The Impact of Covid-19 on Obstructive Pulmonary Diseases: A Narrative Review of Long-Term Consequences and Vaccination Strategies Publisher



Dalfardi B ; Abtahi H ; Edalatifard M ; Mozaffari S ; Rahimi B ; Roostaei G ; Khoshnam Rad N
Source: Health Science Reports Published:2026

Abstract

Background and Aims: The COVID-19 pandemic has posed significant challenges for individuals with obstructive pulmonary diseases (OPDs), such as asthma and chronic obstructive pulmonary disease (COPD). Emerging evidence highlights the complex interplay between SARS-CoV-2 infection and OPDs, including increased risks of severe disease, long-term sequelae, and potential new-onset respiratory conditions. This narrative review synthesizes current knowledge on the pathophysiological mechanisms, clinical outcomes, and management strategies for COVID-19 in OPD patients, with a focus on long-term consequences and vaccination efficacy. Methods: A comprehensive literature search was conducted using PubMed, Embase, and Scopus (January 2020–June 2025). Inclusion criteria encompassed original studies, reviews, and meta-analyses examining COVID-19's impact on asthma or COPD, while non-English publications, animal studies, and case reports were excluded. Data were extracted and thematically synthesized to address acute outcomes, long COVID, vaccination, and therapeutic considerations. Results: Risk and Severity: COPD patients faced higher risks of severe COVID-19 (hospitalization, ICU admission, and mortality), while asthma phenotypes influenced outcomes (eosinophilic asthma conferred milder disease). Long COVID: Persistent respiratory symptoms (dyspnea and cough), fatigue, and cognitive dysfunction were prevalent in OPD patients, with new-onset asthma reported post-infection. Vaccination: mRNA vaccines significantly reduced severe outcomes in OPDs, though biologic therapies in asthma may attenuate immune responses. Treatment: Antivirals (e.g., nirmatrelvir–ritonavir) and corticosteroids were effective, but drug interactions (e.g., CYP3A4 inhibitors) required careful management. Conclusion: COVID-19 exacerbates OPD-related morbidity, underscoring the need for tailored prevention (vaccination and early diagnosis) and multidisciplinary management. Future research should prioritize phenotype-specific therapeutic strategies and long-term surveillance to mitigate post-COVID sequelae in this vulnerable population. © 2026 The Author(s). Health Science Reports published by Wiley Periodicals LLC.