muscles and tiredness. In the most severe cases it causes a pneumonia with breathlessness and coughing in addition to the symptoms above.

    Because COPD patients have lung problems to begin with, they may be more likely to experience breathlessness with COVID-19, and more likely therefore to need hospital treatment. Nevertheless, most people with COPD would experience no symptoms or just mild symptoms and make a full recovery.

  • What are the risks of COVID-19 for people with severe pulmonary emphysema?

    Patients with severe COPD and emphysema are among those considered to be at higher risk of complications from COVID-19. This is because the lungs are affected by COVID-19, and if the lungs are already slightly damaged, they have less ability to fight the virus. A large UK research study found that people with chronic respiratory conditions, the majority of which were COPD, had a 17% increase in the risk of death from COVID-19.

Cystic fibrosis

  • Is there anything that I should not do as someone with cystic fibrosis?

    Please follow guidance from your healthcare professionals and the local response to COVID-19.

    Avoid places where there is likely to be an increased risk of exposure such as crowds – especially in poorly ventilated areas.

    Currently there are no blanket recommendations about school attendance. This will depend on your local circumstances and individual advice from your local CF centre.

    If you are employed, we recommend contacting your employer to consider what reasonable adjustments can be made to your working conditions to help protect you. Your local CF centre may be able to provide advice and support for this.

    The information above was summarised from the Cystic Fibrosis Trust. You can find out more here https://www.cysticfibrosis.org.uk/news/COVID-19-qa

     

Lung transplant

  • I’ve had a lung transplant. Is there any specific advice that applies to me?

    Your transplant team or specialist may already have a plan in place and if so you should follow their advice.

    In general, if you develop symptoms that would be consistent with a viral infection it would be advisable to self-isolate at home and contact your local transplant team for advice. If you are unwell with problems such as difficult breathing you should seek medical attention urgently, as would be the case at any other time.

Pneumonia

Tuberculosis

Alpha-1 Antitrypsin Deficiency

Pneumothorax (collapsed lung)

(Idiopathic) pulmonary fibrosis

  • I have (idiopathic) pulmonary fibrosis. Am I more at risk if I get COVID-19?

    Yes, European research shows that patients with interstitial lung disease have a 60% increase in risk of complications compared to people without interstitial lung disease. Therefore, patients with idiopathic pulmonary fibrosis should make every effort to avoid infection. Even though the risk is increased in patients with IPF, most IPF patients that develop COVID-19 will still have a mild infection and recover fully.

Other Specific Respiratory Conditions

  • I have pleural thickening. Does this put me at a higher risk if I catch COVID-19?

    No, pleural thickening would not affect the risk of catching COVID-19 and would not increase the risk of complications unless it is combined with other heart or lung conditions.

  • I have pleurisy. Am I more vulnerable if I contact COVID-19?

    No, unless the pleurisy is due to another underlying lung condition. The lung conditions that place you at greater risk are those that affect the airways or cause reduced lung function, such as COPD, severe asthma, bronchiectasis, cystic fibrosis, pulmonary fibrosis or lung cancer.

  • I have had part of my lung removed – how will COVID-19 affect me?

    If you are otherwise healthy, there is no reason to think that this would make COVID-19 infection more severe or more likely.

    This information also applies to healthy people with smaller lungs caused for example by scoliosis or kyphosis. It might cause some restriction of your lung volume and your risk would depend on how severe the restriction was, but in general you would not be at significantly increased risk of complications.

  • I have a pulmonary embolism. How will COVID-19 affect me?

    Pulmonary embolism, if it has been treated with blood thinning medication and your oxygen levels are normal, would not be expected to have any effect on your risk of complications with COVID-19.

  • I am over 70, I have been diagnosed with Chronic Thromboembolic Disease and I am on lifelong warfarin. What are the risks and should I remain indoors for 12 weeks?

    The recommendations are different in different countries, but in the UK at the moment (for example) you would not be asked to remain indoors for 12 weeks. You would be asked to socially distance, meaning:

    • Avoid contact with someone who is displaying symptoms of coronavirus (COVID-19). These symptoms include high temperature and/or new and continuous cough
    • Avoid non-essential use of public transport when possible
    • Work from home, where possible
    • Avoid large and small gatherings in public spaces, noting that pubs, restaurants, leisure centres and similar venues may be shut as infections spread easily in closed spaces where people gather together
    • Avoid gatherings with friends and family. Keep in touch using remote technology such as phone, internet, and social media
    • Use telephone or online services to contact your GP or other essential services.

     

    Only those with severe underlying conditions such as immune problems, cancer or severe COPD, asthma and other lung conditions are being asked to stay indoors for 12 weeks. Chronic thromboembolic disease in not one of these conditions.

  • I have a chronic cough; am I at a higher risk if I catch COVID-19?

    No, if you have a chronic cough that is not due to a severe lung condition such as COPD or cystic fibrosis, you would not be considered to be at higher risk.

  • I have had VATS and pleurodesis. Does this put me at a higher risk of severe illness?

    No, VATS and pleurodesis treat the pleura – the lining of the lung. There is no evidence that COVID-19 affects the lining of the lung and so there is no reason to think this would make you more likely to get severe illness.

  • I have low IgM levels - what risks does this pose to myself and my family at this time?

    Low levels of IgM, if they are not associated with low levels of IgG or IgA or another medical condition, would not be expected to greatly increase your risk of severe COVID-19 infection.

  • My mother was diagnosed with oesophageal palsy - how might COVID-19 affect her? Is she at high risk?

    It is hard to comment on individual cases, but this does not sound like a risk factor, in and of itself, for complications of COVID-19.

  • Is a punctured lung a high-risk condition?

    No, not if the punctured lung has repaired itself, or has been repaired through treatment with a chest drain. You would not be at any higher risk of complications than the general population if your lungs are otherwise healthy.

  • I have primary ciliary dyskinesia syndrome (PCD). Am I more at risk if I catch COVID-19?

    Yes, we think that because primary ciliary dyskinesia makes it harder to clear the lungs, it could make COVID-19 more severe. For that reason, in many countries patients with PCD have been advised to stay at home as much as possible and pay extra special attention to hand hygiene, social distancing and avoiding visitors to the house.

  • I have more than 50% tracheal stenosis. Am I more at risk if I catch COVID-19?

    It is very difficult to comment on individual cases. You may be more at risk if this causes you to have frequent chest infections or to have lower lung function than normal. It is important to remember that even if you have a slightly higher risk, most people who catch COVID-19 recover fully.

  • I have had whooping cough (pertussis). Am I more at risk if I catch COVID-19?

    No, not unless you have been left with permanent lung damage such as bronchiectasis as a result.

  • I have cysts in my lungs. Am I more at risk if I catch COVID-19?

    Probably not, unless the cysts in the lungs have caused a lower lung function or lower oxygen level than normal.

  • I have benign metastasizing leiomyomatosis. Am I more at risk if I catch COVID-19?

    This is quite a rare condition and so there will not be specific information about this condition and COVID-19. In general, we think that people are more at risk if they have very low lung function, get breathless easily (such as having to stop after walking 100 metres or less) or have frequent chest infections. If your condition is not causing these kinds of symptoms and signs, you are not likely to be at greatly increased risk.

  • I’ve had aspergillosis; am I at greater risk if I get COVID-19?

    It depends on whether your aspergillosis is still active or not. If it has been successfully treated and you are feeling well you should be at no further risk. If you are very breathless, such as not being able to walk 100 metres without stopping, or have low lung function due to your aspergillosis, you would be at higher risk of complications. If this is the case, you should pay special attention to social distancing measures and may be advised to stay at home as much as possible.

  • I have left pulmonary agenesis; am I at greater risk if I get COVID-19?

    It is difficult to comment without more information but it is quite likely. People with severe lung conditions are at higher risk, for example people who have low lung function and those who get breathless walking short distances such as 100 metres. You should discuss with your doctor whether you should be taking extra measures to protect yourself such as staying at home as much as possible.

  • Does a high IgE level increase my risk of COVID-19?

    No, a high IgE level by itself would not increase your risk of COVID-19 or complications if you get COVID-19. There is no evidence that IgE is involved in COVID-19.

  • I have a tracheostomy; am I at high risk if I catch COVID-19?

    It is hard to say without further information but usually this would be a risk factor for breathing problems and therefore COVID-19 could be more complicated. In general, it is important to remember that most people who catch COVID-19, even if they have underlying conditions, experience just a mild flu like illness and recover fully.

  • Will people who have rhinitis and sinusitis be at risk of more severe COVID-19?

    Probably not – we have not seen this come out as a risk factor in any of the analyses that have been conducted so far and there is not a strong reason to believe that this would be a risk factor either for catching COVID-19 or having a severe condition.

  • Does having neuroendocrine hyperplasia of infancy (NEHI) increase risk of severe COVID-19?

    This condition is too rare for there to be any reports of the risk in this condition. In general, children are at low risk of severe infection and, even if they have underlying conditions, children seem to do very well with a low risk of severe disease.

  • Does having hypersensitivity pneumonitis put me at higher risk if I catch COVID-19?

    In general, patients with interstitial lung diseases such as hypersensitivity pneumonitis are thought to be at higher risk of complications from COVID-19. A European study found people with these types of lung conditions had a 60% increase in risk of complications compared to people without interstitial lung diseases. It is not possible to comment on a specific case but hypersensitivity pneumonitis can vary from mild to very severe and the risk is likely to be highest in those with severe lung disease.

COVID-19 Specific


  • Can people catch COVID-19 more than once?

    Yes, there have been people who have had a confirmed case of COVID-19 and have been re-infected. It is not common and research has shown that having the virus once gives approximately 85% protection over at least 6 months. This is similar to the level of protection provided by vaccines. The fact that reinfection can happen does highlight that it is important to continue to practice safety measures such as hand washing, wearing a face covering and social distancing even if you have had COVID-19.

  • Is there any long-term damage to the lungs after having COVID-19?

    Most people who get COVID-19 recover fully with no lasting effects. A small proportion of people have developed long lasting effects such as lung scarring. This is more likely with very severe infections or people that require ventilation in the intensive care unit. Rehabilitation and support can help patients to get back to a normal life. This will only affect a small percentage of patients who get the infection.

  • I have had COVID-19; I still have chest pains almost two months later. Is this normal?

    Symptoms of COVID-19 can persist for a significant period of time and a majority of people who have been hospitalized will still have some symptoms up to 4 weeks after recovering from the infection. The most common ongoing symptoms are fatigue and breathlessness but there are a wide range of symptoms that have been reported. Recovery is expected between 4 and 12 weeks after COVID-19.

    Some people are getting longer term problems and complications with COVID-19 and this is referred to as post-COVID-19 syndrome or “long COVID-19”. This is diagnosed if the symptoms continue beyond 12 weeks and are not explained by another condition. Estimates of developing this vary between 1 in 20 and 1 in 10 cases of COVID-19 depending on how it is defined.

    Chest pains after 2 months are unusual and should be discussed with your doctor to ensure they are not caused by something else.

  • Why might COVID-19 cause a stabbing pain in the lungs?

    A lot of patients are reporting pain or discomfort in the chest during COVID-19 and it is quite a common symptom; in a recent UK report more than 1 in 10 patients with COVID-19 had chest pain. It is most likely caused by inflammation of the lining of the lung (sometimes called pleurisy) although pains in the muscles of the chest due to coughing are also common.

    It is important you discuss the pain with your doctor because although it is a common symptom of COVID-19 there are other important things that can cause chest pain.

  • Could previously healthy people develop bronchiectasis due to lung damage caused by COVID-19?

    This is possible as severe infections are known to be a cause of bronchiectasis. So far, some studies using CT lung scanning have found around 10% of people with COVID-19 infection have bronchiectasis. This might mean that COVID-19 can cause bronchiectasis, but it is too early to know if the bronchiectasis being found in these studies will be permanent, or if some people had bronchiectasis before they got COVID-19.

  • How close are we to having a treatment?

    Most people will have mild infections and be able to treat themselves at home using similar treatments to those used for the flu, such as paracetamol to bring down a fever. For people who need to go to hospital several treatments have been trialed and the ERS has released guidelines on this which are under constant review. If you go to hospital your doctors will know the best way to look after you under the current guidelines. Two treatments have been shown to cut the risk of death from COVID-19, both of which are anti-inflammatory treatments. There is ongoing research to find the best treatments for COVID-19 and many patients admitted to hospital with COVID-19 will be asked if they would like to participate in research trials.

    We now have vaccines that have been approved and are in use across the world.

  • Is COVID-19 airborne?

    What most people mean when they say airborne is that it can spread through the air. COVID-19 is mostly spread by droplets, meaning small droplets of water containing the virus which are released when infected people cough or sneeze. COVID-19 can therefore be spread through the air when infected people cough or sneeze, and aerosols can be formed by vigorous coughing or certain procedures. The fact it can be spread from person to person through droplets in the airway is why we strongly recommend you stay at least 2 metres away from others at the moment, because this protects you from being affected by droplets. Face coverings also catch any droplets or aerosols that you generate during coughing and helps to protect others, and you, from infection.

  • Is it still the case that for many who catch the virus, it will be little more than a mild flu like illness?

    Yes, the vast majority of people who catch COVID-19 will experience no symptoms at all, or just mild symptoms.

  • What is meant by mild symptoms?

    It can be as little as a fever, cough or a runny nose and a headache for a few days. COVID-19 seems to be quite different for different people, but for the majority of people who have had it, it is mild and passes in a few days.

    Find more information about symptoms on our COVID-19 information page.

  • If I have a common cold or the flu, can I still contract COVID-19 at the same time? If I can't contract COVID-19 when I have a common cold, should I get the cold as a preventative?

    You can get COVID-19 if you have other infections and there are reports of “co-infections”, meaning two infections at the same time. Don’t catch a cold!

  • How do you stop pulmonary fibrosis caused by COVID-19?

    Pulmonary fibrosis after COVID-19 is uncommon but it does happen. Research is needed to find out how to prevent this as we currently do not know the answer to this question. The only definite way to prevent this from happening is to avoid infection in the first place. Several trials are happening across Europe to test treatments that might prevent this from happening.

  • I never get a fever even when I have flu; how will I know if I have COVID-19?

    Fever is a common symptom of COVID-19 but is not the only symptom. Other symptoms are a persistent cough, loss of taste and smell, sore throat, runny nose, tiredness and in severe cases, breathing difficulties. Other viruses and chest conditions can cause these symptoms as well and so you can never be 100% sure they are caused by COVID-19 without a test.

    If you have these symptoms but they are not severe enough to need to go to hospital, you should assume that you have COVID-19 and self-isolate. If testing is available where you are, you should get tested.

  • Would a COVID-19 infection affect lung capacity?

    In most cases the answer is no. There are cases, particularly when patients are admitted to the intensive care unit, where a loss of lung capacity and lung scarring have happened after COVID-19. If you have ongoing symptoms of breathlessness or difficulty exercising, your healthcare professionals may arrange a follow-up to test your lung function. Most people will not require this kind of follow-up.

  • What is the pathophysiology of respiratory failure caused by COVID-19?

    In severe cases COVID-19 causes a condition called pneumonia and in the most severe cases it causes a condition called acute respiratory distress syndrome (ARDS). In both cases the blood vessels supplying the lungs become “leaky” due to too much inflammation and the lungs fill with fluid and cells that can damage the lung. There is also evidence that the blood becomes thicker during COVID-19 causing blood clots to form in the blood vessels supplying the lungs. This problem can be mild in some people, and they will get better with oxygen and time. In severe cases of ARDS a ventilator may be needed to support the lungs until the inflammation settles and the fluid goes away.

  • At what temperature does COVID-19 become dormant? Should I try to breathe in very cold air?

    Unfortunately we don’t think that the temperature of the air is going to have much effect on your risk of catching COVID-19. The disease can spread in very warm countries and in very cold countries. Extreme air temperatures will not prevent you from catching COVID-19 but could cause breathing difficulties.

  • Could having COVID-19 cause a pulmonary embolism?

    Pulmonary embolism has been reported in a high number of patients with COVID-19 including patients admitted to hospital and particularly in patients with severe COVID-19 in the intensive care unit. This is because of the inflammation caused by COVID-19 and because patients in hospital are not able to move around as much as normal. There is no evidence that people with a mild COVID-19 infection at home are at increased risk of a pulmonary embolism.

  • I have IPF (Idiopathic pulmonary fibrosis). Am I at greater risk if I get COVID-19?

    Yes, research shows a 60% increase in the risk of complications for people with pulmonary fibrosis. Patients with IPF are advised to pay special attention to social distancing rules and stay at home as much as possible.

  • Can you catch COVID-19 from breathing in other people's skin particles/dandruff?

    No, the virus is mostly spread via droplets of water from coughs and sneezes. It can also be passed from person to person by touch when these droplets are transferred from one person to another.

  • Could COVID-19 cause a strange sound of air in your chest when you rotate (like your lungs brushing together)?

    This is not something I have seen or heard from patients. I would suggest you discuss this with your doctor.

  • What is the likelihood of having a false-positive or false-negative on a test for COVID-19? What factors might affect this - for example having bronchitis?

    The main test used to diagnose COVID-19 is a swab of the nose, throat or both to detect the virus. This test is very specific – so if your test is positive it means you have the virus or have recently had the virus (false-positives are uncommon). If the test is negative, there is a small chance that this is a false-negative test. UK scientists have estimated that 10% of people who truly have COVID-19 will have a negative test.

    We do not know any factors that are associated with a negative test and there is no evidence that this is influenced by having a lung condition.

  • Does COVID-19 cause bronchospasm (a sudden tightening of some of the smaller muscles in your lungs) or airway narrowing?

    Not usually. The main effect of COVID-19 on the lungs is to cause them to fill with fluid (sometimes called pneumonia or ARDS). This does not cause bronchospasm or airway narrowing as we would see in asthma. Even patients with asthma who get COVID-19 are often not wheezy, suggesting no large element of bronchospasm.

  • Does COVID-19 cause necrosis (death) of the lung tissue?

    This has been reported in studies that have looked at lung tissue under the microscope in COVID-19. This most likely occurs only in the most severe cases, such as those patients admitted to the intensive care unit. It is important to remember that most cases of COVID-19 are mild and either do not involve the lungs extensively or do not result in long term damage to the lungs.

  • Is it safe to exercise while wearing a mask? Will it affect my oxygen levels?

    It is completely safe to exercise with a mask and it will not affect your oxygen levels. Make sure you check the regulations where you live. It is not required in all European countries to wear a mask while exercising outdoors as the risk of transmission of the virus in outdoor settings is very low.

  • I am in a high-risk group and would feel safer if I continued to work from home. I need certification to confirm I am high risk. Is there anything on a European level that would allow this, or would it need to be from my doctor directly?

    This needs to be completed by someone with knowledge of your medical history and so this would usually be your doctor or a doctor working in an occupational health department. You should discuss the situation with your employer.

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