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  1. Article: Using Social Marketing to Promote COVID-19 Vaccination Uptake: A Case Study from the "AUBe Vaccinated" Campaign.

    Bardus, Marco / Assaf, Sara A / Sakr, Carine J

    Vaccines

    2023  Volume 11, Issue 2

    Abstract: The availability of and access to COVID-19 vaccines has been challenging in many low- and middle-income countries (LMICs), coupled with mistrust in public health organizations instigated by misinformation and disinformation diffused by traditional and ... ...

    Abstract The availability of and access to COVID-19 vaccines has been challenging in many low- and middle-income countries (LMICs), coupled with mistrust in public health organizations instigated by misinformation and disinformation diffused by traditional and social media. In the Spring of 2021, the American University of Beirut (AUB) in Lebanon spearheaded a nationwide vaccination drive with the ambitious goal of vaccinating its entire community by the beginning of the academic year 2021-2022, as the campus was due to be opened only to vaccinated individuals. This case study outlines the development, implementation, and evaluation of a social marketing campaign to encourage COVID-19 vaccinations among members of the AUB community, comprising students, faculty, staff, and dependents. Following French and Evans' 2020 guidelines, we implemented an evidence-based and co-designed strategy to maximize the availability and facilitate vaccine access. The campaign used a mix of methods to convince the segments of the population to receive their shots before accessing campus, resulting in a 98% uptake among the community segments within three months (July-September 2021). In this case study, we reflect on the experience and share suggestions for future research and applications that other higher education institutions could use to address similar problems.
    Language English
    Publishing date 2023-02-16
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2703319-3
    ISSN 2076-393X
    ISSN 2076-393X
    DOI 10.3390/vaccines11020459
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Prevalence and Characteristics of Health and Wellness Programs for Arab Hospitals' Employees: A Cross-Sectional Study.

    Romani, Maya / Ahmed, Mohamed A / Salman, Doaa O / Hamadeh, Ghassan / Assaf, Sara A / Sakr, Carine J

    Risk management and healthcare policy

    2023  Volume 16, Page(s) 623–634

    Abstract: Background: Compared to the general workforce, hospital staff has a greater incidence of chronic diseases and mental health illnesses. Wellness programs have been shown to improve the health and well-being of hospital employees by reducing risk factors ... ...

    Abstract Background: Compared to the general workforce, hospital staff has a greater incidence of chronic diseases and mental health illnesses. Wellness programs have been shown to improve the health and well-being of hospital employees by reducing risk factors and promoting healthy behaviors. In the Arab World, there are no available studies on the number, nature, or impact of wellness services provided to healthcare workers.
    Objective: The study aims to assess the prevalence, characteristics, and components of health and wellness programs targeting hospital employees in Arab countries. It also aims to test the association of hospitals' characteristics and the challenges faced by these hospitals with the availability of such programs.
    Methods: A cross-sectional study was conducted through an online questionnaire in English and Arabic emailed to directors of Arab hospitals registered in the Arab Hospital Federation.
    Results: Only 39.5% of the hospitals in the Arab region have an established wellness program. No significant association was found between hospital characteristics and the availability of these wellness programs. The most provided services for hospital staff are Flu vaccine (90.7%), pre-employment medical exam (79.1%), healthy food options (65.1%), and health risk assessment (60.5%), while the least common provided services are mental health (20.9%) and stress management (23.3%). The most common challenges facing wellness services (scale: 0-10) are financial restriction (5.95), creating a culture of health (5.88), and motivating employees (5.56). Only 4.7% of hospitals provide incentives to participate in their wellness programs.
    Conclusion: In general, Arab hospitals lack a wellness culture, and more investment is needed in essential wellness services such as mental health, weight reduction, stress management, and smoking cessation.
    Language English
    Publishing date 2023-04-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 2495128-6
    ISSN 1179-1594
    ISSN 1179-1594
    DOI 10.2147/RMHP.S391603
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Asthma in the era of COVID-19.

    Assaf, Sara / Stenberg, Henning / Jesenak, Milos / Tarasevych, Svitlana P / Hanania, Nicola A / Diamant, Zuzana

    Respiratory medicine

    2023  Volume 218, Page(s) 107373

    Abstract: Since its global invasion in 2019, COVID-19 has affected several aspects of patients' lives and posed a significant impact on the health care system. Several patient populations were identified to be at high risk of contracting SARS-CoV-2 infection and/ ... ...

    Abstract Since its global invasion in 2019, COVID-19 has affected several aspects of patients' lives and posed a significant impact on the health care system. Several patient populations were identified to be at high risk of contracting SARS-CoV-2 infection and/or developing severe COVID-19-related sequelae. Conversely, anyone who has contracted SARS-CoV-2 is at risk to experience symptoms and signs consistent with post-COVID manifestations. Patients with asthma were initially thought to be at increased risk and severity for SARS-CoV-2 infection. However, accumulating evidence demonstrates that asthma endotypes/phenotypes and comorbidities influence the risk stratification in this population. Furthermore, initial concerns about the potentially increased risk of poor outcomes with asthma treatments such as inhaled corticosteroids and biologics have not been substantiated. In this review, we provide an update on COVID-19 and asthma, including risk of susceptibility, clinical manifestations and course in this population as well as discuss recommendations for management.
    MeSH term(s) Humans ; COVID-19/epidemiology ; COVID-19/complications ; SARS-CoV-2 ; Asthma/diagnosis ; Comorbidity ; Adrenal Cortex Hormones/therapeutic use
    Chemical Substances Adrenal Cortex Hormones
    Language English
    Publishing date 2023-08-10
    Publishing country England
    Document type Review ; Journal Article
    ZDB-ID 1003348-8
    ISSN 1532-3064 ; 0954-6111
    ISSN (online) 1532-3064
    ISSN 0954-6111
    DOI 10.1016/j.rmed.2023.107373
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Biological treatments for severe asthma.

    Assaf, Sara M / Hanania, Nicola A

    Current opinion in allergy and clinical immunology

    2019  Volume 19, Issue 4, Page(s) 379–386

    Abstract: Purpose of review: Asthma is a heterogenous disease associated with different phenotypes and endotypes. The unmet needs with severe asthma have led to the emergence of potential therapeutic targets beyond the existing therapies. Recently, several ... ...

    Abstract Purpose of review: Asthma is a heterogenous disease associated with different phenotypes and endotypes. The unmet needs with severe asthma have led to the emergence of potential therapeutic targets beyond the existing therapies. Recently, several biologics were examined and some have now been approved to target T2 airway inflammation in patients with severe disease. We provide an overview of recently approved biologic, those which are emerging and highlight unmet needs in this area.
    Recent findings: Multiple biologics targeting T2 high asthma are now available for clinical use in the appropriate groups of severe asthma. These target overlapping phenotypes, which include allergic and eosinophilic asthma. Available biologics were shown to improve outcomes that include the reduction of exacerbations and improvement of lung function. Some have also demonstrated improvement in patient-reported outcomes. Some of these biologics have also demonstrated beneficial effects on associated asthma comorbidities. Biomarkers help predict response to certain biologics, although only few currently exist. Emerging biologics blocking other pathways of airway inflammation are under development. Several small molecule antagonists and inhibitors are also in development. Biologics and therapies targeting T2 low or non-T2 asthma are needed.
    Summary: Recently approved biologic therapies improve asthma outcomes in subset of patients. Future research to uncover better predictors of response can improve the precise approach to therapy of patients with severe disease.
    MeSH term(s) Animals ; Anti-Asthmatic Agents/therapeutic use ; Asthma/drug therapy ; Biological Products/therapeutic use ; Biomarkers, Pharmacological ; Eosinophilia/drug therapy ; Humans ; Hypersensitivity/drug therapy ; Lung/physiology ; Phenotype ; Pneumonia/drug therapy ; Recovery of Function
    Chemical Substances Anti-Asthmatic Agents ; Biological Products ; Biomarkers, Pharmacological
    Language English
    Publishing date 2019-06-06
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2088710-3
    ISSN 1473-6322 ; 1528-4050
    ISSN (online) 1473-6322
    ISSN 1528-4050
    DOI 10.1097/ACI.0000000000000549
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: First trend analysis of antifungals consumption in Lebanon using the World Health Organization collaborating center for drug statistics methodology.

    Rahme, Deema / Ayoub, Mayssam / Shaito, Khalil / Saleh, Nadine / Assaf, Sara / Lahoud, Nathalie

    BMC infectious diseases

    2022  Volume 22, Issue 1, Page(s) 882

    Abstract: Background: Antimicrobial resistance has reached an alarming rate globally, especially in middle-income countries such as Lebanon. The development of antifungal resistance is associated with the increased population's injudicious consumption. This study ...

    Abstract Background: Antimicrobial resistance has reached an alarming rate globally, especially in middle-income countries such as Lebanon. The development of antifungal resistance is associated with the increased population's injudicious consumption. This study aims to measure antifungals consumption in Lebanon as a trend analysis of national data from 2004 to 2018.
    Methods: This is a trend analysis of the consumption of antifungal agents in the Lebanese community. Data were obtained from the Intercontinental Marketing Statistics Database between 2004 and 2018. It measures the total consumptions per year, per drug, and the percentage of its correspondents for three routes of administration (oral, parenteral, and topical). Results were reported by Defined Daily Dose (DDD) per 1000 inhabitants per day and the total number of DDDs.
    Results: Community consumption of antifungals in Lebanon has increased by approximately 18.64% between 2004 and 2018, as measured by the number of DDDs per 1000 inhabitants per day; and amplified by approximately 87.76% as measured by the number of DDDs. The highest consumption level was noted in 2017, with 1.52 DDDs/1000 inhabitants/day and 3,386,930 DDDs. Fluconazole was the most consumed antifungal while micafungin was the least with 6,723,869.2 (20.99%) and 48.5 (0.0002%) DDDs respectively. Topical antifungals ranked the first type consumed followed by oral and parenteral antifungals representing 51.72%, 48.24%, and 0.033% of the total consumption respectively.
    Conclusion: The findings from this study indicate a marked increase in antifungal consumption in the Lebanese community. This accelerates the need of implementing disease management guidelines and national antifungal stewardship. Moreover, these findings may be used in further benchmark utilization and antimicrobial resistance studies in Lebanon.
    MeSH term(s) Humans ; Antifungal Agents/therapeutic use ; Pharmaceutical Preparations ; Lebanon ; Micafungin ; World Health Organization
    Chemical Substances Antifungal Agents ; Pharmaceutical Preparations ; Micafungin (R10H71BSWG)
    Language English
    Publishing date 2022-11-24
    Publishing country England
    Document type Journal Article
    ZDB-ID 2041550-3
    ISSN 1471-2334 ; 1471-2334
    ISSN (online) 1471-2334
    ISSN 1471-2334
    DOI 10.1186/s12879-022-07883-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Risk Factors for SARS-CoV-2 Among a Cohort of Healthcare Workers in Lebanon.

    Sakr, Carine J / Abou Hassan, Farouk F / Fakih, Lina / Bou Hamdan, Mirna / Assaf, Sara / Rahme, Diana / Melhem, Nada M

    Workplace health & safety

    2023  Volume 72, Issue 2, Page(s) 48–59

    Abstract: Background: Healthcare workers (HCWs) faced substantial risk of infection during the COVID-19 outbreak. This study aims to determine the prevalence of anti-SARS-CoV-2 antibodies in a cross-sectional sample of HCWs as well as risk factors associated with ...

    Abstract Background: Healthcare workers (HCWs) faced substantial risk of infection during the COVID-19 outbreak. This study aims to determine the prevalence of anti-SARS-CoV-2 antibodies in a cross-sectional sample of HCWs as well as risk factors associated with exposure to SARS-CoV-2.
    Methods: The study was conducted between March and May 2021 at the American University of Beirut Medical Center (AUBMC), a tertiary hospital located in Lebanon. Socio-demographic and clinical data, as well as data on exposure, PCR results, PPE adherence, and vaccination status, were collected using an online questionnaire. Sera were also collected to determine seropositivity using commercially available enzyme-linked immunoassay (ELISA) targeting the spike (S) and the nucleocapsid proteins (NCP) of SARS-CoV-2.
    Findings: Among 92 recruited HCWs, 72.3% received PPE training, more than 70% were adherent to using appropriate PPEs, and around 80% were vaccinated. Nurses in this study population were at higher risk of exposure compared to medical doctors, technicians, and other HCWs. Among the HCWs who performed a PCR test, 28.6% were infected with SARs-CoV-2 with workplace exposure not associated with COVID-19 infection. All vaccinated HCWs were seropositive for anti-S IgG with high titer (≥384 BAU/mL), with a significantly higher median anti-S IgG titer compared to unvaccinated HCWs with previous infection (384 vs. 140.1 BAU/mL;
    Conclusions: Our study highlights the importance of implementing strict infection control policies among HCWs and deploying an effective COVID-19 vaccination strategy. More studies are needed in Lebanon to assess risk factors of SARS-CoV-2 exposure in the workplace.
    MeSH term(s) Humans ; SARS-CoV-2 ; Lebanon ; COVID-19 ; COVID-19 Vaccines ; Cross-Sectional Studies ; Health Personnel ; Risk Factors ; Immunoglobulin G
    Chemical Substances COVID-19 Vaccines ; Immunoglobulin G
    Language English
    Publishing date 2023-12-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2649181-3
    ISSN 2165-0969 ; 2165-0799
    ISSN (online) 2165-0969
    ISSN 2165-0799
    DOI 10.1177/21650799231214234
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Hospitals' Collaborations Strengthen Pandemic Preparedness: Lessons Learnt from COVID-19.

    Sakr, Carine J / Assaf, Sara A / Fakih, Lina / Dakroub, Saada / Rahme, Diana / Musharrafieh, Umayya / Khater, Beatrice / Naous, Jihane / Romani, Maya / Tannous, Joseph / Zahreddine, Nada / Fakhreddine, Mohammad / Itani, Mira / Zalaquett, Nader / Honein, Gladys

    Healthcare (Basel, Switzerland)

    2024  Volume 12, Issue 3

    Abstract: Background: The COVID-19 pandemic strained healthcare systems around the world. This study aims to understand the preparedness of private remote hospitals in Lebanon to respond to the pandemic and evaluate the impact of inter-hospital collaborations on ... ...

    Abstract Background: The COVID-19 pandemic strained healthcare systems around the world. This study aims to understand the preparedness of private remote hospitals in Lebanon to respond to the pandemic and evaluate the impact of inter-hospital collaborations on the hospitals' readiness.
    Methods: A multi-centered study was conducted between August 2020 and June 2021 in ten Lebanese private remote hospitals based on a mixed-methods embedded approach where the quantitative supported the qualitative. Through the AUB-USAID (American University of Beirut-United States Agency for International Development) COVID-19 project, these hospitals received personal protective equipment and medical equipment in addition to COVID-19-related training using the Train-the-Trainer model. The quantitative part used knowledge and evaluation questionnaires and a pre-post-intervention hospital preparedness checklist. The qualitative approach adopted semi-structured interviews with a purposive sample from key hospital personnel. Quantitative data were analyzed using SPSS version 27, and a
    Results: Of the 393 healthcare workers who attended the training and completed the evaluation questionnaire, 326 completed the pre- and post-training knowledge questionnaire. A significant improvement was observed in mean knowledge scores following training for infection control, nursing, and polymerase chain reaction sampling staff (
    Conclusions: A timely and proactive collaborative program between academic/tertiary care centers and remote community hospitals that includes sharing supplies and expertise is feasible and highly effective during public health emergencies.
    Language English
    Publishing date 2024-01-26
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2721009-1
    ISSN 2227-9032
    ISSN 2227-9032
    DOI 10.3390/healthcare12030321
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Asthma and severe acute respiratory syndrome coronavirus 2019: current evidence and knowledge gaps.

    Assaf, Sara M / Tarasevych, Svitlana P / Diamant, Zuzana / Hanania, Nicola A

    Current opinion in pulmonary medicine

    2020  Volume 27, Issue 1, Page(s) 45–53

    Abstract: Purpose of review: Although respiratory viruses are common triggers of asthma exacerbation, it is unknown whether this also applies to infection with SARS-CoV-2. Indeed, patients with asthma and allergy appear underrepresented in large reports of COVID- ... ...

    Abstract Purpose of review: Although respiratory viruses are common triggers of asthma exacerbation, it is unknown whether this also applies to infection with SARS-CoV-2. Indeed, patients with asthma and allergy appear underrepresented in large reports of COVID-19 cases worldwide. In this review, we evaluate existing literature on this topic and potential underlying mechanisms for any interrelationship between asthma and COVID-19.
    Recent findings: Data from several preclinical and clinical reports suggest a lower susceptibility for COVID-19 in patients with underlying type 2 airway inflammation including asthma that may be related to a reduced expression of ACE2 and TMPRSS2 receptors for SARS-CoV-2. Corticosteroids further decrease expression of the ACE2 and TMPRSS2 receptors, hence may also have a protective effect against infection with SARS-CoV-2. In addition, some studies suggest that the reported improvement in asthma control and a reduction in asthma exacerbations during the COVID-19 pandemic may be related to improvement in adherence to controller therapy and reduced exposure to triggers, such as other respiratory viruses and air pollutants. Recent data point towards differential susceptibility for COVID-19 among asthma patients based on their phenotype and/or endotype. On the basis of existing evidence, continuation with controller therapies is recommended for all patients with asthma. For patients with severe uncontrolled asthma infected by SARS-CoV-2, adjustment of controllers and biologics should be based on a multidisciplinary decision.
    Summary: Underrepresentation of SARS-CoV-2-infected patients with asthma and related allergic diseases may be based on potentially protective underlying mechanisms, such as type 2 airway inflammation, downregulation of ACE2/TMPRSS2 receptors, reduced exposures to triggers and improved adherence to controller medications. Although it is imperative that control should be maintained and asthma medications be continued in all patients, management of patients with severe uncontrolled asthma infected by SARS-CoV-2 including adjustment of controllers and biologics should be discussed on an individual basis.
    MeSH term(s) Anti-Asthmatic Agents/therapeutic use ; Asthma/drug therapy ; Asthma/immunology ; Asthma/physiopathology ; Asthma/virology ; COVID-19/complications ; COVID-19/immunology ; COVID-19/physiopathology ; COVID-19/prevention & control ; Disease Progression ; Humans ; Protective Factors ; Risk Factors
    Chemical Substances Anti-Asthmatic Agents
    Keywords covid19
    Language English
    Publishing date 2020-07-06
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1285505-4
    ISSN 1531-6971 ; 1070-5287 ; 1078-1641
    ISSN (online) 1531-6971
    ISSN 1070-5287 ; 1078-1641
    DOI 10.1097/MCP.0000000000000744
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Gender differences in pulmonology and critical care authorship and editorial boards.

    Nasrullah, Adeel / Sharma, Alisha / Hamza, Amina / Ramanujam, Deeksha / Shah, Sana / Virk, Shiza / Shah, Aaisha / Javed, Anam / Garg, Ishan / Saa, Lisa / Verma, Akanksha / Faturous, Andrew / Assaf, Sara / DiSilvio, Briana / Sheikh, Abu Baker

    Current medical research and opinion

    2023  Volume 39, Issue 3, Page(s) 375–381

    Abstract: Objective: This study aims to characterize the gender distribution of first authors, senior authors, and editorial board members across several high-impact factor journals in PCCM.: Methods: In this cross-sectional study, we analysed gender ... ...

    Abstract Objective: This study aims to characterize the gender distribution of first authors, senior authors, and editorial board members across several high-impact factor journals in PCCM.
    Methods: In this cross-sectional study, we analysed gender disparities in critical care authorship and editorial boards, based on publications from 1 January 2019 to 31 December 2021 from the top 20 high impact journals based on the Journal of Citation Reports.
    Results: Among 20 journals (median impact factor of 6.66), 25% of editors-in-chief and 28.8% of editorial board members were female. From 2019 to 2021, a total of 23,994 articles were published. Female first authors and last authors made up 29.1% and 21.2% of the authorship, respectively (
    Conclusions: Our study demonstrates significant gender disparities in critical care authorship and editorial boards, with males predominantly filling the roles of editors in chief, editorial members, and first and senior authors. Despite this significant difference in gender distribution, there was no statistically significant correlation between authorship and editor gender.
    MeSH term(s) Humans ; Authorship ; Pulmonary Medicine ; Critical Care ; Publishing ; Periodicals as Topic ; Diversity, Equity, Inclusion ; Gender Equity ; Leadership
    Language English
    Publishing date 2023-02-03
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 80296-7
    ISSN 1473-4877 ; 0300-7995
    ISSN (online) 1473-4877
    ISSN 0300-7995
    DOI 10.1080/03007995.2023.2174329
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  10. Article: Asthma and severe acute respiratory syndrome coronavirus 2019: current evidence and knowledge gaps

    Assaf, Sara M / Tarasevych, Svitlana P / Diamant, Zuzana / Hanania, Nicola A

    Curr. opin. pulm. med

    Abstract: PURPOSE OF REVIEW: Although respiratory viruses are common triggers of asthma exacerbation, it is unknown whether this also applies to infection with SARS-CoV-2. Indeed, patients with asthma and allergy appear underrepresented in large reports of COVID- ... ...

    Abstract PURPOSE OF REVIEW: Although respiratory viruses are common triggers of asthma exacerbation, it is unknown whether this also applies to infection with SARS-CoV-2. Indeed, patients with asthma and allergy appear underrepresented in large reports of COVID-19 cases worldwide. In this review, we evaluate existing literature on this topic and potential underlying mechanisms for any interrelationship between asthma and COVID-19. RECENT FINDINGS: Data from several preclinical and clinical reports suggest a lower susceptibility for COVID-19 in patients with underlying type 2 airway inflammation including asthma that may be related to a reduced expression of ACE2 and TMPRSS2 receptors for SARS-CoV-2. Corticosteroids further decrease expression of the ACE2 and TMPRSS2 receptors, hence may also have a protective effect against infection with SARS-CoV-2. In addition, some studies suggest that the reported improvement in asthma control and a reduction in asthma exacerbations during the COVID-19 pandemic may be related to improvement in adherence to controller therapy and reduced exposure to triggers, such as other respiratory viruses and air pollutants. Recent data point towards differential susceptibility for COVID-19 among asthma patients based on their phenotype and/or endotype. On the basis of existing evidence, continuation with controller therapies is recommended for all patients with asthma. For patients with severe uncontrolled asthma infected by SARS-CoV-2, adjustment of controllers and biologics should be based on a multidisciplinary decision. SUMMARY: Underrepresentation of SARS-CoV-2-infected patients with asthma and related allergic diseases may be based on potentially protective underlying mechanisms, such as type 2 airway inflammation, downregulation of ACE2/TMPRSS2 receptors, reduced exposures to triggers and improved adherence to controller medications. Although it is imperative that control should be maintained and asthma medications be continued in all patients, management of patients with severe uncontrolled asthma infected by SARS-CoV-2 including adjustment of controllers and biologics should be discussed on an individual basis.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #873131
    Database COVID19

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