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1.
Eur Rev Med Pharmacol Sci ; 26(7): 2556-2568, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1811976

ABSTRACT

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.


Subject(s)
Asthma , COVID-19 , Dermatitis, Atopic , Rhinitis, Allergic , Adolescent , Asthma/epidemiology , COVID-19/epidemiology , Dermatitis, Atopic/epidemiology , Humans , Male , Pandemics , Prevalence , Republic of Korea/epidemiology , Rhinitis, Allergic/epidemiology
2.
Front Public Health ; 9: 749388, 2021.
Article in English | MEDLINE | ID: covidwho-1775929

ABSTRACT

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.


Subject(s)
Asthma , Rhinitis, Allergic , Adult , Asthma/complications , Asthma/epidemiology , China/epidemiology , Cross-Sectional Studies , Humans , Middle Aged , Prevalence , Rhinitis, Allergic/complications , Rhinitis, Allergic/epidemiology , Risk Factors , Self Report
3.
Ann Allergy Asthma Immunol ; 129(1): 52-61, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1623298

ABSTRACT

OBJECTIVE: To summarize the current literature of the psychological impacts of coronavirus disease 2019 (COVID-19) on people with allergic diseases and to identify gaps in need of future research. DATA SOURCES: Ovid MEDLINE(R) and Embase Classics + Embase from 1947 to present (October 18, 2021) were searched using a search strategy that included the following keywords: allergic diseases, covid*, and psychological disorders. STUDY SELECTIONS: Primary manuscripts and abstracts using online and telephone surveys, mixed-method studies capturing patient and caregiver experiences, case studies, and published guidelines from allergic disease-specific expert groups were included. RESULTS: People with asthma and other chronic respiratory conditions are at higher risk of negative psychological outcomes, and risk factors include asthma severity, female sex, and previous history of anxiety and depression, likely owing to the perceived risk of severe disease from COVID-19. One study identified that people with allergic rhinitis had significantly high anxiety and depression scores compared with healthy controls (both, P < .001). The psychological impacts of food allergy during COVID-19 were most strongly felt by parents and caregivers. Similarly, parents of children with asthma experienced substantial psychological burden. CONCLUSION: COVID-19 had a considerable psychological impact on patients with asthma. Limited data have been published on the mental health impacts of COVID-19 on patients with allergic rhinitis and food allergy. As COVID-19 research continues to evolve and the literature captures later stages of the pandemic, it is important that physicians be aware of the potential coincidence of mental illness and chronic allergic diseases and refer these patients, and their caregivers, to appropriate resources while also continuing to manage their allergic disease(s).


Subject(s)
Asthma , COVID-19 , Food Hypersensitivity , Rhinitis, Allergic , Asthma/epidemiology , COVID-19/epidemiology , Child , Female , Food Hypersensitivity/epidemiology , Humans , Pandemics , Rhinitis, Allergic/epidemiology
4.
Ital J Pediatr ; 48(1): 1, 2022 Jan 06.
Article in English | MEDLINE | ID: covidwho-1613246

ABSTRACT

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.


Subject(s)
Asthma/epidemiology , COVID-19/complications , COVID-19/epidemiology , Conjunctivitis, Allergic/epidemiology , Rhinitis, Allergic/epidemiology , Asthma/complications , Child , Conjunctivitis, Allergic/complications , Humans , Italy , Prevalence , Rhinitis, Allergic/complications , Risk Factors , Surveys and Questionnaires
5.
Allergy Asthma Proc ; 42(6): 522-529, 2021 Nov 01.
Article in English | MEDLINE | ID: covidwho-1533596

ABSTRACT

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.


Subject(s)
Allergens/adverse effects , Asthma/diagnosis , COVID-19/complications , Dermatitis, Atopic/diagnosis , Hypersensitivity/diagnosis , Rhinitis, Allergic/diagnosis , Skin Tests/statistics & numerical data , Adolescent , Asthma/epidemiology , Asthma/immunology , COVID-19/diagnosis , COVID-19/epidemiology , Child , Child, Preschool , Dermatitis, Atopic/epidemiology , Dermatitis, Atopic/immunology , Female , Humans , Hypersensitivity/epidemiology , Hypersensitivity/immunology , Immunoglobulin E/blood , Male , Respiratory Function Tests , Rhinitis, Allergic/epidemiology , Rhinitis, Allergic/immunology , SARS-CoV-2 , Severity of Illness Index , Turkey/epidemiology
6.
Int Immunol ; 34(4): 177-188, 2022 03 25.
Article in English | MEDLINE | ID: covidwho-1522225

ABSTRACT

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.


Subject(s)
Asthma , COVID-19 , Rhinitis, Allergic , Asthma/epidemiology , Comorbidity , Humans , Immunity, Innate , Lymphocytes , Rhinitis, Allergic/epidemiology , SARS-CoV-2
7.
Eur Ann Allergy Clin Immunol ; 54(2): 53-59, 2022 03.
Article in English | MEDLINE | ID: covidwho-1404266

ABSTRACT

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.


Subject(s)
Asthma , COVID-19 , Rhinitis, Allergic , Adult , Asthma/epidemiology , Child , Humans , Pandemics , Rhinitis, Allergic/diagnosis , Rhinitis, Allergic/drug therapy , Rhinitis, Allergic/epidemiology , SARS-CoV-2
8.
Allergy ; 76(11): 3383-3389, 2021 11.
Article in English | MEDLINE | ID: covidwho-1352411

ABSTRACT

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.


Subject(s)
COVID-19 , Rhinitis, Allergic , Allergens , Desensitization, Immunologic , Humans , Pandemics , Rhinitis, Allergic/diagnosis , Rhinitis, Allergic/epidemiology , Rhinitis, Allergic/etiology , SARS-CoV-2
9.
Int J Clin Pract ; 75(10): e14532, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1269740

ABSTRACT

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.


Subject(s)
Asthma , COVID-19 , Pulmonary Disease, Chronic Obstructive , Rhinitis, Allergic , Asthma/diagnosis , Asthma/epidemiology , Diagnosis, Differential , Humans , Prevalence , Pulmonary Disease, Chronic Obstructive/complications , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/epidemiology , Rhinitis, Allergic/diagnosis , Rhinitis, Allergic/epidemiology , SARS-CoV-2
10.
Eur Arch Otorhinolaryngol ; 279(3): 1349-1355, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1261788

ABSTRACT

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.


Subject(s)
Adenoids , COVID-19 , Rhinitis, Allergic , COVID-19/epidemiology , Humans , Hypertrophy/epidemiology , Internet , Rhinitis, Allergic/diagnosis , Rhinitis, Allergic/epidemiology , SARS-CoV-2
11.
Eur Arch Otorhinolaryngol ; 278(11): 4367-4371, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1209218

ABSTRACT

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.


Subject(s)
Asthma , COVID-19 , Rhinitis, Allergic , Asthma/epidemiology , Case-Control Studies , Humans , Rhinitis, Allergic/epidemiology , SARS-CoV-2
12.
In Vivo ; 35(3): 1409-1417, 2021.
Article in English | MEDLINE | ID: covidwho-1207958

ABSTRACT

The nasal epithelium expressing enriched angiotensin-converting enzyme II (ACE2), the key cell entry receptor of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), could serve as the first barrier to protect the airway from viral infection. Recent studies have demonstrated that higher viral loads were detected in the nasal cavity than the pharynx in coronavirus disease 2019 (COVID-19) patients, and otolaryngologists should carefully consider infection prevention in clinical practice for the treatment of nasal conditions. Moreover, several studies have indicated that anosmia is one of the clinical characteristics of COVID-19, but the precise prevalence and mechanism remain unclear. Thus far, comorbidity of allergic rhinitis and chronic rhinosinusitis do not seem to be a major risk factor for severe COVID-19. However, we should develop strategies in clinical practice for treatment of nasal diseases during the pandemic. In this article, we reviewed current evidence of the relationship between COVID-19 and nasal conditions, such as COVID-19-related olfactory dysfunction, allergic rhinitis, and chronic rhinosinusitis.


Subject(s)
COVID-19 , Rhinitis, Allergic , Sinusitis , Humans , Pandemics , Peptidyl-Dipeptidase A , Rhinitis, Allergic/epidemiology , SARS-CoV-2 , Sinusitis/epidemiology , Sinusitis/therapy
13.
Allergy ; 77(1): 197-206, 2022 01.
Article in English | MEDLINE | ID: covidwho-1203825

ABSTRACT

BACKGROUND: The success of subcutaneous immunotherapy (SCIT) mostly depends on regular injections. Our aim was to investigate adherence to SCIT with aeroallergens during the COVID-19 pandemic and demonstrate clinical consequences of treatment disruptions in real life. METHODS: Visual analogue scale for quality of life (VAS-QoL), VAS for symptom scores (VAS-symptom), medication scores (MSs), and total symptom scores (TSS-6) were recorded during the pandemic in 327 adult allergic rhinitis and/or asthmatic patients receiving maintenance SCIT, and these scores were compared with the pre-pandemic data. Patients were grouped according to SCIT administration intervals; no delay (Group 1), <2 months (Group 2), and ≥2-month intervals (Group 3). RESULTS: A total of 104 (31.8%) patients (Group 3) were considered as nonadherent which was mostly related to receiving SCIT with HDMs and using public transportation for reaching the hospital. Median MS, VAS-symptom, and TSS-6 scores of Group 3 patients during the pandemic were higher than the pre-pandemic scores (p = 0.005, p < 0.001, p < 0.001, respectively), whereas median VAS-QoL scores of Group 3 during the pandemic were lower than the pre-pandemic scores (p < 0.001). Median TSS-6 and VAS-symptom scores were the highest in Group 3 compared with other groups (p < 0.001 for each comparison). Median VAS-QoL scores were the lowest in Group 3 compared with Group 1 and Group 2 (p < 0.001, p = 0.043, respectively). CONCLUSION: When precautions in allergy clinics are carefully applied, adherence to SCIT can be high during a pandemic. Patients must be encouraged to regularly adhere to SCIT injections since delays in SCIT administration can deteriorate clinical symptoms.


Subject(s)
COVID-19 , Rhinitis, Allergic , Adult , Desensitization, Immunologic , Humans , Immunotherapy , Injections, Subcutaneous , Pandemics , Quality of Life , Rhinitis, Allergic/epidemiology , Rhinitis, Allergic/therapy , SARS-CoV-2
14.
Ann Allergy Asthma Immunol ; 126(5): 569-575, 2021 05.
Article in English | MEDLINE | ID: covidwho-1114370

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) emerged as a pandemic toward the end of 2019, causing large numbers of people to become infected and die. OBJECTIVE: To determine whether allergic diseases are a risk factor for hospitalization in COVID-19. METHODS: We conducted a study including 107 pediatric patients after COVID-19 recovery. The International Study of Asthma and Allergies in Childhood Phase 3 questionnaires were distributed together with a detailed history of environmental factors and an allergic evaluation including skin prick tests, specific immunoglobulin E tests, and spirometry. We investigated the prevalence of allergic diseases and evaluated the factors associated with hospitalization in COVID-19. RESULTS: A total of 61 (57%) patients were hospitalized and 46 (43%) patients were followed closely in the outpatient clinic. The prevalences of allergic rhinitis, asthma, atopic dermatitis, and episodic wheezing were 10.3%, 6,5%, 4.7%, and 3.7%, respectively, within the whole study population. Although having asthma with or without allergic rhinitis, atopic dermatitis, and passive tobacco exposure were not found to be related to hospitalization because of COVID-19, having a pet at home was found to decrease the risk of hospitalization (odds ratio, 0.191; 95% confidence interval, 0.047-0.779; P = .02). Spirometry tests revealed a higher forced expiratory volume in one second to forced vital capacity ratio and a peak expiratory flow reversibility in hospitalized patients than in nonhospitalized ones (P = .02 and P = .003, respectively). CONCLUSION: Asthma and allergic diseases do not seem to be risk factors for hospitalization in children because of COVID-19, and having a pet at home can be a protective effect. Pulmonary function testing seems to be important for monitoring lung damage after COVID-19.


Subject(s)
Asthma/epidemiology , COVID-19/epidemiology , Coinfection/epidemiology , Dermatitis, Atopic/epidemiology , Rhinitis, Allergic/epidemiology , Adolescent , Asthma/complications , COVID-19/diagnosis , COVID-19/pathology , Child , Child, Preschool , Coinfection/diagnosis , Coinfection/pathology , Dermatitis, Atopic/complications , Disease Susceptibility/pathology , Female , Forced Expiratory Volume/physiology , Hospitalization/statistics & numerical data , Humans , Infant , Male , Prospective Studies , Rhinitis, Allergic/complications , Risk Factors , SARS-CoV-2 , Severity of Illness Index , Surveys and Questionnaires , Tobacco Smoke Pollution/adverse effects , Treatment Outcome , Vital Capacity/physiology
15.
Immun Inflamm Dis ; 9(2): 561-568, 2021 06.
Article in English | MEDLINE | ID: covidwho-1114167

ABSTRACT

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.


Subject(s)
Anti-Asthmatic Agents/therapeutic use , Asthma/drug therapy , COVID-19 , Omalizumab/therapeutic use , Pandemics , SARS-CoV-2 , Adolescent , Asthma/epidemiology , Asthma/psychology , Attitude to Health , COVID-19/epidemiology , COVID-19/prevention & control , Child , Communicable Disease Control/methods , Female , Humans , Italy/epidemiology , Maintenance Chemotherapy , Male , Retrospective Studies , Rhinitis, Allergic/epidemiology , Self Report , Severity of Illness Index , Social Isolation , Surveys and Questionnaires
16.
Curr Opin Allergy Clin Immunol ; 21(2): 159-165, 2021 Apr 01.
Article in English | MEDLINE | ID: covidwho-1061092

ABSTRACT

PURPOSE OF REVIEW: To summarize the impact of the COVID-19 pandemic on the practice of paediatric allergy. RECENT FINDINGS: Given significant overlap in symptoms, care must be taken to differentiate routine allergic conditions from COVID-19 infection but it appears that most allergic diseases are not risk factors for a severe COVID-19 course. The full impact of restricted allergy/immunology ambulatory services will take months to years to fully understand. One benefit of having to adapt practice style is greater awareness and acceptance of shared decision-making and recognition of preference-sensitive care options in food allergy, in particular for approaches towards allergy prevention, treatment, and anaphylaxis care. Social distancing and masks have helped reduce spread of common respiratory viruses, which may be helping to lower the incidence of viral-associated wheezing episodes, enhancing evidence of the effects of preventing exposure of young children to respiratory viruses on asthma pathogenesis, as well as on allergic rhinitis. There has been a revolution in the rise of telemedicine to increase access to high-quality allergy/immunology specialty care. SUMMARY: Although the field has adapted to remain operational in the face of a significant challenge, it is important to apply lessons learned to evolve patient care and optimize treatment in the aftermath of the pandemic.


Subject(s)
Asthma/epidemiology , COVID-19/epidemiology , Dermatitis, Atopic/epidemiology , Eczema/epidemiology , Food Hypersensitivity/epidemiology , Pandemics , Rhinitis, Allergic/epidemiology , SARS-CoV-2 , Asthma/therapy , COVID-19/virology , Child , Child, Preschool , Comorbidity , Dermatitis, Atopic/therapy , Disease Management , Eczema/therapy , Food Hypersensitivity/therapy , Humans , Rhinitis, Allergic/therapy , Telemedicine
17.
Curr Opin Allergy Clin Immunol ; 21(1): 1-7, 2021 02 01.
Article in English | MEDLINE | ID: covidwho-927140

ABSTRACT

PURPOSE OF REVIEW: Coronavirus disease 2019 (COVID-19), a respiratory infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 virus), is a pandemic in over 120 countries worldwide. Risk factors for severe COVID-19 include older age, ethnicity, sex, comorbidities, and living conditions. Although asthmatics and those with allergies are susceptible to more severe outcomes to viral infections, interestingly, asthma has not been reported to be a major comorbidity of COVID-19. However, there are some conflicting reports on the impact of asthma on COVID-19. The underlying immunological and molecular mechanisms may explain at least in part these observations. Furthermore, environmental factors like air pollution that have detrimental effects on asthma and respiratory illnesses also have an impact on COVID-19. RECENT FINDINGS: Angiotensin-converting enzyme 2 (ACE2) is the receptor for the attachment and entry of SARS-CoV-2 into the host cells that is upregulated by Th1-mediated responses. In asthmatics, ACE2 gene expression is generally reduced and recent studies have shown a negative correlation between the levels of Th2 cytokines including IL-4, IL-5, and IL-13 in airway epithelial cells and other type 2 biomarkers with ACE2 expression. This may explain in part the potential protective role of asthma on COVID-19. Here, we review the relation of respiratory viral illnesses and asthma, the immune-molecular mechanisms of SARS-CoV-2 infection, the impact of asthma on COVID-19 and that of SARS-CoV-2 on asthma and allergic rhinitis, and the impact of environmental factors like air pollution on COVID-19. SUMMARY: Expression of ACE2 in airway epithelial cells in SARS-COV-2 is influenced by inflammatory profile. Respiratory allergic diseases like asthma appear to have a protective effect against SARS-COV-2 infection. However, the clinical association between asthma and SARS-COV-2 is not fully established and the underlying immune-molecular mechanisms may explain these observations.


Subject(s)
Air Pollution/adverse effects , Asthma/epidemiology , Asthma/immunology , COVID-19/epidemiology , COVID-19/immunology , Pandemics , Rhinitis, Allergic/epidemiology , Rhinitis, Allergic/immunology , SARS-CoV-2/physiology , Angiotensin-Converting Enzyme 2/genetics , Angiotensin-Converting Enzyme 2/metabolism , COVID-19/virology , Comorbidity , Cytokines/metabolism , Humans , Risk Factors , Th1 Cells/immunology , Virus Internalization
18.
Ital J Pediatr ; 46(1): 146, 2020 Oct 06.
Article in English | MEDLINE | ID: covidwho-818113

ABSTRACT

BACKGROUND: There is ample evidence that COVID-19 is significantly less severe in children than in adults and asthma and allergy, the most common chronic disorders in children, are not included in the top 10 comorbidities related to COVID-19 fatalities. Nevertheless, concerns about asthma and allergy are still high.. In order to evaluate the impact of paediatric COVID-19 among Italian paediatricians, we sent a 20-questions anonymous internet-based survey to 250 Italian paediatricians with particular address to allergic symptoms and those affecting the upper airways. METHODS: The questionnaire was conceived and pretested in April 2020, by a working group of experts of the Italian Paediatric Society for Allergy and Immunology (SIAIP), and structured into different sections of 20 categorized and multiple choice questions. The first part included questions about epidemiological data follows by a second part assessing the way to manage a suspected COVID-19 infection and personal experiences about that. The third part concerned questions about patients' clinical characteristics and clinical manifestations. The survey was emailed once between April and mid-May 2020. RESULTS: A total 99 participants had participated in our survey and provided responses to our electronic questionnaire. The distribution of patients reported per month varies significantly according to the geographical area (P = 0.02). Data confirmed that in the North part of Italy the rate of patients referred is higher than in the rest of Italy. Almost all respondents (98%) reported caring for up to a maximum of 10 infected children and the last 2% more than twenty. Among these patients, according to the 75% of responders, a maximum rate of 20% were affected by allergic rhino-conjunctivitis and in particular in the North of Italy while in the Centre and in the South there was a higher incidence (P = 0.09). Almost the same applies for asthma, 83% of responders declared that up to a maximum of 20% of affected children were asthmatic, from 20 to 40% for the 13,5% of responders and from 40 to 60% for the last 3,5%. As for the allergic conjunctivitis also for asthma, we found a higher incidence in the Centre and in South than in the North (P = 0.03). CONCLUSIONS: This study is the first to provide a comprehensive review of COVID-19 knowledge and impact among paediatricians in Italy about allergic asthma and upper airway involvement. From our point of view, it provides important information clearly useful for improving a good practice.


Subject(s)
Conjunctivitis, Allergic/epidemiology , Coronavirus Infections/epidemiology , Pandemics/statistics & numerical data , Pneumonia, Viral/epidemiology , Rhinitis, Allergic/epidemiology , Surveys and Questionnaires , Adolescent , Age Distribution , COVID-19 , Causality , Child , Conjunctivitis, Allergic/diagnosis , Coronavirus Infections/prevention & control , Cross-Sectional Studies , Female , Humans , Incidence , Italy/epidemiology , Male , Pandemics/prevention & control , Pediatricians/statistics & numerical data , Pediatrics/standards , Pneumonia, Viral/prevention & control , Rhinitis, Allergic/diagnosis , Risk Assessment , Sex Distribution , Societies, Medical
20.
Ann Allergy Asthma Immunol ; 125(4): 481-483, 2020 10.
Article in English | MEDLINE | ID: covidwho-716534
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