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Relapse or worsening of chronic spontaneous urticaria during SARS-CoV-2 infection and vaccination in children: A telemedicine follow-up.
Lascialfari, Giulia; Sarti, Lucrezia; Barni, Simona; Liccioli, Giulia; Paladini, Erika; Guarnieri, Valentina; Ricci, Silvia; Giovannini, Mattia; Mori, Francesca.
  • Lascialfari G; Allergy Unit, Department of Pediatrics, Meyer Children's Hospital, Florence, Italy.
  • Sarti L; Division of Immunology, Section of Pediatrics, Department of Health Sciences, University of Florence and Meyer Children's Hospital, Florence, Italy.
  • Barni S; Allergy Unit, Department of Pediatrics, Meyer Children's Hospital, Florence, Italy.
  • Liccioli G; Allergy Unit, Department of Pediatrics, Meyer Children's Hospital, Florence, Italy.
  • Paladini E; Allergy Unit, Department of Pediatrics, Meyer Children's Hospital, Florence, Italy.
  • Guarnieri V; Allergy Unit, Department of Pediatrics, Meyer Children's Hospital, Florence, Italy.
  • Ricci S; Division of Immunology, Section of Pediatrics, Department of Health Sciences, University of Florence and Meyer Children's Hospital, Florence, Italy.
  • Giovannini M; Allergy Unit, Department of Pediatrics, Meyer Children's Hospital, Florence, Italy; mattiag88@hotmail.it.
  • Mori F; Allergy Unit, Department of Pediatrics, Meyer Children's Hospital, Florence, Italy.
Allergol Immunopathol (Madr) ; 50(S Pt 2): 1-7, 2022.
Article in English | MEDLINE | ID: covidwho-2056550
ABSTRACT

BACKGROUND:

Chronic urticaria (CU), characterized by daily wheals and/or angioedema lasting more than 6 weeks, is a common skin disease. CU is classified as spontaneous or inducible. Because of Coronavirus Disease-19 (COVID-19) pandemic, face-to-face visits were reduced, and many centers started remote consultations to minimize hospital admissions and risk for viral diffusion. Telemedicine became a valuable tool for evaluating and monitoring patients with chronic diseases, such as CU. This study aims to evaluate the effectiveness of telemedicine as a means for the follow-up of patients with chronic spontaneous urticaria (CSU) during the COVID-19 pandemic. In particular, we collected data related to CSU evolution and treatment by remote consultation. Moreover, we specifically investigated the impact of SARS-CoV-2 infection or vaccination on CSU in relapsing or worsening of such a disease.

METHODS:

The electronic charts were reviewed for patients diagnosed with CSU, who were referred to the allergy unit of Meyer Children's Hospital, Florence. For each patient, a review of demographic characteristics, diagnostic workup, efficacy, and tolerability of the treatment was performed. Patients with a physical agent triggering CU were excluded from the study. Disease activity was monitored using the Urticaria Activity Score (UAS7). In addition, when the COVID-19 pandemic started, follow-up continued through telemedicine after an initial face-to-face visit when possible. Approximately 1 year after the diagnosis of CSU, patients were recontacted to investigate whether they had experienced a relapse or worsening of urticaria during a possible COVID-19 or immediately after receiving a COVID-19 vaccine.

RESULTS:

From January 2020 to March 2021, 84 cases of CSU were identified, with 71 (84.5%) of these being evaluated via televisit (remote consultation). During the remote follow-up period, 38/71 (53.5%) patients who were evaluated via televisit recovered completely from CSU, while 24 (33.8%) made therapy adjustments, and 9 (12.7%) had to discontinue follow-up through remote visits and return to face-to-face visits. In February 2022, we recontacted the 71 patients with CSU, and 50 (70.4%) of them answered by phone call interview. Four (19.2%) of the 26 patients who had COVID-19 showed CSU relapse, while 1 (3.8%) had a CSU worsening. Instead, 1 (3.8%) patient of the 26 who were vaccinated had a relapse of CSU, and 1 (3.8%) had a worsening of CSU, both after the first dose.

CONCLUSION:

Our data showed that telemedicine can be an effective tool for the follow-up of patients with CSU. Moreover, COVID-19, as well as COVID-19 vaccination, may trigger CSU relapse or worsening, but both are unspecific triggers, and urticaria shows a very short duration in most cases.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Urticaria / Telemedicine / Chronic Urticaria / COVID-19 Vaccines / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Qualitative research Topics: Long Covid / Vaccines Limits: Child / Humans Language: English Journal: Allergol Immunopathol (Madr) Year: 2022 Document Type: Article Affiliation country: Aei.v50iSP2.722

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Urticaria / Telemedicine / Chronic Urticaria / COVID-19 Vaccines / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Qualitative research Topics: Long Covid / Vaccines Limits: Child / Humans Language: English Journal: Allergol Immunopathol (Madr) Year: 2022 Document Type: Article Affiliation country: Aei.v50iSP2.722