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1.
ORL J Otorhinolaryngol Relat Spec ; 83(6): 428-433, 2021.
Article in English | MEDLINE | ID: covidwho-1403139

ABSTRACT

BACKGROUND: Sublingual immunotherapy (SLIT) had good effectiveness for children with allergic rhinitis (AR). However, no studies explored the effect of persistent allergen exposure on SLIT treatment. Coronavirus disease 2019 (COVID-19) restricts outdoor activities of children significantly. We aimed to evaluate the effectiveness of SLIT during this special period. METHODS: A total of 335 AR children who sensitize to house dust mite (HDM) undergoing SLIT were recruited in this study. The clinical effectiveness and safety were evaluated at different time points using symptom and medication scores. The serum total IgE and specific IgE (sIgE) at different time points were detected by using the Unicap system. RESULTS: The total nasal symptoms score (TNSS) and total medication score (TMS) during the epidemic of COVID-19 increased significantly compared with the same period last year (p < 0.05), despite that they were still significantly lower than baseline levels (p < 0.05). The occurrence of adverse reactions at different time points had no significant differences. We also found that the family of the good response group had more frequent bedding cleaning. Both the tIgE and sIgE levels had no significant changes during SLIT treatment. CONCLUSION: Our results suggest that continuous HDM exposure reduced the effectiveness of SLIT, whereas effective reduction of HDM levels by frequent bed cleaning will be helpful during the SLIT treatment.


Subject(s)
COVID-19 , Rhinitis, Allergic , Sublingual Immunotherapy , Allergens , Animals , Antigens, Dermatophagoides , Child , Humans , Pyroglyphidae , Rhinitis, Allergic/therapy , SARS-CoV-2 , Treatment Outcome
2.
Allergy Asthma Proc ; 42(4): 301-309, 2021 07 24.
Article in English | MEDLINE | ID: covidwho-1242273

ABSTRACT

Background: Most U.S. patient and health care provider surveys with regard to nasal allergy treatments were conducted before sublingual immunotherapy (SLIT)-tablets and allergy immunotherapy (AIT) shared decision-making tools were available. Objective: Patient and health care provider surveys with regard to current perceptions of nasal allergy burden, symptoms, and treatments were conducted to compare with previous surveys and provide insight into the use of SLIT-tablets and AIT shared decision-making tools. Methods: From November-December 2019, adults (N = 510) diagnosed with nasal allergies and health care providers (N = 304) who treated nasal allergies in the United States completed surveys with regard to nasal allergy management. Results: Of the patient respondents, 42% reported that their symptoms were only somewhat controlled and 48% had avoided activities because of their nasal allergies. In all, 38% were using only over-the-counter (OTC) medications for treatment, and 42%, 7%, and 8% had ever received subcutaneous immunotherapy (SCIT), sublingual allergy drops, or SLIT-tablets, respectively; 56% and 85% reported that they had never discussed SCIT or SLIT, respectively, with their health care provider. Of the health care provider respondents, 45%, 58%, and 20% were very likely to discuss OTC medications, SCIT, or SLIT, respectively. Allergists were more inclined to discuss SCIT with their patients than other health care providers (82% versus 33%, respectively). Most allergists (67%) and other health care providers (62%) reported that they did not use an AIT shared decision-making tool, primarily because of unawareness. Conclusion: The patients with nasal allergies continued to report inadequate symptom control and activity impairment. SLIT-tablets and AIT shared decision-making tools were underused. In the coronavirus disease 2019 era, social distancing may limit office visits, which impacts SCIT administration and prompts increased use of telemedicine and a possible advantage for at-home-administered SLIT-tablets over SCIT.


Subject(s)
Allergy and Immunology/trends , COVID-19 , Decision Making, Shared , Decision Support Techniques , Desensitization, Immunologic/trends , Nonprescription Drugs/therapeutic use , Practice Patterns, Physicians'/trends , Rhinitis, Allergic/therapy , Telemedicine/trends , Adolescent , Adult , Aged , Health Care Surveys , Humans , Middle Aged , Physical Distancing , Prognosis , Rhinitis, Allergic/diagnosis , Sublingual Immunotherapy/trends , Time Factors , United States , Young Adult
3.
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
4.
Curr Allergy Asthma Rep ; 21(2): 8, 2021 02 09.
Article in English | MEDLINE | ID: covidwho-1070935

ABSTRACT

PURPOSE OF REVIEW: The coronavirus disease 2019 (COVID-19) has challenged healthcare system capacities and safety for health care workers, reshaping doctor-patient interaction favoring e-Health or telemedicine. The pandemic situation may make difficult to prioritize patients with allergies diseases (AD), face-to-face evaluation, and moreover concern about the possible COVID-19 diagnosis, since COVID-19 shared many symptoms in common with AD. Being COVID-19 a novel disease, everyone is susceptible; there are some advances on vaccine and specific treatment. We evaluate existing literature on allergic diseases (AD): allergic rhinitis, asthma, food allergy, drug allergy, and skin allergy, and potential underlying mechanisms for any interrelationship between AD and COVID-19. RECENT FINDINGS: There is inconclusive and controversial evidence of the association between AD and the risk of adverse clinical outcomes of COVID-19. AD patients should minimize hospital and face-to-face visits, and those who have used biologics and allergen immunotherapy should continue the treatment. It is essential to wear personal protective equipment for the protection of health care workers. Social distancing, rational use of facemasks, eye protection, and hand disinfection for health care workers and patients deserve further attention and promotion. Teleconsultation during COVID-19 times for AD patients is very encouraging and telemedicine platform can provide a reliable service in patient care.


Subject(s)
Asthma/therapy , COVID-19/prevention & control , Food Hypersensitivity/therapy , Infection Control/methods , Rhinitis, Allergic/therapy , Telemedicine , Asthma/immunology , Biological Products , Dermatitis, Allergic Contact/immunology , Dermatitis, Allergic Contact/therapy , Dermatitis, Atopic/immunology , Dermatitis, Atopic/therapy , Desensitization, Immunologic , Disease Management , Disease Outbreaks , Drug Hypersensitivity/immunology , Drug Hypersensitivity/therapy , Food Hypersensitivity/immunology , Health Personnel , Humans , Pandemics/prevention & control , Personal Protective Equipment , Physical Distancing , Rhinitis, Allergic/immunology , SARS-CoV-2
5.
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
8.
Allergy ; 75(7): 1546-1554, 2020 07.
Article in English | MEDLINE | ID: covidwho-116569
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