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1.
Acta cardiologica ; : 1-2, 2023.
Article in English | EuropePMC | ID: covidwho-2212238
2.
Pediatr Allergy Immunol ; 33(10): e13851, 2022 10.
Article in English | MEDLINE | ID: covidwho-2121550

ABSTRACT

By the April 12, 2022, the COVID-19 pandemic had resulted in over half a billion people being infected worldwide. There have been 6.1 million deaths directly due to the infection, but the pandemic has had many more short- and long-term pervasive effects on the physical and mental health of the population. Allergic diseases are among the most prevalent noncommunicable chronic diseases in the pediatric population, and health-care professionals and researchers were seeking answers since the beginning of pandemic. Children are at lower risk of developing severe COVID-19 or dying from infection. Allergic diseases are not associated with a higher COVID-19 severity and mortality, apart from severe/poorly controlled asthma. The pandemic disrupted routine health care, but many mitigation strategies, including but not limited to telemedicine, were successfully implemented to continue delivery of high-standard care. Although children faced a multitude of pandemic-related issues, allergic conditions were effectively treated remotely while reduction in air pollution and lack of contact with outdoor allergens resulted in improvement, particularly respiratory allergies. There is no evidence to recommend substantial changes to usual management modalities of allergic conditions in children, including allergen immunotherapy and use of biologicals. Allergic children are not at greater risk of multisystem inflammatory syndrome development, but some associations with Long COVID were reported, although the data are limited, and further research is needed. This statement of the EAACI Section on Pediatrics provides recommendations based on the lessons learnt from the pandemic, as available evidence.


Subject(s)
Asthma , COVID-19 , Hypersensitivity , Immunologic Deficiency Syndromes , Child , Humans , COVID-19/epidemiology , Pandemics , Asthma/epidemiology
3.
Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology ; 33(10), 2022.
Article in English | EuropePMC | ID: covidwho-2058218

ABSTRACT

By the April 12, 2022, the COVID‐19 pandemic had resulted in over half a billion people being infected worldwide. There have been 6.1 million deaths directly due to the infection, but the pandemic has had many more short‐ and long‐term pervasive effects on the physical and mental health of the population. Allergic diseases are among the most prevalent noncommunicable chronic diseases in the pediatric population, and health‐care professionals and researchers were seeking answers since the beginning of pandemic. Children are at lower risk of developing severe COVID‐19 or dying from infection. Allergic diseases are not associated with a higher COVID‐19 severity and mortality, apart from severe/poorly controlled asthma. The pandemic disrupted routine health care, but many mitigation strategies, including but not limited to telemedicine, were successfully implemented to continue delivery of high‐standard care. Although children faced a multitude of pandemic‐related issues, allergic conditions were effectively treated remotely while reduction in air pollution and lack of contact with outdoor allergens resulted in improvement, particularly respiratory allergies. There is no evidence to recommend substantial changes to usual management modalities of allergic conditions in children, including allergen immunotherapy and use of biologicals. Allergic children are not at greater risk of multisystem inflammatory syndrome development, but some associations with Long COVID were reported, although the data are limited, and further research is needed. This statement of the EAACI Section on Pediatrics provides recommendations based on the lessons learnt from the pandemic, as available evidence.

4.
Braz J Infect Dis ; 26(1): 101702, 2022.
Article in English | MEDLINE | ID: covidwho-1588201

ABSTRACT

OBJECTIVE: To estimate the effect of tocilizumab or glucocorticoids in preventing death and intubation in patients hospitalized with SARS-CoV-2 pneumonia. METHODS: This was a retrospective cohort study enrolling all consecutive patients hospitalized at Reggio Emilia AUSL between February the 11th and April 14th 2020 for severe COVID-19 and treated with tocilizumab or glucocorticoids (at least 80 mg/day of methylprednisolone or equivalent for at least 3 days). The primary outcome was death within 30 days from the start of the considered therapies. The secondary outcome was a composite outcome of death and/or intubation. All patients have been followed-up until May 19th 2020, with a follow-up of at least 30 days for every patient. To reduce confounding due to potential non-comparability of the two groups, those receiving tocilizumab and those receiving glucocorticoids, a propensity score was calculated as the inverse probability weighting of receiving treatment conditional on the baseline covariates. RESULTS AND CONCLUSION: Therapy with tocilizumab alone was associated with a reduction of deaths (OR 0.49, 95% CI 0.21-1.17) and of the composite outcome death/intubation (OR 0.35, 95% CI 0.13-0.90) compared to glucocorticoids alone. Nevertheless, this result should be cautiously interpreted due to a potential prescription bias.


Subject(s)
COVID-19 , Glucocorticoids , Antibodies, Monoclonal, Humanized , COVID-19/drug therapy , Glucocorticoids/therapeutic use , Humans , Retrospective Studies , SARS-CoV-2 , Treatment Outcome
5.
Clin Exp Rheumatol ; 38(6): 1215-1222, 2020.
Article in English | MEDLINE | ID: covidwho-958715

ABSTRACT

OBJECTIVES: To identify predictors of clinical improvement and intubation/death in tocilizumab-treated severe COVID19, focusing on IL6 and CRP longitudinal monitoring. METHODS: 173 consecutive patients with severe COVID-19 pneumonia receiving tocilizumab in Reggio Emilia province Hospitals between 11 March and 3 June 2020 were enrolled in a prospective cohort study. Clinical improvement was defined as status improvement on a six-category ordinal scale or discharge from the hospital, whichever came first. A composite outcome of intubation/death was also evaluated. CRP and IL-6 levels were determined before TCZ administration (T0) and after 3 (T3), and 7 (T7) days. RESULTS: At multivariate analysis T0 and T3 CRP levels were negatively associated with clinical improvement (OR 0.13, CI 0.03-0.55 and OR 0.11, CI 0.0-0.46) (p=0.006 and p=0.003) and positively associated with intubation/death (OR 17.66, CI 2.47-126.14 and OR 5.34, CI: 1.49-19.12) (p=0.01 and p=0.004). No significant associations with IL-6 values were observed. General linear model analyses for repeated measures showed significantly different trends for CRP from day 3 to day 7 between patients who improved and those who did not, and between patients who were intubated or died and those who were not (p<0.0001 for both). ROC analysis identified a baseline CRP level of 15.8 mg/dl as the best cut-off to predict intubation/death (AUC = 0.711, sensitivity = 0.67, specificity = 0.71). CONCLUSIONS: CRP serial measurements in the first week of TCZ therapy are useful in identifying patients developing poor outcomes.


Subject(s)
Betacoronavirus , Coronavirus Infections , Pneumonia, Viral , Acute-Phase Proteins , Antibodies, Monoclonal, Humanized , Humans , Pandemics , Prospective Studies , SARS-CoV-2
6.
Pediatr Allergy Immunol ; 31 Suppl 26: 89-91, 2020 11.
Article in English | MEDLINE | ID: covidwho-944778

ABSTRACT

BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, causing COVID-19, is rapidly spread across the world, by posing novel challenges for all physicians. Cutaneous manifestations of COVID-19 may be present in 20% of patients, but they are still now poorly characterized. METHODS: We search literature to describe all the various cutaneous manifestation observed during COVID-19 pandemic. RESULTS: Different cutaneous clinical patterns were described, showing a wide polymorphism. CONCLUSION: We provided an overview of all the various cutaneous manifestations of COVID-19 described in the literature today, to improve our knowledge and lead a more prompt and accurate diagnosis, especially in asymptomatic or paucisymptomatic cases.


Subject(s)
COVID-19/complications , SARS-CoV-2 , Skin Diseases/etiology , COVID-19/epidemiology , Humans , Mucocutaneous Lymph Node Syndrome/etiology
7.
Arthritis Rheumatol ; 73(1): 48-52, 2021 01.
Article in English | MEDLINE | ID: covidwho-696616

ABSTRACT

OBJECTIVE: To evaluate the susceptibility to coronavirus disease 2019 (COVID-19) in patients with autoimmune conditions treated with antimalarials in a population-based study. METHODS: All residents treated with chloroquine (CQ)/hydroxychloroquine (HCQ) from July through December 2019 and living in 3 provinces of Regione Emilia-Romagna were identified by drug prescription registries and matched with the registry containing all residents living in the same areas who have had swabs and tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated. RESULTS: A total of 4,408 patients were identified. The prevalence of patients receiving antimalarials was 0.85 per 1,000 men and 3.3 per 1,000 women. The cumulative incidence of testing during the study period was 2.7% in the general population and 3.8% among those receiving CQ or HCQ, while the cumulative incidence of testing positive was 0.55% in the general population and 0.70% among those receiving CQ/HCQ. Multivariate models showed that those receiving CQ/HCQ had a slightly higher probability of being tested compared to the general population (OR 1.09 [95% CI 0.94-1.28]), the same probability of being diagnosed as having COVID-19 (OR 0.94 [95% CI 0.66-1.34]), and a slightly lower probability of being positive once tested (OR 0.83 [95% CI 0.56-1.23]). None of the differences were significant. CONCLUSION: Our findings do not support the use of antimalarials as a prophylactic treatment of COVID-19.


Subject(s)
Antirheumatic Agents/therapeutic use , Autoimmune Diseases/drug therapy , COVID-19/epidemiology , Chloroquine/therapeutic use , Hydroxychloroquine/therapeutic use , Adult , Aged , Aged, 80 and over , Antimalarials/therapeutic use , Arthritis, Juvenile/drug therapy , Arthritis, Rheumatoid/drug therapy , COVID-19/prevention & control , Disease Susceptibility , Female , Humans , Italy/epidemiology , Lupus Erythematosus, Discoid/drug therapy , Lupus Erythematosus, Systemic/drug therapy , Male , Middle Aged , Odds Ratio , SARS-CoV-2
9.
Pediatr Allergy Immunol ; 31(5): 442-448, 2020 07.
Article in English | MEDLINE | ID: covidwho-601359

ABSTRACT

While the world is facing an unprecedented pandemic with COVID-19, patients with chronic diseases need special attention and if warranted adaptation of their regular treatment plan. In children, allergy and asthma are among the most prevalent non-communicable chronic diseases, and healthcare providers taking care of these patients need guidance. At the current stage of knowledge, children have less severe symptoms of COVID-19, and severe asthma and immunodeficiency are classified as risk factors. In addition, there is no evidence that currently available asthma and allergy treatments, including antihistamines, corticosteroids, and bronchodilators, increase the risk of severe disease from COVID-19. Most countries affected by COVID-19 have opted for nationwide confinement, which means that communication with the primary clinician is often performed by telemedicine. Optimal disease control of allergic, asthmatic, and immunodeficient children should be sought according to usual treatment guidelines. This statement of the EAACI Section on Pediatrics puts forward six recommendations for the management of childhood allergies and immunodeficiencies based on six underlying facts and existing evidence.


Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Hypersensitivity/therapy , Immunologic Deficiency Syndromes/therapy , Pandemics/prevention & control , Pediatrics/methods , Pneumonia, Viral/prevention & control , Academies and Institutes , Adolescent , COVID-19 , Child , Child, Preschool , Europe , Humans , Infant , Practice Guidelines as Topic , SARS-CoV-2
10.
Ital J Pediatr ; 46(1): 84, 2020 Jun 16.
Article in English | MEDLINE | ID: covidwho-599459

ABSTRACT

The COVID-19 pandemic has surprised the entire population. The world has had to face an unprecedented pandemic. Only, Spanish flu had similar disastrous consequences. As a result, drastic measures (lockdown) have been adopted worldwide. Healthcare service has been overwhelmed by the extraordinary influx of patients, often requiring high intensity of care. Mortality has been associated with severe comorbidities, including chronic diseases. Patients with frailty were, therefore, the victim of the SARS-COV-2 infection. Allergy and asthma are the most prevalent chronic disorders in children and adolescents, so they need careful attention and, if necessary, an adaptation of their regular treatment plans. Fortunately, at present, young people are less suffering from COVID-19, both as incidence and severity. However, any age, including infancy, could be affected by the pandemic.Based on this background, the Italian Society of Pediatric Allergy and Immunology has felt it necessary to provide a Consensus Statement. This expert panel consensus document offers a rationale to help guide decision-making in the management of children and adolescents with allergic or immunologic diseases.


Subject(s)
Allergy and Immunology , Betacoronavirus , Consensus , Coronavirus Infections/therapy , Disease Management , Pandemics , Pneumonia, Viral/therapy , Societies, Medical , Adolescent , COVID-19 , Child , Coronavirus Infections/epidemiology , Decision Making , Humans , Italy/epidemiology , Pneumonia, Viral/epidemiology , Pragmatic Clinical Trials as Topic/methods , SARS-CoV-2
11.
Ann Rheum Dis ; 79(7): 986-988, 2020 07.
Article in English | MEDLINE | ID: covidwho-435835
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