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.

Background: Allergic rhinitis (AR) is characterized by chronic inflammation of the nasal mucosa. T-helper 2 lymphocytes, neutrophils, and eosinophils play an active role during the late-phase immune response after exposure to allergen.Objective: We aimed to investigate the usefulness of inflammatory parameters of neutro-phil-to-lymphocyte ratio (NLR), eosinophil-to-neutrophil ratio (ENR), and eosinophil-to-lymphocyte ratio (ELR) as markers for distinction between intermittent and persistent allergic rhinitis.Material and Methods: This was a double-center, retrospective study. Patients were enrolled after diagnosed with AR according to the Allergic Rhinitis and Its Impact on Asthma guide-lines. Individuals with an active infection were excluded. A cohort of healthy subjects acted as a control group. NLR, ENR, and ELR were calculated using the results obtained from the patients’ complete blood count. Descriptive statistical analysis was performed for all studied variables.Results: In all, 205 AR patients and 49 healthy individuals were included. AR patients had sig-nificantly higher levels of absolute eosinophils, ENR, and ELR, and significantly lower levels of NLR than the healthy controls (P < 0.05). A total of 160 (78%) patients with persistent AR had significantly higher levels of absolute eosinophils, ENR, and ELR, and significantly lower levels of NLR than patients with intermittent AR (P < 0.05). Conclusion: Currently, classification of severity of AR is based on the patient’s anamnesis. It has been shown in this study that serum eosinophil levels in persistent AR patients could be used as traceable parameters in evaluating severity of the disease by looking at the propor-tions of ENR and ELR. We anticipate that in the future this issue would be supported by a larger number of studies.

Background Hereditary angioedema (HAE) attacks can be provoked with psychological factors. The aim of this study was to assess the effects of anxiety, depression and stress related to COVID‐19 pandemic on disease activity of HAE patients during the quarantine period (QP) and the return to normal period (RTNP). Methods This study was conducted between March 2020 and September 2020 in four allergy centres. Demographic, clinical features and mental health status were evaluated in QP (from March to the beginning of June) and RTNP (from June to the beginning of September) applied by the government. The 10‐point visual analogue scale (VAS10) was used to define the severity of HAE attacks. Depression‐Anxiety‐ Stress Scale‐21 (DASS‐21) and Fear of COVID‐19 (FC‐19) scales were performed to assess mental health status. Results 139 HAE patients were included in the study. In QP, median attack numbers and median VAS10 scores were 5 (min‐max: 0‐45) and 6 (min‐max: 0‐10), respectively. HAE attack numbers, DASS‐21 stress, anxiety, depression and total DASS‐21 scores, as well as FC‐19 scores were higher in QP than RTNP (p=0.001, p<0.001, p=0.001, p<0.001, p<0.001, p<0.001, respectively). However, there was no difference in attack severity scores between the two periods (p>0.05). Conclusions This study revealed that the restriction measures during COVID‐19 outbreak causes an increase in the number of HAE attacks in relation to anxiety, depression, stress and fear of COVID‐19 pandemic. Therefore, it is important to provide psychological support to HAE patients during the pandemic.

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: 104 (31.8%) patients (Group 3) were considered as non-adherent 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 to other groups (p<0.001 for each comparison). Median VAS-QoL scores were the lowest in Group 3 compared to 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 warned about adhering to SCIT injections since delays in SCIT administration can deteriorate clinical symptoms.

BackgroundAllergic reactions developing after bee sting can be severe and life-threatening. According to epidemiological data, serious systemic reactions range between 1.2%–3%, and this is 2–3 times higher (6%) in beekeeping. In different beekeepers' populations, risk factors of systemic reactions have been investigated and diverse results have been found.ObjectiveThe aim of this study is to evaluate the level of knowledge of beekeepers about venom allergy, epidemiological data, systemic reaction rates, risk factors for systemic reactions, and the rate of emergency admissions after bee sting.MethodsWith the collaboration of Uludağ University Beekeeping Development Research Center and Beekeepers Association, a questionnaire consisting of 19 questions was applied to 242 beekeepers in Bursa and Yalova. Two hundred twenty-one beekeepers who completed the questionnaire were involved in the study.ResultsThe mean age of the beekeepers was 49.9 years (range, 18–75 years). The systemic reaction to bee sting in beekeepers was 37.6%. Allergic rhinitis was found to be a risk factor for systemic reaction. Although 80% of the beekeepers recognized that bee venom could be lethal, only 60% of the beekeepers were aware of immunotherapy, and only 30% were aware of the adrenaline auto-injector drug.ConclusionSimilar to previous studies, we found that the systemic response to the bee sting in beekeepers was higher compared to normal population. Considering the occupational exposure to bee venom and thus higher risk, the awareness of venom allergy in this high risk population was low, and they were poorly informed about the treatment options.