Complications of Severe Asthma

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  • For most people with asthma, medicines can control the disease and prevent serious problems. However, this isn’t always the case for people with severe asthma. Severe asthma generally means asthma that is resistant to treatment. People with severe asthma typically use a high-dose inhaled corticosteroid plus another long-term control medicine. Despite this, their asthma remains difficult to control. Airway inflammation continues and problems can develop. Here is a look at some potential severe asthma complications.

  • 1
    Severe asthma symptoms can disrupt daily life.
    Young boy at home with asthma inhaler while father comforts him

    When people are able to control their asthma, it usually doesn’t interfere with life. However, data from the Centers for Disease Control and Prevention (CDC) show the effect that poorly controlled asthma can have on the daily lives of Americans:

    • Asthma accounts for more than 10 million missed days of school each year.

    • Adults with asthma miss more than 14 million days of work because of their disease.

    • Approximately 60% of people with asthma report their disease limits their daily activities and physical activities. 

  • 2
    Severe asthma can disrupt sleep.
    Woman looking fatigued in rearview mirror of car while drowsy driving

    Doctors use various measures to classify the severity of asthma. One of these measures is nighttime wakening due to asthma symptoms. In adults and older children, asthma is mild when this happens no more than four times a month. With severe asthma, asthma symptoms can cause awakenings often, even on a nightly basis. For children under five years of age, severe asthma means they awaken more than once a week with asthma symptoms. Disrupted sleep can lead to other problems, including lack of concentration, drowsy driving, and behavior problems.

  • 3
    Severe asthma can lead to emergency room visits and hospitalizations.
    Older man in hospital with oxygen mask

    Everyone with asthma needs regular medical care to manage the disease. For most asthma sufferers, this regular care keeps them healthy and out of the hospital. This isn’t always the case for people with severe asthma. When severe asthma symptoms occur, emergency medical care if often necessary to regain control of the disease. The latest data from the CDC reveals that people with asthma accounted for 1.7 million emergency room visits in a year. They also had over 400,000 hospitalization visits.

  • 4
    Severe asthma can cause airway remodeling.
    Doctors looking at lung and chest x-ray

    The chronic airway inflammation that happens with severe asthma can eventually lead to airway remodeling. Broadly, airway remodeling is a process that changes the structure of the airways. It leads to bronchial wall thickening, narrowing of the air passages, and other physical changes that can be permanent. This remodeling makes it more difficult to breathe. When inhaled corticosteroids are able to control asthma, there is a positive effect on airway remodeling. Researchers continue to study airway remodeling. They are hoping to find out what factors are most closely linked to airway remodeling and what to do about it.

  • 5
    Severe asthma can lead to respiratory failure and even death.
    Young woman using asthma nebulizer on couch

    A severe asthma attack is a serious event. It can quickly turn into a life-threatening situation. In 2016, more than 3,500 people died from asthma. People with asthma should seek emergency medical care for any of the following:

    • Severe shortness of breath or wheezing, which can make it difficult to speak and cause the chest muscles to strain with each breath

    • Peak flow readings below 50% of a person’s best peak flow

    • No improvement in symptoms 15 minutes after using a rescue inhaler

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Aug 31
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