ABSTRACT
Objective: The effect of biological agents used in severe allergic diseases on the risk of coronavirus disease 2019 (COVID-19) and the course of the disease still remains unclear. The aim of the study was to evaluate retrospectively the frequency and severity of COVID-19 to determine risk factors and to present real-life data in patients using biological agents.Materials and Methods: Patients who have used omalizumab or mepolizumab for at least six months were questioned retrospectively in terms of a history of COVID-19. Patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) polymerase chain reaction (PCR) or serological IgG positivity, symptoms, lung involvement, the need for supplemental oxygen, hospital and intensive care admission, and mortality were queried. Results: Of the 71 patients (omalizumab/mepolizumab: 51/20) included in the study, the average age was 37.2 +/- 12.9, and the female/ male ratio was 46/25. Of the 11 patients (omalizumab/mepolizumab: 6/5) with SARS-CoV-2 positivity, two were hospitalized for pneumonia and needed oxygen. However, intensive care was not required and they survived. There was no significant difference between mepolizumab users who had COVID-19 and those who did not in terms of baseline and post-treatment 6th-month eosinophil values (p= 0.7, p= 0.59, respectively). It was established that eosinopenia developing after treatment did not increase the risk of COVID-19 in patients using mepolizumab [RR (95% Cl) 0.99 (0.97-1.02), p=0.88].Conclusion: According to our single center data, we found the risk of severe COVID-19 in patients using biological agents to be quite low. Especially, eosinopenia that developed after mepolizumab treatment did not constitute a risk factor for the severity of COVID-19.
ABSTRACT
Objective: Although the factors that trigger and exacerbate chronic spontaneous urticaria (CSU) are well known, there is still a lack of information about the effects of COVID-19 vaccines on CSU. This study aimed to investigate exacerbations/relapses triggered by COVID-19 vaccines in patients with CSU who are well controlled with treatment or in remission. Materials and Methods: The study included 350 CSU patients. Demographic and clinical characteristics were collected from patients' medical records. The seven-day urticaria activity score (UAS7) and urticaria control test (UCT) were evaluated separately during the onset of the disease, pre-vaccination, and post-vaccination periods. Results: The mean age was 39.89 +/- 13.30 years and 74.6% of the patients were female. A total of 227 patients were vaccinated with the Pfizer/BioNTech mRNA vaccine, 67 with the Sinovac/CoronaVac inactivated vaccine, and 54 with both vaccines. Urticaria exacerbations/ relapses were observed in a total of 76 patients, and most CSU exacerbations/relapses occurred after the first dose (n=46). Median UAS7 scores increased significantly in the post-vaccination period in patients who experienced urticaria exacerbation (p<0.0001). Median UCT scores were significantly decreased due to urticaria exacerbation with vaccination (p<0.0001). Conclusion: Both mRNA and inactivated COVID-19 vaccine may lead to exacerbations or relapses in patients with CSU. Even so, exacerbations/relapses associated with COVID-19 vaccines can be easily controlled with treatments and do not preclude subsequent doses.
ABSTRACT
BACKGROUND AND AIM: Biologics can be used safely for patients with severe asthma during the coronavirus pandemic, but there is still a lack of information regarding their effects during SARS-CoV-2 infection. The aim of this study was to evaluate the impact of biologic therapies on the course of SARS-CoV-2 infection and to assess the outcome of COVID-19 for severe asthmatics in pandemic conditions. METHODS: A total of 100 severe asthma patients treated with biologics (7 treated with dupilumab, 22 with mepolizumab, and 71 with omalizumab) were included. Patients' demographic, clinical, and laboratory findings as well as the course of the COVID-19 disease were evaluated. RESULTS: Of the total 100 patients, 15% of patients were diagnosed with COVID-19. There were no significant differences between SARS-CoV-2 positive and negative patient groups in terms of demographic features, atopy, comorbidity, duration of asthma, and duration of biological use. The body mass index (BMI) was higher in the SARS-CoV-2 negative group than the positive group (p=0.005). Asthma exacerbation during COVID-19 was observed in 3 patients, and only 2 were hospitalized for 5 days. SARS-CoV-2 positive group exhibited lower eosinophil and lymphocyte levels when infected with COVID-19 than before COVID-19 (p=0.01 and p=0.0009 respectively). CONCLUSIONS: The rate of COVID-19 infection was higher in patients with severe asthma receiving biologics than in the general population. However, it can be speculated that treatment with biologics may have protection against severe COVID-19 and mortality. Further studies are required to investigate the role of biologic agents, which affect the level and function of eosinophils in viral infections, especially SARS-CoV-2.
ABSTRACT
Covid-19 SARS-CoV-2 (severe acute respiratory syndrome-coronavirus-2) is a new type of coronavirus known as an infectious upper respiratory tract infection disease. The coronavirus, which poses a great threat to human health worldwide, emerged in Wuhan, China in December 2019. The most important reason for coronavirus epidemics to become a pandemic that the disease was easily transmitted by droplets in close proximity with infected people. The disease spread rapidly all over the world within a few months and it was declared a worldwide epidemic by the World Health Organization in March 2020. It poses a risk for severe diseases such as hypertension, diabetes, cardiovascular disease, cancer, chronic lung disease and chronic kidney disease in the advanced age group. Considering the mortality rates to date, great efforts have been made both worldwide and in our country to manufacture successful drugs and vaccines against Covid-19 infection. The main purpose of this review is to assist in an immune response and preventive work for Covid-19, thanks to the available information about the coronavirus epidemic that deeply affects humanity and the diseases it causes.
ABSTRACT
Objective: The effect of the COVID-19 pandemic on mental health in the long term is unclear. We evaluated severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)–related transmission fear and mental-health disorders in populations at high risk for COVID-19. Materials and Methods: Healthcare workers and patients with primary immunodeficiency disorders (PIDs), severe asthma, malignancy, cardiovascular disease, hypertension, and diabetes mellitus were included in the study. The hospital anxiety and depression scale (HADS) and Fear of Illness and Virus Evaluation (FIVE) scales were applied during face-to-face interviews. Results: There was a total of 560 participants, 80 per group;306 (55%) were female. The FIVE and HADS-A scale scores of health care workers were significantly higher than the other groups (p = 0.001 and 0.006). The second-highest scores were in patients with PID. There was no significant difference between the groups in HADS-D scores (p = 0.07). There was a significant positive correlation between FIVE scale scores and anxiety (r = 0.828;p < 0.001) and depression (r = 0.660;p < 0.001). The FIVE scale had significant discriminatory power for anxiety (AUC = 0.870, 95% confidence interval [CI] = 0.836–0.904;p < 0.0001) and depression (area under the curve = 0.760, 95% CI = 0.717–0.803;p < 0.0001). Conclusion: During the COVID-19 pandemic, mental-health disorders may develop in patients with comorbidities, especially healthcare workers. They should be referred to mental-health centers.