Caring for children with asthma during COVID-19: Answering parents FAQs

Dr. Irene Papaconstadopoulos, MD FAAP

Is my child at higher risk for getting sick from COVID19 if she is diagnosed with asthma?

There is still a lot we don't know about COVID-19. People with chronic health conditions appear to have a higher risk of more severe illness if they get COVID-19. Having your child’s asthma under control is especially important now. We want to prevent children from needing emergency department care when possible. But, if your child is having an asthma attack, don't delay seeking immediate medical care.

How do I know if my child's asthma is well-controlled?

Having uncontrolled asthma is an important risk factor for an asthma attack.

Symptoms of poorly controlled asthma may be:

  • Daytime coughing and/or wheezing for more than 2 days a week

  • Nighttime waking due to coughing or wheezing

  • Rescue inhaler needed more than 2 times a week

  • Limitation of physical activity due to asthma symptoms

Asthma guidelines have been updated!

For safety, GINA no longer recommends the treatment of asthma in adolescents and adults with SABA (Short-acting beta-agonists - like albuterol) ONLY. Instead, to reduce their risk of serious exacerbations, all adults and adolescents with asthma should receive IN ADDITION to albuterol, either symptom-driven (in mild asthma) or daily inhaled corticosteroid (ICS)-containing treatment. Talk with your pediatrician if you have to update your written asthma action plan. 

With COVID-19, what is the best form of asthma medication to give: an inhaler or nebulizer treatment?

It may be safer to use an inhaler with a spacer.  Using a nebulizer, which turns liquid medicine into a mist, for albuterol treatments, may increase the amount of virus in the air if the person has COVID-19. This could spread the virus to others more easily, since the virus may stay in air droplets for up to several hours. Inhalers are an appropriate alternative especially for moderate asthma managed at home. Children should be trained to use inhalers always with a spacer. Used properly, either method is equally effective. It's important for people with asthma to talk with their health care providers about what delivery method is best for them.


How can I help prevent my child from having an asthma attack during the pandemic?

Every child with asthma should have a written asthma action plan from their Pediatrician. Help your child follow their plan and take their controller medications if prescribed. Know when to step up care and when to call your pediatrician according to your written asthma action plan. During your well check-up, your doctor will discuss this plan, and depending on your child’s age may request a Pulmonary function test. 

Especially during these stressful times, preparation beats panic. 

Currently in the office we are not conducting pulmonary function tests due to the risk of COVID19 exposure. We will post updates once this changes, as we plan to offer this service 


GINA 2019: a fundamental change in asthma management

Helen K. Reddel, J. Mark FitzGerald, Eric D. Bateman, Leonard B. Bacharier, Allan Becker, Guy Brusselle, Roland Buhl, Alvaro A. Cruz, Louise Fleming, Hiromasa Inoue, Fanny Wai-san Ko, Jerry A. Krishnan, Mark L. Levy, Jiangtao Lin, Søren E. Pedersen, Aziz Sheikh, Arzu Yorgancioglu, Louis-Philippe Boulet

European Respiratory Journal 2019 53: 1901046; DOI: 10.1183/13993003.01046-2019

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Happy Parents

    "I was so impressed with Dr. Irene Papaconstadopolous. Everything is at her practice is streamlined and organized. Paperwork all sent beforehand in an easy to use digital format. Communication was clear and office easy to access. Went for our 18 month old’s check up and it was the most time I have ever been able to spend with a doctor! She even administered the vaccines. She was thorough, friendly, and creative in approach to making my toddler comfortable and engaged. So happy to have a competent, friendly, organized, and WONDERFUL pediatrician on Maui. Such a blessing. Mahalo!"

    Nicole B. Google reviews March, 2022

    Dr. Irene is the kind of doctor United States badly need more of. I took my child to see her for a hard to troubleshoot chronic issue, and I was very surprised that instead of typical in the US approach of prescribing a medicine to treat the symptom and get you out of the door, she took the time to understand medical history, went over each possibility what could have been causing the issue, and proposed a few possible follow-ups how to zero in to the root cause. Her advice was very helpful and produced positive results. I highly recommend Dr. Irene Papaconstadopoulos.

    S.D via google reviews

    "I can’t express how grateful I am, as a mother of two young children, to have found such a wonderful pediatrician. Dr. Irene is knowledgeable, accessible, and above all, great with kids! Even though my girls have had to be poked and prodded on occasion, they still love Dr. Irene so much that they get excited to see her again - and that’s saying a lot. If you are looking for a pediatrician who you can trust with your children’s health, who can answer your questions, who gets back to you quickly, and who herself is an amazing mother, then you’ve found her! I’m so glad we have. ❤️"

    K.F. 2020 via Google reviews

    We love Dr. Irene with CHAMPS Pediatrics! My two daughters have been seeing her since 2018 and we trust her completely. She's extremely warm, understanding and takes her time to explain and answer any questions that you may have as parents. She is extremely fast with the text replies through the online portal (klara) as well, which is great for those forgotten questions in between visits. Dr. Irene is super sweet and efficient and truly cares about your experience and the welfare of your children. HIGHLY recommended!

    J.P 2020 via Google reviews

    "Dr. Irene is the most caring, gentle, genuine Pediatrician. She is so kind and loving with my boys. She makes them feel so comfortable and they are even excited when we have an appt! She was so quick to respond on the Klara App to communicate with me even during a holiday weekend and answer my questions about my son. She takes time to go over everything and answer all my questions and concerns, every time we've met with her. I've never felt rushed. I highly recommend her! She's been so great caring for my family. I feel so blessed to have been referred to her!! Thank you Dr. Irene, for caring for my kids!"

    Tammy M. via Yelp

    "Dr. Irene is amazing! She really listens to you and your concerns, and takes the time to address them. She is so gentle and kind with my kids! She has definitely exceeded our expectations! I’m positive that my kids are having the best care on island. We love her and we are so happy that she joined our Maui community!"  via Google reviews

    Sueshine R.

    "Dr. Irene is amazing. She is caring, gentle, truly listens and graciously worked with us and our children to provide the best medical care. Highly recommend!!!"