COVID-19 severity in allergic patients with or without allergen immunotherapy

ABSTRACT

Background: SARS-CoV- 2 impacts on the immune response in a variable way. In pilot study we showed last year that in allergic patients allergen immunotherapy (AIT) seemed to reduce COVID-19 severity. Here we present final results. Method(s) in cooperation with allergists, dermatologists and ENTs we conducted a Latin-American registry of patients with allergic disorders, including urticaria, who got COVID-19. Apart from demographic data, COVID-19 severity, allergic diseases, comorbidities and compliance with underlying allergy/asthma treatment we collected data on AIT. Result(s) Of the 1095 registered patients, 54% female, 89.4% were confirmed and 10.6% highly suspected COVID-19 cases. IgE-mediated allergy was confirmed (81%) or clinically suspected (16%);while 3.2% had only urticaria. 630/1095 (57.5%) received AIT;in both groups (yes or no AIT) median age was 30-39y. For COVID-19 severity, see table. Compared to allergic patients without AIT, receiving AIT reduced the Risk Ratio (RR) for severe disease with lower respiratory symptoms or worse (COVID-4- 7) to 0.78 (.95 CI 0.6703-0.9024), p = 0.0017) and for critical COVID-19 in need of oxygen therapy or worse to 0.65 (.95 CI 0.42-0.9992, p = 0.048). There was only one fatality in the no-AIT group. There was no difference between groups in co-morbidities, public or private practice or allergic disease;AIT patients tended to be younger. Conclusion(s) These data seem to favor the outcome of COVID in allergic patients receiving AIT, but more in-depth analysis is needed.