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1.
Allergy Asthma Proc ; 42(4): e107-e115, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1435924

ABSTRACT

Background: The impact of coronavirus disease 2019 (COVID-19) related mental health status on chronic spontaneous urticaria (CSU) has not been addressed before. Objective: The aim of this study was to evaluate the depression, anxiety and stress levels, and the fear of COVID-19 in patients with mild-to-moderate CSU and to determine their impact on urticaria activity during the pandemic. Methods: A total of 509 patients with mild-to-moderate CSU were prospectively evaluated with validated scales, the Depression Anxiety Stress Scale 21 (DASS-21) and the Fear of COVID-19 Scale (FCV-19S) during the lockdown period (LP) and the return to normal period (RTNP). CSU activity was determined with the urticaria activity score summed over 7 days (UAS7) and medication scores (MS). UAS7 and MS before the pandemic were retrospectively collected from medical records. Results: The median UAS7 and MS were both significantly higher in the LP than in the median of related scores during the prepandemic period (p < 0.0001) and the RTNP (p < 0.0001). The mean FCV-19S and DASS-21 scores were both significantly higher in the LP than in the RTNP (p < 0.0001). The FCV-19S and the DASS-21 anxiety and stress subscales were significantly higher in women. The UAS7s were positively correlated with the FCV-19S and depression, anxiety, and stress subscale scores. Conclusion: Fear of COVID-19, anxiety, depression, and stress during the COVID-19 pandemic, especially when strict isolation measures are taken, have a significant impact on mental health and urticaria activity in patients with mild-to-moderate CSU, even though they are not infected. Psychological support for patients with CSU seems to be important to control disease activity during the pandemic.


Subject(s)
COVID-19/psychology , Chronic Urticaria/psychology , Cost of Illness , Mental Health , Adult , Anxiety/diagnosis , Anxiety/epidemiology , Anxiety/psychology , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/therapy , Chronic Urticaria/diagnosis , Chronic Urticaria/epidemiology , Chronic Urticaria/therapy , Cross-Sectional Studies , Depression/diagnosis , Depression/epidemiology , Depression/psychology , Fear , Female , Humans , Longitudinal Studies , Male , Middle Aged , Prospective Studies , Psychiatric Status Rating Scales , Retrospective Studies , Risk Factors , Stress, Psychological/diagnosis , Stress, Psychological/epidemiology , Stress, Psychological/psychology , Time Factors , Turkey/epidemiology , Young Adult
2.
Allergy ; 76(3): 816-830, 2021 03.
Article in English | MEDLINE | ID: covidwho-960768

ABSTRACT

INTRODUCTION: The COVID-19 pandemic dramatically disrupts health care around the globe. The impact of the pandemic on chronic urticaria (CU) and its management are largely unknown. AIM: To understand how CU patients are affected by the COVID-19 pandemic; how specialists alter CU patient management; and the course of CU in patients with COVID-19. MATERIALS AND METHODS: Our cross-sectional, international, questionnaire-based, multicenter UCARE COVID-CU study assessed the impact of the pandemic on patient consultations, remote treatment, changes in medications, and clinical consequences. RESULTS: The COVID-19 pandemic severely impairs CU patient care, with less than 50% of the weekly numbers of patients treated as compared to before the pandemic. Reduced patient referrals and clinic hours were the major reasons. Almost half of responding UCARE physicians were involved in COVID-19 patient care, which negatively impacted on the care of urticaria patients. The rate of face-to-face consultations decreased by 62%, from 90% to less than half, whereas the rate of remote consultations increased by more than 600%, from one in 10 to more than two thirds. Cyclosporine and systemic corticosteroids, but not antihistamines or omalizumab, are used less during the pandemic. CU does not affect the course of COVID-19, but COVID-19 results in CU exacerbation in one of three patients, with higher rates in patients with severe COVID-19. CONCLUSIONS: The COVID-19 pandemic brings major changes and challenges for CU patients and their physicians. The long-term consequences of these changes, especially the increased use of remote consultations, require careful evaluation.


Subject(s)
COVID-19/epidemiology , Chronic Urticaria/therapy , SARS-CoV-2 , Adolescent , Adult , Aged , Cross-Sectional Studies , Female , Humans , Internet , Male , Middle Aged , Patient Reported Outcome Measures , Young Adult
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