Clinical and quality of life assessment in patients with latex allergy during COVID-19 pandemic: Possible protective role of continuous latex immunotherapy

Background: During Covid-19 pandemic, the massive use of Personal Protective Equipment could provoke severe adverse reactions in latex allergy patients and could negatively affect their quality of life. Method(s): The observational single-centre present study was carried out on 67 adult subjects with a latex allergy diagnosis followed by Allergy Unit of Fondazione Policlinico Universitario A. Gemelli IRCCS of Rome. All data were collected from January 2020 to December 2020. All patients underwent to a survey focused on their clinical and psychological conditions during Covid-19 pandemic. For the evaluation of the degree of well-being, we used SF-36 questionnaire (Short-Form 36-Item Health Survey). The aim of our study is: (a) to evaluate the incidence of allergic reactions in patients with latex allergy during the SARS-CoV- 2 pandemic;(b) to evaluate the protective role of continuous latex ITS during this period;(c) to evaluate quality of life of natural rubber latex allergy (NRLA) patients during the pandemic. Result(s): 67 patients (9 males and 58 females, mean age of 45.9 +/- 11.4 years) suffered from latex allergy were included in the present study. We recorded among our patients 13 cases (34.2%) of urticarial/ angioedema (U/A), 9 cases (23.6%) of respiratory symptoms (RS;dyspnoea, shortness of breath, wheezing) and 7 cases (18.4%) of anaphylaxis. In patients undergone continuous ITS, we observed less cases of U/A (p < 0.001), RS (p < 0.001), anaphylaxis (p = 0.003), hospitalizations (p = 0.014) and a lower therapy administration. We compared the results of SF-36 questionnaire in patients undergone continuous and not continuous latex ITS with a significance differences score between these two groups. Conclusion(s): The pandemic challenged the capacity of healthcare systems to provide adequate management of NRLA patients and in this context, we performed a survey to monitor their health status. During the pandemic, the risk of latex exposure was significant increased considering the possibility of direct skin contact, airborne exposure, contamination of food and medical evaluations. Our study is the first that investigated the clinical and quality of life effects of Covid-19 pandemia in NRLA patients demonstrating the importance of SLIT adherence also in this complex period. (Table Presented).

Allergy and COVID Vaccines

We have been experiencing more allergic reactions to vaccines during the recent pandemic. Severe allergic reactions to vaccines are rare and difficult to predict. It might be defined as an idiosyncratic reaction caused by an immunologic mechanism. Regarding the World Allergy Organization (WAO) recommendation, immunologic reactions to drugs are categorized based upon the timing of the appearance of symptoms. This system defines two general types of reactions: immediate and delayed. Recently COVID vaccines are broadly applied worldwide. The CDC has provided the following differentiation: (1) contraindication: persons with a known (diagnosed) allergy to PEG, polysorbate, or another component of a COVID-19 vaccine or who have experienced a severe allergic reaction (e.g., anaphylaxis) after a previous COVID-19 vaccine dose have a contraindication to vaccination;(2) precaution: persons with an immediate allergic reaction to other (non-COVID-19) vaccines or injectable therapies OR a non-severe immediate allergic reaction (onset < 4 hours) after a previous dose of COVID-19 vaccine fall into this category. May proceed with COVID-19 vaccine: (1) persons with a history of food, pet, insect, venom, environmental, oral medication (including the oral equivalent of an injectable medication) or latex allergies;or (2) a family history of allergies. Other reactions like vaccineinduced immune thrombotic thrombocytopenia (VITT) or thrombosis-thrombocytopenia syndrome (TTS) have been reported with adenoviral vector covid-19 vaccines. Myocarditis/pericarditis and Guillain-Barre Syndrome are also reported with COVID vaccines. Results of safety monitoring from VAERS and V-safe after one month of vaccinations show that over 90% of reactions were nonserious. Anaphylaxis rates (4.5 per million doses) remain in the range of other vaccines. The female gender may be a risk factor for adverse reactions and anaphylaxis. To sum up, COVID vaccines are very safe, and severe allergic reactions are exceedingly rare.

Threats to operating room personnel's occupational safety and health: a qualitative study

Background & Objective: Every operating room has been associated with a variety of occupational hazards, but not many studies have been conducted to assess and address these hazards. We used a qualitative approach to explore operating room personnel's experiences of workplace hazards and how these hazards threaten their occupational safety and health (OSH). Methodology: This qualitative study was conducted in five teaching hospitals in the south-west of Iran from February 2019 to March 2021. The sample was 24 operating room personnel who were selected under convenient sampling technique. Data were collected using semi-structured, individual interviews, document review and non-participant observation. The collected data were analyzed according to the qualitative content analysis method using MAXQDA v. 2020. Results: After prolonged analysis of the data, the researchers extracted 644 codes, 13 subcategories, 4 categories, and 1 main theme. The main theme of the study was working in a context of occupational hazards. Conclusions: Operating rooms are full of potential dangers, which, when combined with the personnel's negligence and management inefficiencies, increase the risk of occupational health and safety. Therefore, making working conditions safe by providing adequate personal protective equipment (PPE), in-service training, and identifying and managing the causes of personnel negligence are recommended. Moreover, strategies should be introduced to manage stress and conflicts among the healthcare personnel, thus controlling psychological hazards.

Clinical and quality of life assessment in patients with latex allergy during COVID-19 pandemic: Possible protective role of continuous latex immunotherapy.

Introduction: During COVID-19 pandemic, the massive use of Personal Protective Equipment could provoke severe adverse reactions in latex allergy patients and could negatively affect their quality of life. Methods: Trough a survey the study aimed: (a) to evaluate the incidence of allergic reactions in patients with latex allergy during the SARS-CoV-2 pandemic; (b) to evaluate the protective role of continuous latex sublingual immunotherapy (SLIT) during this period; and (c) to evaluate quality of life of natural rubber latex allergy (NRLA) patients during the pandemic. Results: 67 patients (9 males and 58 females, mean age of 45.9 ± 11.4 years) suffering from latex allergy were included in the present study. We recorded among our patients 13 cases (34.2%) of urticarial/angioedema (U/A), 9 cases (23.6%) of respiratory symptoms (dyspnoea, shortness of breath and wheezing) and 7 cases (18.4%) of anaphylaxis. In patients who underwent continuous SLIT, we observed less cases of U/A (p < 0.001), respiratory symptoms (p < 0.001), anaphylaxis (p = 0.003), hospitalizations (p = 0.014) and a lower therapy administration. We compared the results of SF-36 questionnaire in patients who underwent continuous and not-continuous SLIT with a significance differences score between these two groups. Conclusions: Our study is the first that investigated the clinical and quality of life effects of COVID-19 pandemic in NRLA patients.

Characteristics of hand eczema in final-year apprentice nurses during the COVID-19 pandemic.

BACKGROUND: Apprentice nurses are considered at high risk to developing occupational skin diseases. OBJECTIVES: This study assessed the frequency and origin of hand eczema, and work-related risk factors in apprentice nurses. METHODS: The study involved 240 final-year apprentice nurses (females 75%, median age 19 years) from vocational schools in Zagreb, Croatia. The study was performed in 2020/2021 and included a questionnaire and clinical examination by means of the Osnabrück Hand Eczema Severity Index (OHSI). Skin prick test (SPT) with natural rubber latex (NRL) allergen, and patch test with the basic series of allergens, and disinfectants, were performed in 42 apprentice nurses with hand eczema that lasted more than 3 months. RESULTS: Clinically observed and self-reported hand eczema were found in 49% and 46% of apprentice nurses, respectively. Those with observed changes were older and reported more days per month spent on practical work than those with healthy skin (P = .001). Median OHSI was 4 (interquartile range 2-6). There were no positive SPTs to latex, and 11 (26%) apprentice nurses had positive patch test reactions to one or more tested allergens, mostly nickel. CONCLUSIONS: Hand eczema was common in final-year apprentice nurses during the COVID-19 pandemic. It was mostly of irritative origin, associated with the duration of practical training, confirming cumulative effect of hazards on skin barrier.