Awareness of the risk of airborne transmission of SARS-CoV-2 makes patients hesitant about using inhaled medications that are considered as a potential source of viral transmission and immunosuppression. However, patients with
asthma or
COPD should continue all prescribed inhaled medications. Apparently,
inhalers, including pMDIs, DPIs, or SMIs, have a low risk of contamination although characteristics of drug formulation can precipitate
cough, whereas some researchers do not rule out the probability that
nebulizer treatments may increase the risk of infection transmission via
droplet nuclei and
aerosols. Considering that
aerosol therapy generates fugitive emissions that are not inhaled by the patient and are released from the device during expiration, several international professional bodies have provided recommendations for drug delivery via
inhalers and in particular,
nebulizers. Unfortunately, these recommendations are often in conflict with each other and do not clarify whether it is appropriate to use
nebulizers during this
COVID-19 pandemic. Considering what is available in literature, there are no known
infection-related hazards to an uninfected patient and also a patient with
COVID-19 that preclude the use of a
nebulizer at home, but it fundamental that all patients, regardless of whether or not suffering from
COVID-19, always follow some practical advices.