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1.
Int Arch Allergy Immunol ; : 1-11, 2022 Oct 24.
Article in English | MEDLINE | ID: covidwho-2088999

ABSTRACT

INTRODUCTION: The effect of the COVID-19 pandemic on allergic diseases is not certain, as people's living habits and the environment have been affected by the pandemic. The present study described the influence of the COVID-19 pandemic on the allergen sensitization rate in patients with allergic diseases in central China. The results provide reliable epidemiological data for the prevention and control of allergic diseases during the COVID-19 epidemic. METHODS: Data were collected from a total of 6,915 patients with symptoms of allergic diseases who visited the Third Xiangya Hospital of Central South University in China for allergen testing from January 1, 2018, to December 31, 2021. Patients were divided into a children group (<14 years old), youth group (15∼44 years old), middle-aged group (45∼59 years old), and elderly group (>60 years old). Immunoblotting was used to detect 20 serum allergen-specific IgE (sIgE) antibodies in patient serum samples. We compared the positive rates of various allergens in different age and sex groups before and during the COVID-19 epidemic, and the prevalence data of sIgE sensitization were analysed. RESULTS: Among the 6,915 patients with symptoms of allergic diseases, 2,838 (41.04%) patients were positive for at least one of the allergens. The top three positive rates of inhaled allergens were Dermatophagoides farinae (1,764 cases, 25.51%), Dermatophagoides pteronyssinus (1,616 cases, 23.37%), and house dust (645 cases, 9.33%). The top three positive rates of food allergens were eggs (686 cases, 9.92%), milk (509 cases, 7.36%), and crabs (192 cases, 2.78%). The total positive rate of allergens was higher in men (46.99%) than in women (37.30%). Compared to 2 years before the COVID-19 epidemic, the rate of sensitization to indoor inhalant allergens increased, but outdoor inhalant allergens showed no significant change. The positive rates of milk and eggs peaked during the outbreak of COVID-19 (2020) then declined in 2021. The total positive rate of allergens was higher in males than females before and during the COVID-19 epidemic, but more allergens were different between males and females during the pandemic. Compared to middle-aged and older adults, the children and youth groups were more susceptible to allergic diseases, and they exhibited an increasing positive rate for most common allergens, especially indoor inhalant allergens, during the COVID-19 epidemic than before the pandemic. CONCLUSION: D. pteronyssinus and D. farinae are the most common allergens in South China. Under the background of normalization of epidemic prevention, indoor inhaled allergens should be first in the prevention and control of allergic diseases, and a combination of various indoor cleaning measures should be used to improve the efficiency of interventions.

2.
Chest ; 162(4):A59-A60, 2022.
Article in English | EMBASE | ID: covidwho-2060534

ABSTRACT

SESSION TITLE: Poster Cases in Asthma and Allergy SESSION TYPE: Case Report Posters PRESENTED ON: 10/17/2022 12:15 pm - 01:15 pm INTRODUCTION: Anaphylaxis is an acute, potentially life-threatening, systemic allergic reaction that presents as a multitude of manifestations after exposure to an allergen. It is rare to have an anaphylactic reaction to the SARS-Cov-2 vaccine, however, we present a patient who had a prolonged anaphylactic reaction to the SARS-CoV-2 virus itself. CASE PRESENTATION: A 23-year-old female with past medical history of chronic idiopathic urticaria and dermatographism presented with fatigue, rash, rhinitis, and lip swelling in the setting of being COVID-19 positive. She had received two doses of the Pfizer-BioNTech COVID-19 vaccine nine months prior without any adverse affects. During the SARS-CoV-2 Omicron variant surge, the patient was exposed to a family member who had contracted COVID-19 infection. Two days prior to presentation, she started having a diffuse rash throughout her body. In the Emergency Department, she was given IM epinephrine x2, IV Solu-Medrol and IV Benadryl with temporary improvement in her symptoms. She developed hypotension that required initiation of a continuous epinephrine infusion and was admitted to the Medical Intensive Care Unit. Each time the epinephrine was held, generalized urticaria recurred and she would become hypotensive with her systolic blood pressure decreasing below 80 mmHg. The urticaria completely resolved and her blood pressure improved when the epinephrine infusion was restarted. The patient was treated with remdesivir, Solu-Medrol, loratadine, and famotidine. She was able to be weaned off the epinephrine infusion over the course of four days. Immunological workup was unremarkable apart from elevation of IL-10 on her cytokine panel. DISCUSSION: The symptoms and syndromes associated with COVID-19 infection remain diverse and while urticaria has been a documented manifestation of the virus, it is uncommon (1). There is a single case report of an anaphylactic reaction in response to COVID-19 (2). Given our patient's symptoms were temporally related to the COVID-19 infection, we believe the SARS-COV-2 virus was the trigger. She did not have any other exposure during this time. This case is unique in that the virus not only triggered the urticaria, but that her symptoms persisted for four days. After receiving antiviral therapy plus steroids and antihistamines, her symptoms finally resolved. The SARS-COV-2 virus itself is primarily attacked by immune cells, including mast cells, which release an array of proinflammatory cytokines (3). We postulate that in our patient, her history of chronic urticaria predisposed her to an exaggerated inflammatory response. CONCLUSIONS: SARS-CoV-2 has clinically presented itself in a multitude of ways across many disciplines. In a patient with a history of urticaria, prolonged anaphylactic symptoms can be triggered by the virus itself. Reference #1: Adeliño R., Andrés-Cordón J.F., De la Cruz Martínez C.A. Acute urticaria with angioedema in the setting of coronavirus disease 2019. J Allergy Clin Immunol Pract. 2020;8(7):2386–2387. Reference #2: Alvarez-Perea A, Baeza ML. Anaphylactic shock following the diagnosis of coronavirus disease 2019. Ann Allergy Asthma Immunol. 2020;125(4):477-478. Reference #3: Kritas SK, Ronconi G, Caraffa A, Gallenga CE, Ross R, Conti P. Mast cells contribute to coronavirus-induced inflammation: new anti-inflammatory strategy. J Biol Regul Homeost Agents. 2020 January-February,;34(1):9-14. DISCLOSURES: No relevant relationships by Brianne Navetta-Modrov No relevant relationships by Azzam Paroya Speaker/Speaker's Bureau relationship with Bayer Please note: current Added 03/30/2022 by Paul Strachan, value=Honoraria Speaker/Speaker's Bureau relationship with United Therapeutics Please note: more than 5 years Added 03/30/2022 by Paul Strachan, value=Honoraria Speaker/Speaker's Bureau relationship with Gilead Please note: $1001 - $5000 by Paul Strachan, value=Honoraria Removed 03/30/2022 by Pau Strachan Speaker/Speaker's Bureau relationship with Genentech Please note: $5001 - $20000 by Paul Strachan, value=Honoraria Removed 03/30/2022 by Paul Strachan Speaker/Speaker's Bureau relationship with Boehringer Ingelhein Please note: More than 5 years Added 03/30/2022 by Paul Strachan, value=Honoraria Stock Ownership relationship with Pfizer Please note: Purchased in 2000-2002 Added 03/30/2022 by Paul Strachan, value=nothing, I purchased stock Speaker/Speaker's Bureau relationship with Portola Please note: $1001 - $5000 by Paul Strachan, value=Honoraria Removed 03/30/2022 by Paul Strachan Stock Ownership relationship with Portola Please note: $5001 - $20000 by Paul Strachan, value=nothing, I purchased stock Removed 03/30/2022 by Paul Strachan Stock Ownership relationship with La Jolla Pharmaceuticals Please note: Purchased a few years back Added 03/30/2022 by Paul Strachan, value=nothing, I purchased stock Stock Ownership relationship with Seatle Genetics Please note: Purchased more than 5 years ago Added 03/30/2022 by Paul Strachan, value=nothing, I purchased stock PI relationship with United Therapeutics Please note: Current Added 03/30/2022 by Paul Strachan, value=Grant/Research Support PI relationship with Actelion/Janssen Please note: Current Added 03/30/2022 by Paul Strachan, value=Grant/Research Support PI for clinicial trial relationship with Roche Please note: Current Added 03/30/2022 by Paul Strachan, value=Grant/Research PI for clinicial trial relationship with Bellerophon Please note: Current Added 03/30/2022 by Paul Strachan, value=Grant/Research Support Speaker/Speaker's Bureau relationship with Actelion/Janssen Please note: Current Added 03/30/2022 by Paul Strachan, value=Honoraria

3.
Journal of Comprehensive Pediatrics ; 13(Supplement 1):14-15, 2022.
Article in English | EMBASE | ID: covidwho-2058188

ABSTRACT

Severe allergic reactions to vaccines are rare and occur approximately once per million administrations. The most severe form of an immediate reaction is anaphylaxis, usually IgE-mediated, and may cause death. Immediate reactions with features of anaphylaxis have been reported after immunization with COVID-19 vaccines, mainly after the mRNA vaccines. The reported incidence of 2.5 to 4.7 events per million administrations of mRNA vaccines is higher than reported rates of anaphylaxis (1 per million) with other vaccines. Anaphylaxis after injection of other COVID-19 vaccines has also been reported, although to a lesser extent. Many individuals who experienced possible anaphylaxis to COVID-19 vaccines had a history of allergy to various other allergens. While a history of anaphylaxis to other substances (e.g., foods, drugs, insect stings) is not a contraindication to vaccination, it is recommended that such individuals remain for 30 minutes of observation after receiving the injection, rather than the 15 minutes recommended for all other vaccine recipients. History of anaphylaxis after receiving other vaccines or the first dose of COVID-19 vaccine is a contraindication of COVID-19 vaccine injection. As with any vaccine, all vaccination sites should be equipped with the medications (epinephrine) and staff required to treat possible anaphylactic reactions. Mast cell-mediated reactions may involve various combinations of up to 40 potential symptoms and signs, which typically begin within minutes to an hour of vaccination, but can rarely be delayed beyond this time frame. It is also essential to understand that some other reactions to vaccines can mimic anaphylaxis, including vasovagal reactions and anxiety-related symptoms.

4.
Rev Infirm ; 71(282): 30-32, 2022.
Article in French | MEDLINE | ID: covidwho-2049878

ABSTRACT

Allergy is a frequent and often disabling condition for the patients. In the context of allergic rhinitis and asthma or anaphylactic shock to hymenoptera venom, allergenic desensitization can be proposed to limit the symptoms or recurrence of major reactions. Access to this treatment is made difficult by a lack of allergists, a lack of products or, more recently, by the Covid-19 crisis.


Subject(s)
Anaphylaxis , Arthropod Venoms , COVID-19 , Allergens , Anaphylaxis/etiology , Anaphylaxis/therapy , Desensitization, Immunologic , Humans
5.
Food Research ; 6(4):407-412, 2022.
Article in English | EMBASE | ID: covidwho-2044349

ABSTRACT

Nutritional labelling is the nutritional description of the food on the label to help the consumer in food selection. The present study aimed to assess the knowledge, attitude and practices adopted by the subjects and correlate them to have a better understanding of their nutritional background. Nutrition labels are a prominent first-glance article that needs to be very catchy and easy to interpret. The organizations responsible for formulating the rules and regulations must keep them updated and devise new formats of the display to enhance the usage of food labels up to the maximum possible level. A cross-sectional research study on 100 working women of Varanasi, aged between 20-50 years was conducted through a self-structured questionnaire to evaluate their KAP level. In view of the COVID-19 pandemic, the questionnaire was administered to the respondents through the online medium using Google forms. It can be inferred from the study that 58 % of the total respondents surveyed were aware of the labels, 61% of them had a positive attitude towards its usage but only 52% practised healthy shopping more often. About 70% of the participants preferred back-of-pack labelling rather than front-of-pack because the former provides elaborative information. The factors like qualification and occupation of women participants had negative associations with the satisfaction of the display format. The women having knowledge regarding traffic light labelling showed a positive association with the usefulness of the same. The average practice percentage adopted by the consumers had a negative association with factors like qualification, income, and occupation. The need for simplifying the display format and providing basic nutrition information to the population is highlighted in this study.

6.
Allergol Immunopathol (Madr) ; 50(5): 57-60, 2022.
Article in English | MEDLINE | ID: covidwho-2025812

ABSTRACT

Allergen immunotherapy (AIT) is a common treatment for patients with allergic asthma and allergic rhinoconjunctivitis. There is evidence that the COVID-19 pandemic could have altered the administration of AIT in patients in some countries, as the pandemic caused major limitations to healthcare access and delivery. The objective of this study was to evaluate the impact of the disruption imposed by the pandemic on the perceptions and administration of AIT therapies in Italy. An online survey was carried out among Italian allergists between 22 February 2021 and 12 April 2021. The results show that Italian physicians (N=66) did not consider that the COVID-19 pandemic presented an added risk to patients with allergic asthma or rhinitis receiving AIT. Although most treatments continued, there were reduced rates of AIT therapy initiations and sublingual AIT was favored over subcutaneous AIT.


Subject(s)
Asthma , COVID-19 , Sublingual Immunotherapy , Asthma/therapy , COVID-19/epidemiology , COVID-19/therapy , Desensitization, Immunologic/methods , Humans , Pandemics
7.
Journal of General Internal Medicine ; 37:S463, 2022.
Article in English | EMBASE | ID: covidwho-1995748

ABSTRACT

CASE: A 61-year-old male with self-reported coronary artery disease (CAD), Hypertension, and bipolar disorder who presented to the Emergency Room with dyspnea. STAT chest CT angiography (CTA) was negative for pulmonary embolism but it demonstrated scattered patchy ill-defined bilateral ground-glass opacities concerning for possible atypical viral pneumonia. Basic work-up showed elevated WBC count and lactic acid. He was started on supportive management and empirical Ceftriaxone and Azithromycin. While on the hospital floor, he started to have sinus- tachycardia and hypoxia necessitating escalation in supplemental oxygen delivery modality. He was later transferred to the ICU. Patient's hypoxic respiratory failure was suspected to be an acute process strongly including COVID-19 pneumonia. Acute bacterial insult was also considered as the WBC count was elevated and this consideration discouraged against starting immunosuppressive regimen targeted against possible COVID-19 pneumonia. A repeat CT scan of the chest was ordered to better highlight the pulmonary findings. The study could not be completed as the patient was unable to lie flat and was developing hypoxia. The diastolic blood pressure (DBP) was noted be elevated and STAT chest xray showed flash pulmonary edema. The patient was started on IV diuretics and potent IV antihypertensive medications. He had not seen a physician for a long time and the medical charts were deficient. The patient soon disclosed that he had recently used synthetic form of inhaled cannabinoids and that he had a similar episode after using synthetic inhaled cannabinoids one year prior. In the meantime, the patient tested negative the second time for COVID-19 infection. Taking these new developments into consideration, the suspicion for an infective pulmonary process did not remain very strong. He was started on IV steroids to address possible hypersensitivity pneumonitis which resulted in prompt and drastic improvement in his respiratory status. IMPACT/DISCUSSION: The patient's unknown COVID-19 vaccination status, pulmonary imaging findings, and the sudden respiratory decompensation very strongly supported possible COVID-19 pneumonia. Acute bacterial pneumonia was also on the differential diagnoses list. The patient's active bipolar disorder made history-taking quite challenging. Since the treatment modalities targeted against the possible etiology of his respiratory failure varied greatly, the need for a clinical diagnosis was imperative. CONCLUSION: Medical history-taking is the backbone of medical practice. It has the highest yield when it comes to patient management. Our patient presented with a spectrum that would be applicable to multiple pathological processes but at the end it was a case of hypersensitivity pneumonitis to a known allergen that was complicated by the presence of hypertensive urgency. IV steroid initiation made significant improvement in the patient's respiratory status as evidenced by the promptly decreasing supplemental oxygen need.

8.
Clin Transl Allergy ; 12(5): e12152, 2022 May.
Article in English | MEDLINE | ID: covidwho-1940789

ABSTRACT

Background: Sars-CoV-2 infections are hazardous, especially to the elderly and patients with comorbidities. With no efficient treatment available, newly developed vaccines are the only way to change the course of the pandemic. However, reports of allergic reactions resulted in some patients and practicing physicians being concerned about the safety of vaccine administration, particularly in people with severe anaphylactic reactions to multiple or unknown factors in their medical history.This study aimed to develop an allergic work-up protocol based on skin prick tests (SPT), intradermal testing (IDT) and intramuscular provocations, and desensitisation which may contribute to diagnosis and management of anti-COVID-19 vaccine allergy. Methods: Two hundred and eighty-five patients were enrolled. Two hundred and five of them entered the study based on severe anaphylactic reaction to unknown or multiple factors in their medical history which disqualified them for standard treatment. Another 80 patients were enrolled after developing an allergic reaction to the first dose of one such vaccine. In all subjects, SPT and IDT were performed. Serum tryptase was assessed in 79 patients randomly chosen from the study group. Results: Two hundred and seventy-seven patients with negative tests were given a vaccine without complications. Seven patients had positive skin tests. In two cases, tests confirmed Comirnaty allergy, while the other five confirmed solely skin sensitisation with no exposure prior to the study. Six patients with positive tests received titrated challenge using desensitisation protocol with a reasonable tolerance. One patient did not consent to desensitisation and one patient resigned despite negative tests. Overall, 283 (99%) patients were vaccinated using this newly developed protocol. Patients with adverse reactions to the first dose of the vaccine before the study had a significantly lower basal serum tryptase concentration (p = 0.001). Conclusion: Skin tests with anti-COVID-19 vaccines are a useful tool in the vaccination protocol. This protocol enables safe immunisation of high-allergy-risk patients even in cases of positive skin tests.

9.
American Journal of Respiratory and Critical Care Medicine ; 205(1), 2022.
Article in English | EMBASE | ID: covidwho-1927844

ABSTRACT

RATIONALE: Over 400,000 individuals are estimated to have been exposed to the fallout of the World Trade Center (WTC) disaster. The incidence of acquired allergy and lung injury among rescue and cleanup workers exposed to the WTC fallout has been established. Briefly, rescue and cleanup workers exposed to the WTC fallout had a high incidence of allergic hypersensitivity and permanent small airways dysfunction characterized by distal airways narrowing and airway hyperresponsiveness. The current study sought to quantify the utilization of allergy/immunology services among rescue and cleanup workers exposed to the WTC fallout. METHODS: Subjects (N=65) were referred from the WTC Health Program to a multispecialty allergy/immunology and pulmonology clinic for provision of allergy-immunology specialty services. Electronic health records of all subjects were retrospectively reviewed from the date of first referral to March 2020-when routine care was interrupted due to the coronavirus disease 2019 pandemic-to quantify utilization of allergy/immunology and pulmonology services;10 subjects were excluded from analysis due to incomplete health records. RESULTS: On average, time to referral for allergy-immunology services by the WTC Health Program was 15.2 years (SD=1.7). The majority of the subjects were male (89.1%), police officers (67.3%) who never smoked (65.5%) and had no history of allergic or respiratory disease prior to being exposed to the WTC fallout. Most were found to have environmental allergies (83.6%);the most common comorbidities were allergic rhinitis (89.1%), asthma (67.3%), and chronic sinusitis (63.6%). All subjects underwent environmental allergy testing. Most subjects-35 of 55 (63.6%)-were prescribed an epinephrine autoinjector for environmental allergies. Regarding allergic immunotherapy (IT), 33 of 55 (60.0%) received IT;additionally, 7 subjects (12.7%) were determined to be IT candidates but did not receive IT. The most common monoclonal antibody therapy used in this cohort was omalizumab (18.2%). Only 11 (20.0%) and 3 (5.5%) underwent serum IgE and IgG testing, respectively. CONCLUSION: Rescue and cleanup workers referred to a multispecialty allergy/immunology and pulmonology practice from the WTC Health Program not only had a high incidence of acquired allergies to environmental allergens, but the majority were prescribed and epinephrine autoinjector and either received or were candidates to receive allergy immunotherapy. Given that hundreds of thousands of individuals were exposed to the WTC fallout and exposure is an independent risk factor for developing allergic disease, this research may have identified ways we may be falling short in providing allergy/immunology services to exposed individuals.

10.
American Journal of Respiratory and Critical Care Medicine ; 205(1), 2022.
Article in English | EMBASE | ID: covidwho-1927706

ABSTRACT

Rationale We have previously reported blocking the IL-25 receptor (IL-17RB) prevented viral increased allergic airways inflammation and this was associated with reduced lung viral load. To investigate IL-25 regulation of airway anti-viral immunity we hypothesised that IL-25 directly inhibits airway epithelial cell (AEC) type I/III interferon expression and antibody blockade of IL-25 in vivo boosts lung interferon expression and reduces lung viral load in parallel with reduced type 2 airway inflammation. Methods In vitro Immunofluorescence was used to visualise epithelial IL-25 and IL- 17RB proteins in endobronchial biopsies from patients with asthma and healthy subjects and in AEC differentiated at ALI. AEC from n = 14 donors with asthma were differentiated at the air-liquid interface (ALI) and infected with RV-A1, MOI=0.1. A subset of AECs was treated with anti-IL-25 mAb (LNR125) before infecting with RV-A1 or human coronavirus 229E. Differentiated AEC from healthy donors were treated with recombinant IL-25 protein and infected with RV-A1. Nanostring immune transcriptomic data expressed as digital mRNA counts for exact copy number or was expressed as log2 fold change ratio against -log10 Bejamini-Yekutieli-corrected p-values. In vivo 6- 8-week-old, BALB/c mice sensitised and intranasally challenged daily for 3 days with ovalbumin to induced allergic airways disease. A single subcutaneous injection of 250 μg LNR125 was administered during ovalbumin challenge. Mice were then infected i.n. with RV-A1, 6 hours after final allergen challenge. On day 1 and day 7 post-infection, BAL were collected, lung lobe tissue was collected for viral RNA and cytokine expression. Results IL-25 and IL-17RB were constitutively expressed at the apical surface of airway epithelium in biopsies and AEC cultures. RV infection increased IL-25 expression by AEC from asthmatic donors. LNR125 treatment reduced IL-25 mRNA and significantly increased RV induced IFN-β a and IFN-λ protein expression and this was confirmed by Nanostring transcriptomic analyses which also identified down-regulated type-2 immune genes CCL26 (eotaxin 3) and IL1RL1(IL-33 receptor). LN125 treatment also increased IFN-λ expression by 229E-infected differentiated AECs. IL-25 treatment increased viral load associated with 50% reduced expression of IFN-β and CXCL10 and 75% reduced IFN-λ. Allergen challenged, RV-infected mice treated with LNR125 had significantly increased BAL IFN-β protein and 60% reduction in lung viral load associated with reduced IL-25, IL-4, IL-5 and IL-13 BAL proteins compared to controls. Conclusion IL-25-induced inflammation combined with suppression of AEC anti-viral immunity identify IL-25 as a central mediator of viral asthma exacerbations and therefore a target for mAb-based treatment.

11.
Contact Dermatitis ; 86(SUPPL 1):47-48, 2022.
Article in English | EMBASE | ID: covidwho-1927570

ABSTRACT

Background: A 29-year-old woman, with personal history of atopy, presented with face and neck dermatitis lasting 6 months. During the past year, she worked as a nurse in a COVID-19-dedicated ward. The dermatitis had developed since she started using FFP2 masks. She referred using three FFP2 masks, with similar symptoms: 3 M© 9320+, Halyard© Fluidshield N95 and PM 2.5©. She also mentioned history of contact-hypersensitivity reactions to metals, green clothes and leather shoes for several years. Physical examination exhibited erythematous plaques distributed along the contact area of the elastic bands of the FFP2 masks. Patch tests revealed delayed hypersensitivity to the elastic bands 3 M© 9320+ and PM 2.5© (++), mercapto mix (++), 2-mercaptobenzothiazole (MBT) (++), 2-(4-morpholinylmercapto)benzothiazol (MOR) (++), N-cyclohexyl-2-benzothiazolesulfenamide (++), textile dye mix Mx-30 (++), disperse yellow 3 (++), disperse blue 106 (+), potassium dichromate (+), cobalt dichloride (+) and nickel sulfate hexahydrate (+). A latex skin prick test was negative. Allergic contact dermatitis (ACD) caused by elastic bands of FFP2 masks (3 M© 9320+ and PM 2.5 ©) was diagnosed. She was prescribed methylprednisolone aceponate 0.1% cream bid during five days and masks were changed to a type with cotton cloth bands, with resolution of the complaints. ACD to FFP2 masks components in health care workers can be severe, given the prolonged and continuous contact with the source of allergens. The rubber additives thiurams and dithiocarbamates are the main allergen groups involved in ACD to rubber bands in FFP2 masks. This seems to be the first report caused by mercaptobenzothiazole.

12.
Contact Dermatitis ; 86(SUPPL 1):49, 2022.
Article in English | EMBASE | ID: covidwho-1927569

ABSTRACT

Background: In the last 10 year prior to the COVID-19 pandemic approximately 1 healthcare worker (HCW) per year has been investigated for suspected occupational facial skin disease at our department. In contrast, during the present pandemic several HCWs has been investigated because of suspected occupational facial skin disease. Objectives: To report the findings in consecutively investigated HCWs with occupational facial skin disease. Methods: More than 40 HCWs has been investigated including patch test with their own face mask as is and with acetone extracts of the masks. Chemical analyses of potential allergens been performed in a number of different brands of face masks. Results: In all cases the skin disease was of recent onset. The most common diagnoses were irritant dermatitis and acne or acne-like eruptions including perioral dermatitis. No occupational contact allergies were found, and all patch tests with face masks were negative. Chemical analysis indicated colophonium-related substances in one brand of face mask. Conclusions: Based on referral pattern there has been increase of occupational facial dermatitis during the pandemic. Irritant factors like occlusion and friction appears to be the most common cause while contact allergy to the masks were not detected in this population.

13.
Immunologiya ; 43(2):224-234, 2022.
Article in Russian | EMBASE | ID: covidwho-1897334

ABSTRACT

SARS-CoV-2 is the cause of COVID-19, which has a serious effect on the lower respiratory system. COVID-19 causes bilateral pneumonia and acute respiratory syndrome. Smell disorders are important diagnostic symptoms of COVID-19. This symptom is detected in about 90 % of cases. Anosmia may be the first or even the only symptom and may appear before other symptoms of SARS-CoV-2 infection. In the context of the COVID-19 epidemic, anosmia can be considered a clinical diagnostic criterion when laboratory tests are not available. The sense of smell is one of the most important senses needed to gain information about the environment. Anosmia can occur in both COVID-19 and allergic rhinitis (AR), which can make it difficult to detect the origin of these symptoms and make a diagnosis in the context of the COVID-19 pandemic. Research results indicate AR is not an aggravating factor for COVID-19. Comorbidity of AR does not affect the reduction of the sense of smell in patients with COVID-19. Patients with AR are recommended to use antihistamines and intranasal corticosteroids for relief of symptoms. Control of AR symptoms can help prevent the spread of SARS-CoV-2 infection. It can be assumed that both local and oral corticosteroids at COVID-19 can be regarded as effective in the treatment of olfactory dysfunction. To restore the sense of smell in patients with AR and COVID-19, experts recommend regular olfactory training, which, at the moment, is the only modern scientifically based therapy for restoring post-viral loss of smell. The use of face masks and respirators during a pandemic aims to minimize exposure to allergens and the SARS-CoV-2 virus. However, prolonged wearing of masks and respirators makes breathing even more difficult with rhinitis caused by AR or COVID-19, which reduces the quality of life and worsens the clinical picture.

14.
Australasian Journal of Dermatology ; 63(SUPPL 1):21-22, 2022.
Article in English | EMBASE | ID: covidwho-1883170

ABSTRACT

Aim: Occupational contact dermatitis (OCD) is common amongst healthcare workers (HCW). This retrospective study describes the causes of allergic contact dermatitis in HCW in New Zealand and reviews the current literature review on OCD in HCW during the COVID-19 pandemic. Material and Methods: All HCW undergoing patch testing between July 2008 and January 2020 at a public hospital patch-test clinic, and between June 2019 and January 2020 at a private dermatology clinic were included. Data collected included patient demographics, occupation, results of patch testing and pre and post-patch test diagnoses. Literature search was performed on Pubmed with keywords: healthcare workers, occupational, allergic contact dermatitis (ACD), irritant contact dermatitis (ICD), COVID-19. Results: Out of 837 patients patch tested during the study period, 67 were HCW. The mean age of HCW was 41 years (standard deviation 14) and 58 (87%) were female. The most common occupations were nurses (40%), allied health (22%) and doctors (18%). Forty-six (69%) patients had a background of atopic dermatitis. Hand dermatitis was the most common presentation (49%), followed by facial/neck dermatitis (25%). The most common relevant positive reactions were to rubber accelerators (24%), fragrances (16%), perservatives (15%) and topical steroids (9%). Literature review reflects that the incidence of ICD increased significantly due to increased frequency of hand washing and use of personal protective equipment during the COVID-19 pandemic. Contemporary data regarding ACD is limited. Conclusion: The most common allergens in HCW are rubber chemicals, fragrances and preservatives. The COVID- 19 pandemic has highlighted the incidence of OCD amongst HCWs. While rates of ICD have risen, data does not yet suggest increased rates of ACD.

15.
J Pers Med ; 12(5)2022 May 10.
Article in English | MEDLINE | ID: covidwho-1875655

ABSTRACT

Allergic diseases are particularly suitable for personalized medicine, because they meet the needs for therapeutic success, which include a known molecular mechanism of the disease, a diagnostic tool for that disease and a treatment that blocks this mechanism. A range of tools is available for personalized allergy diagnosis, including molecular diagnostics, treatable traits and omics (i.e., proteomics, epigenomics, metabolomics, transcriptomics and breathomics), to predict patient response to therapies, detect biomarkers and mediators and assess disease control status. Such tools enhance allergen immunotherapy. Higher diagnostic accuracy results in a significant increase (based on a greater performance achieved with personalized treatment) in efficacy, further increasing the known and unique characteristics of a treatment designed to work on allergy causes.

16.
Rassegna di Patologia dell'Apparato Respiratorio ; 37(1):57-60, 2022.
Article in Italian | EMBASE | ID: covidwho-1870302

ABSTRACT

The basophil activation test (BAT) is a flow cytometric assay that evaluates the percentage of activation or degranulation of peripheral blood basophils, after “in vitro” exposure to specific allergens. In sensitized patients, the stimulation of peripheral blood basophils with a specific allergen induces or up-regulates the expression of molecules, such as CD63 and CD203c, which represent, markers of degranulation and activation of basophils, respectively. The validity of the BAT requires a negative control (sterile saline) and a positive control (anti-IgE molecules). Several studies have demonstrated the role of the BAT in supporting the diagnosis of drug, food and hymenoptera venom allergy. The BAT has shown a low sensitivity but good specificity in diagnosing allergy to drugs such as NSAIDs, beta-lactam antibiotics, quinolones and muscle relaxants. In food allergy, the sensitivity and specificity of the BAT depends on the food;in the case of peanut allergy the sensitivity reaches 96% while the specificity the 100%. In addition, the BAT is an useful tool to monitor the natural resolution of allergies and the clinical effects induced by either immunotherapy or anti-IgE treatment. Finally, the BAT has been utilized to study the pathogenetic mechanisms underlying several IgE-mediated diseases. For example, in patients affected by severe bronchial asthma, the BAT has demonstrated the ability of Staphylococcus aureus enterotoxins to induce the activation of basophils supporting the role of these enterotoxins as “triggers” of the inflammatory cascade in bronchial asthma. In patients with cystic fibrosis the BAT can be used to dis-criminate allergic bronchopulmonary aspergillosis from Aspergillus colonization. More recently, the BAT has been demonstrated as a potential diagnostic tool to evaluate allergy to the polyethylene glycol (PEG) present in the anti-SARS-CoV-2 BNT162b2 mRNA vaccine.

17.
Asthma Allergy Immunology ; 19(3):174-182, 2021.
Article in English | EMBASE | ID: covidwho-1856522

ABSTRACT

Objective: The clinical features of COVID-19 range from asymptomatic disease to severe pneumonia or even death. Therefore, many researchers have investigated the factors that could affect the severity of COVID-19. We aimed to assess the impact of aero-allergen sensitization and allergic diseases on the severity of COVID-19. Materials and Methods: We included 60 adult patients with symptomatic COVID-19 and allocated them into two groups equal in number as having severe and non-severe COVID-19. We evaluated the demographic features and allergic diseases in addition to clinical, laboratory and radiological findings of COVID-19. Skin prick tests (SPTs) with common aero-allergens, serum total IgE levels and blood eosinophil counts were evaluated 3 months after the patient's recovery from COVID-19. Results: The mean age of the patients was 52 ± 11 years and 73.3% of the patients were male. There was no significant difference between the two groups in terms of age, gender, smoking habits, obesity and comorbidities. Although the frequency of sensitization to aeroallergens and the allergic diseases were similar, the history of allergic diseases in the family was higher in the severe group (p<0.001). The polysensitization in SPTs was associated with the presence of a cytokine storm during the infection (p=0.02). Total IgE levels and blood eosinophil counts were not significantly different between the two groups. Conclusion: The presence of atopy or allergic diseases does not seem to be related to the severity of COVID-19. However, polysensitization and a family history of allergic diseases are more prominent in those having a cytokine storm and severe COVID-19, respectively.

19.
Asia Pac Allergy ; 12(1): e6, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1818572

ABSTRACT

BACKGROUND: Allergen-specific immunotherapy (AIT) is accepted as the only disease-modifying therapy for IgE-mediated allergic airway diseases and hymenoptera venom allergy. AIT requires repeated contact between patient and physician or nurse in the hospital. Because it is a long-term treatment, compliance is essential issue to obtain maximal efficacy. Coronavirus disease 2019 (COVID-19) pandemic reshaped doctor-patient interaction and pattern of hospital admissions. OBJECTIVE: We aimed to determine the possible changes in the administration of AIT and associated factors, in addition to the characteristics of patients diagnosed with COVID-19 infection. METHODS: Adult patients who underwent AIT for hymenoptera venom allergy, allergic rhinitis or allergic asthma between 11 March 2020 and 31 January 2021 were included in our retrospective study. Perennial and preseasonal AIT practices were evaluated. We identified patients with COVID-19 infection among the ones who received AIT. RESULTS: The mean age of 215 patients was 37.8±11.9 years and 52.1% of the patients were female. In our study, 35.4% of perennial AIT patients did not continue treatment after the COVID-19 pandemic, and the cause was patient-related in 66.7% of the cases. Compliance was 70.7% in patients receiving perennial AIT. The highest compliance rate for AIT was for venom allergy (86.5%). Thirty-four patients (15.8%) were diagnosed with COVID-19 infection. No mortality due to COVID-19 infection was observed in those who underwent AIT. CONCLUSION: COVID-19 pandemic has reduced compliance to AIT. Compliance was higher in venom immunotherapy than in aeroallergens. Severe COVID-19 infection and COVID-19 related death were not observed in patients receiving AIT.

20.
Vaccines (Basel) ; 10(4)2022 Apr 08.
Article in English | MEDLINE | ID: covidwho-1810351

ABSTRACT

Vaccines against infectious diseases may raise safety concerns in patients undergoing allergen immunotherapy (AIT). The objective of our study was to investigate influenza vaccine and other selected prophylactic vaccines coverage in patients treated with AIT and the attitude of physicians towards vaccinations in this group of patients. We conducted a questionnaire-based study among patients undergoing AIT and physicians. The patients' survey evaluated influenza and other prophylactic vaccines coverage. The physicians' survey assessed their experience and opinions on prophylactic vaccinations during AIT. In total, 176 patients (aged 18-79 years) and 120 doctors filled the questionnaires. Patients were assigned to two groups-inhaled allergens group (n = 101) and insect venoms group (n = 68). The number of patients who received any dose (36% and 45%, p = 0.26), as well as two or more doses (17% and 22%, p = 0.43) of influenza vaccine was comparable between two groups. However, in both groups there was a significant (p < 0.0001) decrease in influenza vaccine uptake after the beginning of AIT. Patients from the inhaled allergens group declared a higher tetanus vaccine rate (41% vs. 19%, p = 0.004). The groups did not differ in the pneumococcal and tick-borne encephalitis vaccination coverage. A majority of doctors believe that prophylactic vaccinations in patients undergoing AIT are safe and effective (96% and 94%, respectively); however, as many as 87% of them identify with the need to create clear recommendations regarding vaccinating patients undergoing AIT. Prophylactic vaccine coverage is not satisfactory among Polish adult patients undergoing AIT. Polish doctors are convinced of the validity of prophylactic vaccinations during AIT.

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