## 1 Introduction  
Asthma is a worldwide public health problem, in both children and adults, mainly because of its prevalence (over 300 million people) and chronicity, with a significant burden of morbidity and mortality [1]. Variable airway obstruction, airway hyper-responsiveness to specific triggers (viral infections, allergens, exercise, etc.) and chronic airway inflammation finally leading to an airway remodeling are peculiar aspects of this disease [2, 3]. The diagnosis of asthma involves the combination of a characteristic pattern of respiratory symptoms and evidence of a variable expiratory flow limitation on spirometry [2, 3]. The typical symptom pattern, especially in adults, consists of recurrent episodes of more than one of shortness of breath, wheezing, coughing and chest tightness worsening at night/early morning, variable in time and intensity and induced by several well-known trigger factors [2, 3]. The guidelines emphasize differences in terminology that seem particularly important when talking about asthma in the ED [4]. The difference between uncontrolled and severe asthma is that in the former, symptoms are uncontrolled due to poor adherence or incorrect inhalation technique, whereas in the latter, symptoms are refractory or only partially responsive to treatment [4, 5]. Exacerbation is an acute/subacute worsening of asthma from the patient's usual status. In a minority of cases, it may represent the first presentation of asthma. Exacerbations are classified as mild, moderate and severe, but here, the term \"severe\" refers to the acute clinical picture and is defined on the basis of signs, symptoms and clinical parameters (see Section 2) [4]. Adult patients with asthma often need access to ED worldwide, requiring care for exacerbations or uncontrolled symptoms (uncontrolled or severe asthma) [4,5]. Sometimes the ED is even where asthma is first diagnosed in patients admitted for ongoing respiratory symptoms [5]. COVID-19 is the infectious disease caused by SARS-CoV-2, a coronavirus belonging to the same family of SARS-CoV-1 and MERS-CoV [6,7]. The main complication of SARS-CoV-2 infection is interstitial pneumonia associated with varying degrees of respiratory involvement, up to acute respiratory distress syndrome [6,8]. During the first pandemic wave and subsequent lockdowns, a significant decrease in emergency healthcare utilization was observed worldwide [9]. During the following waves, instead, the usual overcrowding of the ED returned. The need to properly separate the flows between patients with suspected and unlikely SARS-CoV-2 infection became even more pressing [9]. Separating the two flows is itself a difficult task, but it is even more complicated in patients with asthma.  
Viral respiratory infections are well known as triggers for asthma exacerbations, especially in the development of more severe symptoms [10]. Data on clinical outcomes in asthmatic patients infected with SARS or MERS are scarce and conflicting, but asthma did not appear to worsen prognosis [11]. Because of the pandemic spread of SARS-CoV-2 infection, the literature has produced a large number of studies assessing the prevalence of asthma in COVID-19 populations and the influence of asthma and associated treatments on COVID-19 severity [12,13].  
In the era of COVID-19, some diagnostic and therapeutic aspects related to asthma management, in the ED and after discharge, deserve to be discussed and addressed by the scientific community.