Bronchial Asthma: Complications

The following are the most important diseases or complications that may be contributed to by bronchial asthma:

Respiratory system (J00-J99)

  • Bronchiectasis (synonym: bronchiectasis)-permanent irreversible saccular or cylindrical dilatation of the bronchi (medium-sized airways) that may be congenital or acquired; symptoms: chronic cough with “mouthful expectoration” (large-volume triple-layered sputum: foam, mucus, and pus), fatigue, weight loss, and decreased exercise capacity
  • Chronic bronchitis – chronic inflammation of the bronchi.
  • Chronic obstruction – chronic narrowing of the airways.
  • Chronic obstructive pulmonary disease (COPD)
  • Cor pulmonale with pulmonary hypertension (lung-related increase in pressure of the right heart with pulmonary vascular hypertension.
  • Exacerbation (seizure-like exacerbation of asthma) with possible development of status asthmaticus and/or respiratory insufficiency (respiratory failure)).
  • Pulmonary emphysema – pathological hyperinflation of the lungs.
  • Pneumonia (lung inflammation; 2.4-fold increased risk compared with controls without atopic disease, whether they were smokers or nonsmokers)
  • Pneumothorax – collapse of the lung caused by an accumulation of air between the visceral pleura (lung pleura) and the parietal pleura (chest pleura)

Cardiovascular system (I00-I99).

  • Apoplexy (stroke)
  • Heart failure (weakness)
  • Myocardial infarction (heart attack)
  • Arrhythmias – atrial fibrillation (VHF) (38% increased risk); active asthma (76% increased risk); controlled asthma (61% increased risk); uncontrolled asthma (93% increased risk).

Musculoskeletal system and connective tissue (M00-M99).

Psyche – nervous system (F00-F99; G00-G99).

  • Dementia – in asthma in middle and old age.
  • Insomnia (sleep disorders)
  • Alzheimer’s disease – in asthma in middle and old age.
  • Obstructive sleep apnea (OSA) – characterized by obstruction (narrowing) or complete closure of the upper airway during sleep; most common form of sleep apnea (cessation of breathing during sleep).

Pregnancy, childbirth, and puerperium (O00-O99).

* Effects of asthma exacerbation (worsening of disease) during pregnancy; furthermore, children born during pregnancy to women with UE had an increased risk of asthma (OR 1.23; 95% CI 1.13, 1.33) and pneumonia (pneumonia) (OR 1.12; 95% CI 1.03, 1.22) in the first 5 years of life 11].

Prognostic factors

  • Age:
    • Patients aged 30 years or older were significantly more likely to experience treatment failure than younger patients (17.3% versus 10.3% or 64/621 versus 100/579 patients). The likelihood of this was increased by 82% (odds ratio [OR]: 1.82; 95% confidence interval between 1.30 and 2.54; p < 0.001).Each additional five years of age increased the likelihood of no longer responding to asthma treatment by 13%.
    • In patients who developed bronchial asthma after the age of 18. Age of bronchial asthma was found to be about 60% Compared to non-asthmatics, the risk of cardiac and vascular complications/heart and vascular complications (apoplexy (stroke), angina pectoris (“chest tightness”; sudden pain in the area of the heart), myocardial infarction (heart attack), coronary revascularization, heart failure (cardiac insufficiency), or death from cardiovascular causes).
  • Diet: consumption of ham, sausage or salami was associated with worsening of symptoms in asthma patients. The reason for this is almost certainly the nitrate content of the permanent sausage products. Nitrite salts are converted in the body into nitrogen oxides (NOx), which in low concentrations have a relaxing effect on blood vessels and smooth muscle. This in itself would be rather beneficial for asthma patients.At the same time, however, reactive nitrogen species (RNS) are formed, which promote inflammatory reactions in the body and thus also in the respiratory tract. This explains why a long-term intake of high concentrations of nitrate salts can lead to worsening of asthma symptoms.
  • Air pollution (particulate matter, ozone): approximately 3-fold increased risk of developing asthma-COPD overlap syndrome (ACOS).
  • Risk factors for persistence (persistence) of asthma problems in children and adolescents into adulthood:
    • Family history of allergy
    • Female gender
    • Allergic sensitization before the age of 2 years
    • Severe of asthma and lung function impairment at school age.
    • Proven marked bronchial hyperresponsiveness.
  • Risk factors for asthma-related death:
    • History of a near-fatal asthma attack (i.e., acute asthma with respiratory failure or arterial partial pressure of carbon dioxide >50 mmHg) that required intubation and mechanical ventilation, hospitalization, or emergency care in the past year
    • Current use or recently discontinued use of oral corticosteroids (markers of disease severity)
    • No current use or discontinuation of inhaled corticosteroids.
    • A history of psychiatric illness or psychosocial problems.
    • Poor treatment compliance for asthma medication or poor adherence to or lack of an asthma action plan
    • Food allergies
    • Mold allergies (>50% of patients who required intensive care for their asthma attack showed positive skin tests for fungi)
    • Too many short-acting bronchodilators.