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Allergologie ; 44(1):54-80, 2021.
Article in German | Web of Science | ID: covidwho-1572877

ABSTRACT

With the advent of biologicals, more and more therapeutics are available that specifically address specific switch points in the pathomechanism of immunologically dominated diseases. Thus, the focus of diagnostics and therapy (precision medicine) is more on the individual disease characteristics of the individual patient. Regarding the different phenotypes of atopic diseases, severe asthma was the first entity for which biologicals were approved, followed by urticaria, and finally atopic dermatitis and chronic rhinosinusitis with nasal polyps. Experience in the treatment of severe bronchial asthma has shown that the intensity of the response to biological therapy depends on the quality of clinical and immunological phenotyping of the patients. This also applies to different diseases of the atopic form, as patients can suffer from several atopic diseases at the same time, each with different characteristics. Biologics are already emerging that may represent a suitable therapy for allergic bronchial asthma, which often occurs together with severe neurodennatitis. and chronic rhinosinusitis with nasal polyps. In practice, however, the question of possible combinations of biologicals for the therapy of complex clinical pictures of individual patients is increasingly arising. In doing so, the side effect profile must be taken into account, including hypersensitivity reactions, whose diagnostic and logistical management must aim at a safe and efficient therapy of the underlying disease. Increased attention must also be paid to biological therapy in pregnancy and planned (predictable) vaccinations as well as existing infections, such as SARS-CoV-2 infection. Before starting a biological therapy, the immune status should be checked with regard to chronic vi- ral and bacterial infections and, if necessary. the vaccination status should be refreshed or missing vaccinations should be made up for before starting therapy. Currently, reliable data on the effect of biologicals on the immunological situation of SARS-CoV-2 infection and COVID-19 are not available. Therefore, research and development of suitable diagnostic methods for detection of immunologically caused side effects as well as detection of potential therapy responders and non-responders is of great importance.

6.
consortium, Capacity-Covid collaborative, Group, Leoss Study, Linschoten, M.; Uijl, A.; Schut, A.; Jakob, C. E. M.; Romão, L. R.; Bell, R. M.; McFarlane, E.; Stecher, M.; Zondag, A. G. M.; van Iperen, E. P. A.; Hermans-van Ast, W.; Lea, N. C.; Schaap, J.; Jewbali, L. S.; Smits, P. C.; Patel, R. S.; Aujayeb, A.; Ripley, D. P.; Saxena, M.; Spinner, C.; McCann, G. P.; Moss, A. J.; Parker, E.; Borgmann, S.; Tessitore, E.; Rieg, S.; Kearney, M. T.; Byrom-Goulthorp, R.; Hower, M.; Al-Ali, A. K.; Alshehri, A. M.; Alnafie, A. N.; Alshahrani, M.; Almubarak, Y. A.; Al-Muhanna, F. A.; Al-Rubaish, A. M.; Hanses, F.; Shore, A. C.; Ball, C.; Anning, C. M.; Rüthrich, M. M.; Nierop, P. R.; Vehreschild, Mjgt, Heymans, S. R. B.; Henkens, Mthm, Raafs, A. G.; van der Horst, I. C. C.; van Bussel, B. C. T.; Magdelijns, F. J. H.; Lanznaster, J.; Kopylov, P. Y.; Blagova, O. V.; Wille, K.; Pinto, Y. M.; Offerhaus, J. A.; Bleijendaal, H.; Piepel, C.; ten Berg, J. M.; Bor, W. L.; Maarse, M.; Römmele, C.; Tio, R. A.; Sturkenboom, N. H.; Tometten, L.; den Uil, C. A.; Scholte, N. T. B.; Groenendijk, A. L.; Dolff, S.; Zijlstra, L. E.; Hilt, A. D.; von Bergwelt-Baildon, M.; Groenemeijer, B. E.; Merle, U.; van der Zee, P. M.; van Beek, E. A.; Rothfuss, K.; Tjong, F. V. Y.; van der Lingen, A. C. J.; Kolk, M. Z. H.; Isberner, N.; Monraats, P. S.; Magro, M.; Hermans, W. R. M.; Kochanek, M.; Captur, G.; Thomson, R. J.; Nadalin, S.; Linssen, G. C. M.; Veneman, T.; Zaal, R.; Degenhardt, C.; Martens, Fmac, Badings, E. A.; Strauss, R.; Zaman, A. G.; Alkhalil, M.; Prasad, S.; Grüner, B.; Haerkens-Arends, H. E.; Eberwein, L.; Dark, P.; Lomas, D.; vom Dahl, J.; Verschure, D. O.; Hellwig, K.; Mosterd, A.; Rauschning, D.; van der Heijden, D. J.; Neufang, M.; van Hessen, M.; Raichle, C.; Montagna, L.; Mazzilli, S. G.; Bianco, M.; Westhoff, T.; Shafiee, A.; Hedayat, B.; Saneei, E.; Porhosseini, H.; Jensen, B.; Gabriel, L.; Er, A. G.; Kietselaer, Bljh, Schubert, J.; Timmermans, P.; Messiaen, P.; Friedrichs, A.; van den Brink, F. S.; Woudstra, P.; Trauth, J.; Ribeiro, M. I. A.; de With, K.; van der Linden, Mmjm, Kielstein, J. T.; Macías Ruiz, R.; Guggemos, W.; Hellou, E.; Markart, P.; van Kesteren, H. A. M.; Heigener, D.; de Vries, J. K.; Stieglitz, S.; Baltazar, J. B.; Voigt, I.; van de Watering, D. J.; Milovanovic, M.; Redón, J.; Forner, M. J.; Rüddel, J.; Wu, K. W.; Nattermann, J.; Veldhuis, L. I.; Westendorp, I. C. D.; Riedel, C.; Kwakkel-van Erp, J. M.; van Ierssel, S.; van Craenenbroeck, E. M.; Walter, L.; de Sutter, J.; Worm, M.; Drost, J. T.; Moriarty, A.; Salah, R.; Charlotte, N.; van Boxem, A. J. M.; Dorman, H. G. R.; Reidinga, A. C.; van der Meer, P.; Wierda, E.; van Veen, Hpaa, Delsing, C. E.; Meijs, M. F. L.; van de Wal, R. M. A.; Weytjens, C.; Hermanides, R. S.; Emans, M. E.; al-Windy, N. Y. Y.; Koning, A. M. H.; Schellings, Daam, Anthonio, R. L.; Bucciarelli-Ducci, C.; Caputo, M.; Westendorp, P. H. M.; Kuijper, A. F. M.; van Ofwegen-Hanekamp, C. E. E.; Persoon, A. M.; Seelig, J.; van der Harst, P.; Siebelink, H. J.; van Smeden, M.; Williams, S.; Pilgram, L.; van Gilst, W. H.; Tieleman, R. G.; Williams, B.; Asselbergs, F. W..
2021.
Preprint in English | Other preprints | ID: ppcovidwho-294508

ABSTRACT

Aims Patients with cardiac disease are considered high risk for poor outcomes following hospitalization with COVID-19. The primary aim of this study was to evaluate heterogeneity in associations between various heart disease subtypes and in-hospital mortality. Method and results We used data from the CAPACITY-COVID registry and LEOSS study. Multivariable Poisson regression models were fitted to assess the association between different types of pre-existent heart disease and in-hospital mortality. 16,511 patients with COVID-19 were included (21.1% aged 66 – 75 years;40.2% female) and 31.5% had a history of heart disease. Patients with heart disease were older, predominantly male and often had other comorbid conditions when compared to those without. Mortality was higher in patients with cardiac disease (29.7%;n=1545 versus 15.9%;n=1797). However, following multivariable adjustment this difference was not significant (adjusted risk ratio (aRR) 1.08 [95% CI 1.02 – 1.15;p-value 0.12 (corrected for multiple testing)]). Associations with in-hospital mortality by heart disease subtypes differed considerably, with the strongest association for heart failure aRR (1.19 [1.10 – 1.30];p-value <0.018) particularly for severe NYHA III/IV) heart failure (aRR 1.41 [95% CI 1.20 – 1.64;p-value <0.018]. None of the other heart disease subtypes, including ischemic heart disease, remained significant after multivariable adjustment. Serious cardiac complications were diagnosed in <1% of patients. Conclusion Considerable heterogeneity exists in the strength of association between heart disease subtypes and in-hospital mortality. Of all patients with heart disease, those with heart failure are at greatest risk of death when hospitalized with COVID-19. Serious cardiac complications are rare.

11.
Allergologie ; 44(5):339-348, 2021.
Article in German | EMBASE | ID: covidwho-1227147

ABSTRACT

Background: Vaccinations against Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) are intended to induce an immune response in the sense of protection against infection/disease. Allergen-specific immunotherapy (AIT) is also thought to induce a (different) immune response in the sense of tolerance to allergens. There is uncertainty among patients and physicians regarding the use of vaccination and AIT in temporal relation, which this position paper aims to clarify. The four vaccines currently approved in Germany for vaccination against SARS-CoV-2 are described and possible immunological interactions with AIT are highlighted, as well as practical recommendations for action. Methods: Based on the current internationally published literature, this position paper provides specific recommendations for action regarding the use of AIT in temporal relation to a SARS-CoV-2 vaccination. Results: The present recommendations for action relate to the following conditions for which AIT is used i) allergic rhinitis, ii) allergic bronchial asthma, iii) insect venom allergy, iiii) food allergy (peanut). Conclusions: If vaccination is imminent, initiation of subcutaneous (SCIT), sublingual (SLIT), or oral (OIT) AIT should be delayed until 1 week after the 2nd vaccination date. Thus, there should generally be an interval of approximately 1 week between SCIT and COVID-19 vaccination. For the continuation of an ongoing AIT, we recommend an interval of 1 week before and after vaccination for SCIT. For SLIT and OIT, we recommend taking them up to the day before vaccination and taking a break from SLIT and OIT for 2 – 7 days after vaccination.

12.
Allergologie ; 44(4):261-269, 2021.
Article in German | Scopus | ID: covidwho-1215636

ABSTRACT

Background: After the beginning and during the worldwide pandemic caused by the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), patients with allergic and atopic diseases have felt and still feel insecure. Currently, four vaccines against SARS-CoV-2 have been approved by the Paul Ehrlich Institute in Germany, and vaccination campaigns have been started nationwide. In this respect, it is of utmost importance to give recommendations on possible immunological interactions and potential risks of immunomodulatory substances (monoclonal antibodies, biologicals) during concurrent vaccination with the approved vaccines. Methods: This position paper provides specific recommendations on the use of immunomodulatory drugs in the context of concurrent SARS-CoV-2 vaccinations based on current literature. Results: The recommendations are covering the following conditions in which biologicals are indicated and approved: i) chronic inflammatory skin diseases (atopic dermatitis, chronic spontaneous urticaria), ii) bronchial asthma, and iii) chronic rhinosinusitis with nasal polyps (CRSwNP). Patients with atopic dermatitis or chronic spontaneous urticaria are not at increased risk for allergic reactions after COVID-19 vaccination. Nevertheless, vaccination may result in transient eczema exacerbation due to general immune stimulation. Vaccination in patients receiving systemic therapy with biologicals can be performed. Patients with severe asthma and concomitant treatment with biologicals also do not have an increased risk of allergic reaction following COVID-19 vaccination which is recommended in these patients. Patients with CRSwNP are also not known to be at increased risk for allergic vaccine reactions, and continuation or initiation of a treatment with biologicals is also recommended with concurrent COVID-19 vaccination. In general, COVID-19 vaccination should be given within the interval between two applications of the respective biological, that is, with a time-lag of at least 1 week after the previous or at least 1 week before the next biological treatment planned. Conclusion: Biologicals for the treatment of atopic dermatitis, chronic spontaneous urticaria, bronchial asthma, and CRSwNP should be continued during the current COVID-19 vaccination campaigns. However, the intervals of biological treatment may need to be slightly adjusted (DGAKI/AeDA recommendations as of March 22, 2021). © 2021 Dustri-Verlag Dr. Karl Feistle.

13.
Journal of the European Academy of Dermatology & Venereology ; 29:29, 2021.
Article in English | MEDLINE | ID: covidwho-1208439

ABSTRACT

The Covid-19 pandemic is currently one of the most important health challenges, and the recently approved vaccines can save millions of lives. However, the fact that anaphylaxis might occur after vaccination has raised much concern. Currently, Centers for Disease Control and Prevention (CDC) reported the rate of 2.5 - 4.7 cases/million mRNA vaccine doses administered.

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Allergologie ; 44(3):247, 2021.
Article in German | Scopus | ID: covidwho-1161625
18.
Allergologie ; 44(3):247, 2021.
Article in German | Scopus | ID: covidwho-1158744
20.
Allergologie ; 44(2):95-99, 2021.
Article in German | EMBASE | ID: covidwho-1110620

ABSTRACT

Severe allergic reactions to vaccines are very rare. Single severe reactions have occurred worldwide after vaccination with the new mRNA-based COVID-19 vaccines. PEG2000 is discussed as a possible trigger. We provide guidance on risk assessment regarding COVID-19 vaccination in patients with allergic diseases and suggest a standardized, resource-oriented diagnostic and therapeutic procedure. Reports of severe allergic reactions in the context of COVID-19 vaccination can be made via www.anaphylaxie. net using an online questionnaire.

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