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The Impact of COVID-19 Pandemic on Adult and Pediatric Allergy & Immunology Services in the UK National Health Service.
Krishna, Mamidipudi Thirumala; Beck, Sarah; Gribbin, Nathan; Nasser, Shuaib; Turner, Paul J; Hambleton, Sophie; Sargur, Ravishankar; Whyte, Andrew; Bethune, Claire.
  • Krishna MT; Department of Allergy and Immunology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Institute of Immunology & Immunotherapy and Institute of Clinical Sciences, University of Birmingham, Birmingham, United Kingdom; Accreditation Unit, The Royal College of Physi
  • Beck S; Department of Allergy and Immunology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.
  • Gribbin N; Accreditation Unit, The Royal College of Physicians, London, United Kingdom.
  • Nasser S; Department of Allergy, Cambridge University Hospital NHS Trust, Cambridge, United Kingdom.
  • Turner PJ; National Heart & Lung Institute, Imperial College London, London, United Kingdom.
  • Hambleton S; Newcastle University and Great North Children's Hospital, Newcastle, United Kingdom.
  • Sargur R; Department of Allergy and Immunology, Sheffield Teaching Hospitals NHS Trust, Sheffield, United Kingdom.
  • Whyte A; Department of Allergy and Immunology, University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom.
  • Bethune C; Accreditation Unit, The Royal College of Physicians, London, United Kingdom; Department of Allergy and Immunology, University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom.
J Allergy Clin Immunol Pract ; 9(2): 709-722.e2, 2021 02.
Article in English | MEDLINE | ID: covidwho-949937
ABSTRACT

BACKGROUND:

The coronavirus disease 2019 pandemic imposed multiple restrictions on health care services.

OBJECTIVE:

To investigate the impact of the pandemic on Allergy & Immunology (A&I) services in the United Kingdom.

METHODS:

A national survey of all A&I services registered with the Royal College of Physicians and/or the British Society for Allergy and Clinical Immunology was carried out. The survey covered staffing, facilities, personal protective equipment, appointments & patient review, investigations, treatments, and research activity. Weeks commencing February 3, 2020 (pre-coronavirus disease), April 6, 2020, and May 8, 2020, were used as reference points for the data set.

RESULTS:

A total of 99 services participated. There was a reduction in nursing, medical, administrative, and allied health professional staff during the pandemic; 86% and 92% of A&I services continued to accept nonurgent and urgent referrals, respectively, during the pandemic. There were changes in immunoglobulin dose and infusion regimen in 67% and 14% of adult and pediatric services, respectively; 30% discontinued immunoglobulin replacement in some patients. There was a significant (all variables, P ≤ .0001) reduction in the following face-to-face consultations (increase in telephone consultations), initiation of venom immunotherapy, sublingual and subcutaneous injection immunotherapy, anesthetic allergy testing, and hospital procedures (food challenges, immunoglobulin and omalizumab administration); and a significant increase (P ≤ .0001) in home therapy for immunoglobulin and omalizumab. Adverse clinical outcomes were reported, but none were serious.

CONCLUSIONS:

The pandemic had a significant impact on A&I services, leading to multiple unplanned pragmatic amendments in service delivery. There is an urgent need for prospective audits and strategic planning in the medium and long-term to achieve equitable, safe, and standardized health care.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pediatrics / Delivery of Health Care / Allergy and Immunology / Pandemics / SARS-CoV-2 / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Qualitative research / Randomized controlled trials Topics: Long Covid Limits: Adult / Child / Humans Country/Region as subject: Europa Language: English Journal: J Allergy Clin Immunol Pract Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pediatrics / Delivery of Health Care / Allergy and Immunology / Pandemics / SARS-CoV-2 / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Qualitative research / Randomized controlled trials Topics: Long Covid Limits: Adult / Child / Humans Country/Region as subject: Europa Language: English Journal: J Allergy Clin Immunol Pract Year: 2021 Document Type: Article