Pediatric asthma control during the COVID-19 pandemic.

BACKGROUND: The lockdown imposed by the COVID-19 pandemic resulted in a completely different style of life with possible effects on the attitude toward their disease in patients with chronic lung disease, such as asthma. The aim of our study was to investigate in asthmatic children the level of asthma control and the maintenance therapy used during the lockdown. METHODS: Among asthmatic children attending our clinic, we identified those who had been prescribed the same therapy in March-April 2019 and March-April 2020. The level of asthma control (GINA-score) and the maintenance therapy used during the lockdown (March-April 2020) were compared with those of March-April 2019. We separately analyzed a small group of children with severe asthma treated with Omalizumab during the lockdown. RESULTS: We enrolled 92 asthmatic children (67 males). Compared to 2019, in 2020 a higher proportion of children modified their maintenance therapy (38% vs. 15.2%, p < .001), with a significant increase in both the proportion of children who increased (p = .033) and in that of children who decreased their therapy (p = .026). The level of control resulted as significantly higher in 2020 (March p = .023; April p = .007). Also, the 13 children treated with Omalizumab showed a good level of control in 2020. CONCLUSIONS: In asthmatic children, the COVID-19 pandemic lockdown had a significant impact on their asthma control and on their attitude toward maintenance therapy.

Aeroallergen sensitization in school-age children with allergic rhinitis: What has changed during the COVID-19 pandemic?

BACKGROUND: Pandemic period may affect aeroallergen sensitization. OBJECTIVE: The study aimed to investigate changes in allergen sensitivities of skin prick test (SPT) in patients with allergic rhinitis (AR) during pandemic and to evaluate relationship with disease severity. METHODS: In all, 164 AR patients with or without asthma, aged 6-17 years, who have undergone SPTs prior to the pandemic and after October 1, 2021 (18th month of the pandemic), were evaluated retrospectively. The wheal size of allergens in performed SPTs during and prior to the pandemic were compared. Detected changes in allergen sensitivities via SPT results were compared with changes in the disease severity parameters (AR severity, asthma severity, and the number of asthma exacerbations per year), frequency of upper respiratory tract infections and antibiotic use, laboratory parameters, demographic characteristics, and visual analogue scores (VAS). RESULTS: House dust mites (HDMs), cat, pollen, Artemisia, and Cupressus sensitization increased in AR patients during the Coronavirus disease 2019 (COVID-19) pandemic. HDM, mold, and pollen wheal diameters increased in SPTs. Proportion of polysensitization increased during the pandemic, compared to pre-pandemic period (9.1% vs 3%; P < 0.001), and number of non-sensitized patients decreased during the pandemic period compared to the pre-pandemic period (7.9% vs 22.6%; P < 0.001). An increase in HDM sensitivity in SPTs was correlated with VAS for nasal blockage, and an increase in cat sensitivity was correlated with VAS for all nasal symptoms. CONCLUSION: We believe that inhalant allergen sensitization might have been affected by the lifestyle changes of patients during the pandemic. Hence, it is important to evaluate patients for allergen sensitization, especially patients with moderate/severe AR, to revise disease control measurements.

Allergic rhinitis in Covid-19 patients.

Background: Coronavirus disease-2019 (Covid-19) is transmitted by respiratory droplets and causes upper respiratory tract symptoms. These features of Covid-19 are essential regarding its potential association with allergic rhinitis (AR). Aim: This study aimed to investigate the relationship between Covid-19 and AR and the effects of Covid-19 in patients with AR. Patients And Methods: Between April 2020 and June 2020, in Sanliurfa Mehmet Akif Inan Training and Research Hospital, 322 patients who were diagnosed with Covid-19 with polymerase chain reaction (PCR) positive oropharyngeal and nasopharyngeal swab samples and with AR in their medical history were detected using the hospital's automation system. Demographic data including age, gender, and additional data such as main complaints, physical examination findings, duration of inpatient floor, and intensive care unit (ICU) stay were recorded. The medical history of the patients was reviewed and patients with previously diagnosed AR were identified. These patients were called by phone and their AR diagnoses were confirmed by performing the Score for Allergic Rhinitis (SFAR) questionnaire. Results: The study population consisted of 322 patients aged between 18 and 85. Among these patients, 186 (57.8%) were male and 136 (42.2%) were female. Nineteen (5.9%) of these patients had a history of AR. There was no difference between the patients with and without a history of AR concerning age, gender distribution, type of presentation, ICU referral rate, duration of inpatient floor, and ICU stay (P > 0.05). Conclusion: We conclude that the prognosis of Covid-19 was similar between patients with and without AR. The incidence of AR was relatively lower among patients with Covid-19.

Incidence of Asthma, Atopic Dermatitis, and Allergic Rhinitis in Korean Adults before and during the COVID-19 Pandemic Using Data from the Korea National Health and Nutrition Examination Survey.

The prevalence of allergic diseases has been increasing globally prior to COVID-19. The pandemic resulted in changes in lifestyle and personal habits such as universal mask-wearing and social distancing. However, there is insufficient information on the impact of the COVID-19 pandemic on the prevalence of allergic conditions such as asthma, atopic dermatitis, and allergic rhinitis. We analyzed the incidence rate for self-reported and doctor-diagnosed cases of allergic diseases of asthma, atopic dermatitis, and allergic rhinitis. A total of 15,469 subjects were registered from a national cohort dataset of the National Health and Nutrition Examination Survey. Using multiple logistic regression analysis, we calculated the adjusted odds ratio (OR) for each disease in 2020 compared to 2019. Subgroup analyses were performed according to age and sex. There were no statistically significant differences between the incidence of doctor-diagnosed and current allergic diseases in 2019 and 2020 (asthma, p = 0.667 and p = 0.268; atopic dermatitis, p = 0.268 and p = 0.973; allergic rhinitis, p = 0.691 and p = 0.942, respectively), and subgroup analysis showed consistent results. Among the Korean population from 2019 to 2020, the incidence of the allergic diseases asthma, atopic dermatitis, and allergic rhinitis did not decrease as expected.

Reshaping the Management of Allergic Rhinitis in Primary Care: Lessons from the COVID-19 Pandemic.

The COVID-19 pandemic presented unique challenges to the delivery of healthcare for patients with allergic rhinitis (AR) following its disruption and impact on the healthcare system with profound implications. Reliance on self-care for AR symptom management was substantial during the pandemic with many patients encouraged to only seek in-person medical care when necessary. The advantage of digital technology becomes apparent when patients and healthcare providers had to change and adapt their method of interaction from the regular physical face-to-face consultation to telehealth and mobile health in the provision of care. Despite the pandemic and the ever-evolving post pandemic situation, optimal management of AR remains paramount for both patients and healthcare professionals. A reshaping of the delivery of care is essential to accomplish this goal. In this paper, we present what we have learned about AR management during the COVID-19 pandemic, the role of digital technology in revolutionizing AR healthcare, screening assessment in the identification and differentiation of common upper respiratory conditions, and a framework to facilitate the management of AR in primary care.

Online public attention toward allergic rhinitis in Wuhan, China: Infodemiology study using Baidu index and meteorological data.

Background: With the popularization of the Internet and medical knowledge, more and more people are learning about allergic rhinitis (AR) on the Internet. Objective: This study aims to analyze the epidemiological characteristics and online public attention to AR in Wuhan, China, utilizing the most popular search engine in mainland China and meteorological data of Wuhan. Methods: To study the Internet attention and epidemiological characteristics of AR in Wuhan, the search volume (SV) of "Allergic Rhinitis" in Mandarin and AR-related search terms from 1 January 2014 through 31 December 2021 were recorded. For user interest, the search and demand data were collected and analyzed. Results: The yearly average Baidu SV of AR in both Wuhan and China increased year by year but began to decline gradually after the COVID-19 pandemic. Baidu SV of AR in Wuhan exhibited significant seasonal variation, with the first peak was from March to May and the second peak occurring between September and October. Correlation analysis revealed a moderate positive correlation between the monthly average SV of "Allergic Rhinitis" and "Mites" and "Mites + Pollen Allergy" in Wuhan, a weak positive correlation between the monthly average SV of "Allergic Rhinitis" and "Pollen Allergy," and a positive correlation between monthly SV of "Allergic Rhinitis" and the meteorological index of pollen allergy (MIPA). Conclusion: The attention given to the topic on the internet, as measured by the search volume, was reflective of the situation in Wuhan, China. It has the potential to predict the epidemiological characteristics of AR and help medical professionals more effectively plan seasonal AR health education.

The Association between Allergic Rhinitis and COVID-19: A Systematic Review and Meta-Analysis.

Objective: Previous studies have yielded conflicting results regarding the association of coronavirus disease 2019 (COVID-19) with allergic rhinitis (AR). Data on AR prevalence in COVID-19 patients are limited. Consequently, whether AR is a harmful or protective factor for COVID-19 patients remains controversial. Therefore, we analyzed the relationship between COVID-19 and AR. Methods: We systematically searched PubMed, Embase, Cochrane, and Web of Science databases for studies published between January 1, 2020 and January 11, 2022. We included studies reporting the epidemiological and clinical characteristics of COVID-19 and its incidence in patients with AR. We excluded letters, case reports, literature review articles, non-English language article, and non-full-text articles. The raw data from these studies were pooled into a meta-analysis. Results: We analyzed the results of nine studies. The prevalence of AR in patients with COVID-19 was 0.13 (95% confidence interval [CI] 0.04-0.25), with an overall I 2 of 99.77%, P=0.24. COVID-19 patients with AR are less prone to severe disease (odds ratio [OR] = 0.79, 95% CI, 0.52-1.18, P=0.25) and hospitalization (OR = 0.23, 95%CI, 0.02-2.67, P ≤ 0.0001) than patients without AR. Conclusion: Our data suggest that allergic rhinitis is a protective factor in patients with COVID-19.

Quality of life against seasonal vs perennial allergens: ESPRINT-15 modified in the pediatric population.

INTRODUCTION: Allergic rhinitis (AR) is a clinical syndrome characterized by IgE-mediated inflammation of the nasal mucosa. The present study investigates the quality of life (QoL) with AR among adults, using widely validated questionnaires, unlike in pediatric patients. MATERIALS AND METHODS: A cross-sectional descriptive observational study was conducted, analyzing the QoL of 102 children with AR aged between 10-15 years, belonging to two health centers (HC) in Zaragoza and two HC in Coruña. The comparison of means between the two groups is carried out using the Student's test or the Mann-Whitney test, considering a value of p˂0.05 to be significant. RESULTS: Around 102 children were studied, with a majority (59.8%) being male and a mean age of 12 years. Around 76.5% have a family history of atopy. It was found that AR is more prevalent in Zaragoza (p ˂0.005), and asthmais highly prevalent in Coruña (p ˂0.001). The most important sensitizations are pollen in Zaragoza (p ˂0.05) and dust mites in A Coruña (p ˂0.001). More treatment needs and associated comorbidities (p˂0.05) were observed in A Coruña. The results of the ESPRINT-15 show that 63% of the patients have a good QoL, 27% fair, and 8.8%, poor. Those sensitized to mites have a worse score (p = 0.02). It was found that 52% of children experienced improvement during home confinement, with no notable differences between the two populations. The use of the mask favored QoL in patients from Zaragoza (p ˂0.001). CONCLUSION: It was concluded that AR influences the QoL in pediatric patients. Greater QoL involvement, need for treatment, and comorbidities are observed in patients sensitized to dust mites compared to those sensitized to pollens. It was also observed that masks improved the symptoms, stopping patients being sensitized to pollens.

Cat allergy in children and the effect of the COVID-19 pandemic.

Background: Cat allergen is among the most common household allergens and can cause respiratory allergies and anaphylaxis in children. Objective: The aim of this study was to evaluate the characteristics of cat allergies in children and the impact of the coronavirus disease 2019 (COVID-19) pandemic on these characteristics. Methods: The study included pediatric patients with cat allergen sensitization demonstrated by skin-prick test (SPT) over a period of 2 years: 1 year before and 1 year during the pandemic. Demographic data, clinical features, and laboratory findings were evaluated from the patients' records. Results: Of 7428 SPTs performed, 566 patients (7.6%) were sensitized to cat allergen (56% boys; median age, 11 years). Fifty-eight percent of the patients (n = 329) presented during the pandemic period, 44.5% (n = 252) had symptoms with cat exposure, and 9% (n = 51/566) had anaphylaxis. Allergic rhinitis and asthma were present in 76% (n = 431) and 46.6% (n = 264) of the patients, respectively. When compared to prepandemic period, patients who presented during the pandemic had higher rates of cat sensitization (15% in pandemic group versus 4.4% in prepandemic group of all SPTs performed; p < 0.05), cat ownership (29.1% versus 13.9%; p < 0.001), and symptoms on cat exposure (51% versus 34%; p < 0.001). Factors that predicted symptom development in the patients who were cat sensitized were induration > 5 mm on SPT (odds ratio [OR] 1.9 [95% confidence interval {95% CI}], 1.1-3.2), cat ownership (OR 9.2 [95% CI, 4.9-17.3]), close contact with a cat owner (OR 7.1 [95% CI, 4-12]), allergic rhinitis (OR 3.1 [95% CI, 1.6-5.8]), conjunctivitis (OR 4.7 [95% CI, 2-10]), and atopic dermatitis (OR 2.2 [95% CI, 1-4.7]). Conclusion: We observed an increase in the prevalence of cat allergy among children during the COVID-19 pandemic. Care must be taken in terms of anaphylaxis in patients who were cat sensitized.

Anxiety in adults with allergic rhinitis during the coronavirus disease 2019 pandemic: A Canadian perspective.

BACKGROUND: Despite the symptom overlap between allergic rhinitis (AR) and coronavirus disease 2019 (COVID-19), pandemic-time anxiety in people with AR remains an area of limited study. OBJECTIVE: To assess the AR-anxiety relationship in the unique context of the COVID-19 pandemic from a Canadian perspective. METHODS: The COVID-19 Associated Anxiety in patients with Asthma and AR Experiencing Symptoms survey was distributed on the "Qualtrics XM" platform, with 835 adult participants responding to the first iteration from April to August 2020. Anxiety was assessed on the Generalized Anxiety Disorder Assessment-7 (GAD-7), and AR burden of disease was assessed on the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ). All analyses were conducted using IBM SPSS Statistics 27. RESULTS: High levels of anxiety were found, with 28.0% of the AR group and 27.5% of the control group meeting the diagnostic criteria for generalized anxiety disorder. After controlling for covariates, AR status had no significant predictive effect on GAD-7 in a hierarchal multiple regression model (ΔR² = .00, P = .69). In the AR subgroup, there were significant positive correlations between anxiety and burden of disease for the total RQLQ score and all 7 domain scores (P < .001 for all), with the non-nose or eye symptom domain having the strongest correlation (r = .63). After controlling for covariates, total RQLQ score had a predictive effect on GAD-7 in a hierarchal multiple regression model (ΔR² = .049, P < .001). CONCLUSION: High levels of anxiety exist during the COVID-19 pandemic regardless of AR status, indicating the importance of early anxiety screening in all patients. This study also highlights the importance of non-nose or eye symptoms in AR management.

Prevalence of allergic diseases among Korean adolescents during the COVID-19 pandemic: comparison with pre-COVID-19 11-year trends.

OBJECTIVE: During the coronavirus disease 2019 (COVID-19) pandemic, emergency department utilization and hospitalization rates for allergic diseases declined and the severity of allergies among admitted patients was low. This study aimed to determine the prevalence of allergic diseases among adolescents and the changes in trend during the COVID-19 pandemic compared with those during the preceding 11 years. SUBJECTS AND METHODS: We analyzed data from the nationwide web-based self-report Korea Youth Risk Behavior Survey. From 2009 to 2020, adolescents aged 13-18 years participated in the survey. The survey period was divided into pre-pandemic Periods I (2009-2011), II (2012-2014), III (2015-2017), and IV (2018-2019) and the pandemic period (Period V, 2020). The current prevalence of asthma, allergic rhinitis, atopic dermatitis, allergic morbidity (having at least one of the three conditions) and changes in the prevalence before and during the COVID-19 pandemic were analyzed. RESULTS: Data of 787,043 participants were analyzed after weighting the study population (mean age, 15.1 years; males, 52.3%). The prevalence of asthma, allergic rhinitis, atopic dermatitis, and allergic morbidity was 2.1%, 18.4%, 6.8%, and 23.6%, respectively. The prevalence of allergic morbidity increased between Periods I and IV but declined significantly from Periods IV to V. From Periods I to IV, the prevalence of asthma decreased, the prevalence of allergic rhinitis increased, and the prevalence of atopic dermatitis remained unchanged. During Period V, the prevalence of all three conditions decreased. CONCLUSIONS: It is necessary to update management measures and develop relevant policies in response to the altered prevalence of allergic diseases since the outbreak of COVID-19.

Analysis of Prevalence and Risk Factors of Adult Self-Reported Allergic Rhinitis and Asthma in Plain Lands and Hilly Areas of Shenmu City, China.

Objective: The main aim of this study was to investigate the prevalence and risk factors of adult self-reported allergic rhinitis and asthma in plain lands and hilly areas of Shenmu City in China, and analyze the differences between regions. Methods: The multi-stage stratified random sampling was applied in a cross-sectional survey of adult residents in Shenmu City, from September to December 2019. The unconditional logistic regression analysis was used to screen the influence factors of allergic rhinitis and asthma. Results: 4,706 adults participated in the survey, and 99% (4,655 in 4,706) completed the questionnaires. The prevalence of allergic rhinitis was 25.4%, and the prevalence of asthma was 9.4%. The prevalence of the allergic rhinitis without asthma, asthma without allergic rhinitis, and the combined allergic rhinitis with asthma were 18.9, 2.9, and 6.5%, respectively. The prevalence of allergic rhinitis and asthma existed regional differences. The prevalence of adult self-reported allergic rhinitis was 41.5% in plain lands areas and 22.1% in hilly areas. The prevalence of adult self-reported asthma was 12.8% in plain lands and 8.8% in hilly areas. The prevalence of allergic rhinitis and asthma existed seasonal differences, with the highest prevalence from July to September. The analysis of risk factors showed that higher education [middle and high school (OR 1.72, 95%CI 1.42-2.07); college and above (OR 2.67, 95%CI 1.99-3.59)], comorbidities of other allergic diseases (OR 3.90, 95%CI 3.23-4.70), family history of allergies (OR 2.89, 95%CI 2.36-3.53), and plain lands areas (OR 2.51, 95%CI 2.06-3.05) were the risk factors for the allergic rhinitis without asthma. Aging [40-49 years old (OR 4.29, 95%CI 1.02-18.13); 50-59 years old (OR 5.89, 95%CI 1.40-24.76); ≥60 years old: (OR 6.14, 95%CI 1.41-26.71)], never-smokers (OR 1.66, 95%CI 0.99-2.80), comorbidities of other allergic disorders (OR 2.17, 95%CI 1.42-3.32), and family history of allergies (OR 2.20, 95%CI 1.40-3.47) were the risk factors for the asthma without allergic rhinitis. Advanced age [30-39 years (OR 2.16, 95%CI 1.23-3.82); 40-49 years (OR 2.86, 95%CI 1.56 to 5.25); 50-59 years (OR 2.95, 95%CI 1.58-5.51); ≥60 years old (OR 2.27, 95%CI 1.09-4.72)], higher education [middle and high school (OR 2.23, 95%CI 1.62-3.07); college and above (OR 4.28, 95%CI 2.72-6.74)], non-agricultural workers (OR 1.70, 95%CI 1.18-2.43),never-smokers (OR 2.26, 95%CI 1.51-3.39), comorbidities of other allergic diseases (OR 4.45, 95%CI 3.37-5.88), family history of allergies (OR 5.27, 95%CI 3.98-6.97), and plain lands areas (OR 2.07, 95%CI 1.51-2.86) were the risk factors for the combined allergic rhinitis with asthma. Conclusions: The prevalence of allergic rhinitis and asthma in Shenmu City was relatively high, with regional differences. Genetic and environmental factors were the important risk factors associated with allergic rhinitis and asthma. Our research would provide data support for preventing and controlling allergic rhinitis and asthma in this region in the future, and appropriate prevention and control programs should be formulated according to the characteristics of different regions.

Prevalence of COVID-19 in children affected by allergic rhinoconjunctivitis and asthma: results from the second "SIAIP rhinosinusitis and conjunctivitis committee" survey.

BACKGROUND: The role of allergic sensitization seems to be protective against SARS CoV2 infection. The aim of this study was to evaluate, using online surveys, the impact of COVID-19 on Italian allergic children, comparing the prevalence of AR and asthma symptoms between the first and second pandemic wave. METHODS: Both surveys were emailed to Italian pediatricians in April 2020 (first survey) and in March 2021 (second survey). The first one was related to the impact of COVID-19 and the most frequently reported symptoms. The second one was superimposed on the previous one, taking into account some additional aspects in the management of disease. RESULTS: A total of 99 pediatricians participated in the first survey and 267 in the second one. The first survey showed that, asthma and allergic rhinoconjunctivitis prevalence was mostly between 0 and 20% throughout the country. The second survey showed a lower prevalence of both diseases nationwide in comparison to the first one. Comparing the two surveys, statistically significant differences were reported only in the distribution of asthma prevalence in Southern Italy while no differences were highlighted in the North and in the Center. Finally regarding allergic rhinoconjunctivitis prevalence, no differences were noticed nationwide. CONCLUSIONS: Allergic rhinoconjunctivitis and asthma, if under control, did not represent risk factors for the susceptibility to SARS CoV2. Therefore, it is strongly recommended to continue therapies during COVID-19 outbreak, according to the international guidelines. However, being COVID-19 a new disease, actual knowledge will undergo continuous improvements over time.

Does aeroallergen sensitivity and allergic rhinitis in children cause milder COVID-19 infection?

Background: There are conflicting data with regard to the impact of respiratory and allergic comorbidities on the course of novel coronavirus disease 2019 (COVID-19) in children. Objective: This study aimed to investigate the relationship between allergic diseases and COVID-19 severity in pediatric patients. Methods: Seventy-five pediatric patients with COVID-19 were classified according to clinical severity and evaluated in the allergy/immunology and pulmonology departments 1 to 3 months after the infection resolved. Blood was collected from the patients for a complete blood cell count and assessment of immunoglobulin and total immunoglobulin E (IgE) levels, and skin-prick tests and spirometry tests were performed. Results: A total of 75 patients ages 5-18 years were evaluated. COVID-19 was asymptomatic/mild in 44 patients and moderate/severe/critical in 31 patients. Based on allergy evaluation, allergic rhinitis was diagnosed in 19 patients (25.3%), asthma in 10 patients (13%), and atopic dermatitis in 3 patients (4%). Aeroallergen sensitivity was detected in 26 patients (34.7%). COVID-19 infection was asymptomatic/mild in 15 patients with allergic rhinitis (78.9%) and in 21 with aeroallergen sensitivity (80.8%) (p = 0.038 and p = 0.005, respectively). There was no difference in severity between the patients with and without asthma (p = 0.550). The median (interquartile range) total IgE level was significantly higher in the asymptomatic/mild group (71.8 [30.7-211.2]) (p = 0.015). There were no differences in terms of spirometry parameters. Conclusion: Aeroallergen sensitization and allergic rhinitis in children may be associated with a milder course of COVID-19. The knowledge that atopy is associated with less-severe COVID-19 outcomes in children may guide clinical risk classification.

The effect of allergy and asthma as a comorbidity on the susceptibility and outcomes of COVID-19.

The coronavirus disease 2019 (COVID-19) pandemic causes an overwhelming number of hospitalization and deaths with a significant socioeconomic impact. The vast majority of studies indicate that asthma and allergic diseases do not represent a risk factor for COVID-19 susceptibility nor cause a more severe course of disease. This raises the opportunity to investigate the underlying mechanisms of the interaction between an allergic background and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The majority of patients with asthma, atopic dermatitis, allergic rhinitis, chronic rhinosinusitis, food allergies and drug allergies exhibit an over-expression of type 2 immune and inflammatory pathways with the contribution of epithelial cells, innate lymphoid cells, dendritic cells, T cells, eosinophils, mast cells, basophils, and the type 2 cytokines interleukin (IL)-4, IL-5, IL-9, IL-13, and IL-31. The potential impact of type 2 inflammation-related allergic diseases on susceptibility to COVID-19 and severity of its course have been reported. In this review, the prevalence of asthma and other common allergic diseases in COVID-19 patients is addressed. Moreover, the impact of allergic and non-allergic asthma with different severity and control status, currently available asthma treatments such as inhaled and oral corticosteroids, short- and long-acting ß2 agonists, leukotriene receptor antagonists and biologicals on the outcome of COVID-19 patients is reviewed. In addition, possible protective mechanisms of asthma and type 2 inflammation on COVID-19 infection, such as the expression of SARS-CoV-2 entry receptors, antiviral activity of eosinophils and cross-reactive T-cell epitopes, are discussed. Potential interactions of other allergic diseases with COVID-19 are postulated, including recommendations for their management.

Allergic rhinitis and COVID-19: friends or foes?

Summary: Allergic rhinitis (AR) is a common disease affecting up to 40% of the general population worldwide. In the Coronavirus 2019 (COVID-19) pandemic era, many observational studies analysing the effect of asthma and chronic obstructive pulmonary disease on the risk of developing COVID-19 were conducted, while data on AR are limited.In this paper, we review the risk of developing SARS-Cov-2 infection carried by AR patients, the outcomes of those with COVID-19 disease, and the COVID-19 influence on the allergic and nasal symptoms and the psychological status of AR patients, in both adult and paediatric populations.AR patients seem to be protected from COVID 19 infection. Even if data about the influence of AR on the severity of COVID-19 disease are still not conclusive, it seems that being an AR patient does not increase the risk of poor COVID-19 prognoses. The clinical manifestation of AR can be distinguished by COVID-19 symptoms. Treating AR adequately is also strongly recommended, especially during pandemic.

Advances and highlights in allergic rhinitis.

Allergic rhinitis (AR) is a growing public health, medical and economic problem worldwide. The current review describes the major discoveries related to AR during the past 2 years, including risk factors for the prevalence of AR, the corresponding diagnostic strategy, precise underlying immunological mechanisms, and efficient therapies for AR during the ongoing global "coronavirus disease 2019" (COVID-19) pandemic. The review further attempts to highlight future research perspectives. Increasing evidence suggests that environmental exposures, climate changes, and lifestyle are important risk factors for AR. Consequently, detailed investigation of the exposome and the connection between environmental exposures and health in the future should provide better risk profiles instead of single predictors, and also help mitigate adverse health outcomes in allergic diseases. Although patients with dual AR, a newly defined AR phenotype, display perennial and seasonal allergens-related nasal symptoms, they are only allergic to seasonal allergens, indicating the importance of measuring inflammation at the local sites. Herein, we suggest that a combination of precise diagnosis in local sites and traditional diagnostic methods may enhance the precision medicine-based approach for management of AR; however, this awaits further investigations. Apart from traditional treatments, social distancing, washing hands, and disinfection are also required to better manage AR patients in the ongoing global COVID-19 pandemic. Despite recent advances in understanding the immune mechanisms underlying the effects of allergen immunotherapy (AIT), further understanding changes of cell profiles after AIT and accurately evaluate the efficacy of AIT are required.

Differential clinical diagnosis and prevalence rate of allergic rhinitis, asthma and chronic obstructive pulmonary disease among COVID-19 patients.

BACKGROUND: There is a great need to make a rapid differential clinical diagnosis of COVID-19 among respiratory disease patients and determining the prevalence rate of these diseases among the COVID-19 population. METHOD: Approximately 522 patients with allergic rhinitis, asthma, COPD, and COVID-19 were analysed for demographic and clinical features. Radiological features were analysed only for COVID-19 patients. RESULTS: COPD and asthma were more common among COVID-19 patients than allergic rhinitis. All chest CT scans of COVID-19 patients showed bilateral ground-glass opacity. Fever, dry cough, diarrhea, loss of sense of smell and taste, shortness of breath, and blue lips were significantly higher in all COVID-19 patients compared to COPD, asthma, and allergic rhinitis patients. CONCLUSION: The presence of clinical symptoms such as fever, dry cough, diarrhea, loss of sense of smell and taste, shortness of breath, and blue lips in COVID-19 patients, can be used for differential diagnosis between COVID-19 patients and other respiratory diseases. Then, the diagnosis can be confirmed by chest CT scan for COVID-19 patients without the need for a nasopharyngeal swab or PCR test, especially in epidemic countries. Allergic rhinitis patients are the least exposed to COVID-19 infection among other respiratory disease patients.

Detecting epidemiological relevance of adenoid hypertrophy, rhinosinusitis, and allergic rhinitis through an Internet search.

PURPOSE: This study aimed to detect the epidemiological relevance between adenoid hypertrophy (AH) and rhinosinusitis, and AH and allergic rhinitis (AR) through an Internet search. METHODS: Internet search query data from January 2011 to December 2019 in China were retrieved from the Baidu Index (BI). Spearman's correlation coefficients were used to detect the correlation among the search volumes of AH, rhinosinusitis, and AR. We also collected search data from the first 5 months of 2020, when quarantine was implemented in China due to the coronavirus disease 2019 epidemic. Then, we compared the search data to those obtained during the same period in 2019 to assess the effects of isolation on AH and AR. RESULTS: Statistically significant relevance was found between the search variations of AH and rhinosinusitis during 2011-2019 (R = 0.643, P < 0.05). However, the relationship between AH and AR was weak (R = - 0.239, P < 0.05) and that between rhinosinusitis and AR (R = - 0.022, P > 0.05) was not relevant. The average monthly search volume of AH and rhinosinusitis had a strong correlation (R = 0.846, P < 0.01), but AH and AR and rhinosinusitis and AR were not correlated (R = - 0.350, P > 0.05; R = - 0.042, P > 0.05, respectively). AH and rhinosinusitis search volumes decreased consistently during the first 5 months of 2020 (isolation), whereas that for AR increased during January-February. CONCLUSION: AH had an epidemiological relationship with rhinosinusitis, which was not consistent with AR. The decrease in public gathering effectively reduced the morbidities of AH and rhinosinusitis but not those of AR.

How does allergic rhinitis impact the severity of COVID-19?: a case-control study.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a contagious disease whose symptoms and risk factors are newly described. Some allergic diseases, including asthma, have been defined as risk factors for a poor outcome in COVID-19. We aimed to investigate the role of another allergic disease-allergic rhinitis-in the severity of COVID-19. METHODS: This case-control study was conducted at Sakarya Educational and Research Hospital, Toyota Hospital and Yenikent State Hospital between March 18, 2020 and August 30, 2020. The study included a case group of 125 randomly selected patients who had been diagnosed with allergic rhinitis in advance of having COVID-19 and a control group of 125 patients without allergic rhinitis who were diagnosed with COVID-19. We evaluated all participants' statuses regarding smoking, symptoms, and hospitalization, as well as the length of their hospitalization and the number of their comorbidities. RESULTS: There were no statistically significant differences between the two groups regarding percentage of asymptomatic patients (p = 0.27), presence of smoking (p = 0.068), hospitalization status (p = 0.79), and hospitalization length (p = 0.55). From each group, two patients needed care in an intensive care unit (ICU). One patient from the case group and two from the control group died due to COVID-19. CONCLUSION: We found that allergic rhinitis did not affect the severity of COVID-19. However, we recommend that the literature be augmented with further studies on the COVID-19 prognosis of patients who have allergic rhinitis.