Change in Allergy Practice during the COVID-19 Pandemic

Abstract

<b><i>Background:</i></b> International guidelines in asthma and allergy has been updated for COVID-19 pandemic and pandemic has caused dramatic changes in allergy and immunology services. However, it is not known whether specialty-specific recommendations for COVID-19 are followed by allergists. <b><i>Objectives:</i></b> By conducting this study, we aimed to determine the attitudes and experiences of adult/pediatric allergists on allergy management during COVID-19. <b><i>Method:</i></b> We used a 20-question survey to elicit data from allergists (residents and pediatric and adult allergists registered to the Turkish National Society of Allergy and Clinical Immunology) across Turkey via e-mail. We analyzed the data statistically for frequency distributions and descriptive analysis. <b><i>Results:</i></b> A total of 183 allergists participated in the survey. Telemedicine was used for management of asthma (73%), allergic rhinitis (53%), atopic dermatitis (51%), chronic urticaria/angioedema (59%), drug hypersensitivity (45%), food allergy (48%), venom allergy (30%), anaphylaxis (22%), and hereditary angioedema (28%). Thirty-one percent of the respondents discontinued subcutaneous immunotherapy (SCIT) during the COVID-19 pandemic. Thirty-four percent of the physicians reported interruption of systemic steroid use in asthma patients, and 25% of the respondents discontinued biological therapy. <b><i>Conclusions:</i></b> Allergists in Turkey have been using telemedicine at a high rate during the COVID-19 pandemic for asthma and rhinitis. The continuation rate of SCIT was low while the discontinuation rate of biologicals and systemic steroid use in asthma was high in Turkey.<b><i></i></b>Our study results and learning from the experiences of other countries and specialties may help to optimize allergy practice and compatibility with international guidelines.

The global impact of the COVID‐19 pandemic on the management and course of chronic urticaria

“…This also relates to the changes in treatment linked to the pandemic. A recent study performed among allergists, for example, reported that one third of participating physicians stopped systemic steroid treatment in their patients with asthma 35 . Another study performed among rheumatologists found that one third of participating physicians reported that at least 10% of their patients had self‐discontinued or reduced their immunosuppressive medication to mitigate the risk of COVID‐19 36 …”

“…A recent study performed among allergists, for example, reported that one third of participating physicians stopped systemic steroid treatment in their patients with asthma. 35 and even higher rates in COVID-19 patients, linked to social isolation, the psychological impact of a novel severe and potentially fatal illness, concerns about infecting others, and stigma. 41 Stress leads to increased levels of neuropeptides such as substance P, which activates mast cells via the MRGPRX2.…”

Food Allergy Management Has Been Negatively Impacted During the COVID-19 Pandemic

“…During the COVID-19 pandemic, skin tests, blood tests, and OFCs were discontinued in some allergy clinics (7). In our clinic, the majority of patients had a scheduled OFC, mostly with cow's milk and hen's egg.…”

Progress of Home-Based Food Allergy Treatment during the Coronavirus Disease Pandemic in Japan: A Cross-Sectional Multicenter Survey

“…However, the ingestion of food allergenic products for OIT poses the risk of an adverse reaction [6]. Ozturk et al reported that only 21% of the respondents were continuing subcutaneous immunotherapy as usual during the COVID-19 pandemic [18]. Krishna et al reported that there was a highly significant decrease in subcutaneous immunotherapy up dosing and maintenance during the pandemic [19].…”

“…The relationship between the COVID-19 pandemic and FA treatments has been explored previously [10][11][12][13][14][15][16][17][18], although these reports were review articles (not surveys) [11][12][13][14][15][16][17] or small-scale surveys that included patients and their parents [10,18,19]. However, no large-scale study comprising more than 1000 subjects has evaluated the relationship between the COVID-19 pandemic and FA treatment.…”