COVID-19 and Its Impact on Common Diseases in the Allergy Clinics

Kocatürk, Emek; Abrams, Elissa M.; Maurer, Marcus; Mitri, Jad; Oppenheimer, John; Vestergaard, Christian; Zein, Joe

doi:10.1016/j.jaip.2023.08.038

Cited by 4 publications

(3 citation statements)

References 149 publications

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“…The possibility of continuing mAbs during infections such as COVID-19 may also reduce the risk of flares among these patients with severe disease [ 25 , 26 , 27 ], indirectly limiting the use of courses of systemic glucocorticoids that are a risk factor for infectious complications [ 28 , 29 , 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Clinical Features and Outcome in Italian Patients Treated with Biological Drugs Targeting Type 2 Inflammation

Sambugaro,

Brambilla,

Costanzo

et al. 2024

Life

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This is a multicentric investigation involving two Italian centers that examined the clinical course of COVID-19 in patients receiving biological therapy targeting type 2 inflammation and those not receiving biologicals. Since the beginning of the COVID-19 pandemic, the management of respiratory and allergic disorders and the potential impact of biological therapy in the most severe forms has been a point of uncertainty. Our multicentric investigation aimed to compare the clinical course of COVID-19 and the impact of vaccination in an Italian cohort of patients with atopic disorders caused by a type 2 inflammation, such as eosinophilic asthma, chronic rhinosinusitis with nasal polyposis (CRSwNP), atopic dermatitis (AD), and chronic spontaneous urticaria (CSU). A questionnaire was given to patients coming to our outpatient clinic for the first evaluation or follow-up visit, asking for the clinical characteristics of the infection, the ongoing therapy during the infection, any relevant change, and the patient’s vaccination status. We enrolled 132 atopic patients from two Italian centers; 62 patients were on biological therapy at the time of infection (omalizumab 31%, mepolizumab 26%, benralizumab 19%, and dupilumab 24%). The median age was 56 (IQR 22.8) for patients on biologicals and 48 (IQR 26.5) for those not on biologicals (p = 0.028). The two groups were comparable in terms of sex, body mass index (BMI), smoking history, and systemic oral corticosteroid use (OCS). There were no significant differences in non-biological therapy and comorbidity between the two groups. The patients not on biological therapy had a prevalence of 87% for asthma, 52% for CRSwNP, 10% for CSU, and 6% for AD. The patients on biologicals had a prevalence of 93% for asthma, 17% for CRSwNP, and 10% for CSU. In our work, we observed that mAbs targeting type 2 inflammation in patients with COVID-19 appeared to be safe, with no worsening of symptoms, prolongation of infection, or increase in hospitalizations. Between the two groups, there were no significant differences in the duration of swab positivity (p = 0.45) and duration of symptoms (p = 0.38). During COVID-19, patients on biologicals experienced a significant increase in common cold-like symptoms (p = 0.038), dyspnea (p = 0.016), and more, but not significant, asthma exacerbations, with no significant differences between the different biologicals. Regarding the vaccination status, we observed that there was an increased number of hospitalizations among unvaccinated patients in both groups, although the difference did not reach statistical significance. No patients on biologicals reported safety issues or adverse effects associated with the use of biological treatments during COVID-19. Our investigation showed that mAbs against type 2 inflammation given during Coronavirus Disease 2019 are safe and do not impact the clinical course or main outcomes. Therefore, we found no signals suggesting that anti-Th2 biological therapy should be discontinued during SARS-CoV-2 infection. Controlled studies and analysis, including data from registries and real-life studies, are required to draw firm conclusions regarding the safety or possible advantages that anti-type 2 mAbs could offer in particular clinical contexts, such as infections.

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Section: Discussionmentioning

confidence: 99%

COVID-19 Clinical Features and Outcome in Italian Patients Treated with Biological Drugs Targeting Type 2 Inflammation

Sambugaro,

Brambilla,

Costanzo

et al. 2024

Life

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“…There are some papers shows controversy about the association of allergic diseases and SARS-CoV-2 infection. Some studies reported that allergic diseases have no obvious correlation with COVID-19, and others showed that Patients with allergic diseases may have a lower risk of COVID-19 ( 5 – 7 ). However, our findings revealed a strong association between allergic diseases and the incidence and severity of SARS-CoV-2 infection symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…While it is known that respiratory infections can exacerbate AR and asthma ( 3 , 4 ), the impact of chronic respiratory comorbidities on patients with SARS-CoV-2 infection remains inconclusive. Some studies have suggested that AR and asthma act as protective factors against COVID-19 incidence, and asthma was associated with lower hospitalization of COVID-19 ( 5 ). Conversely, other literature reports have indicated that AR and asthma are not risk factors for COVID-19 aggravation ( 6 , 7 ).…”

Section: Introductionmentioning

confidence: 99%

Allergic diseases aggravate the symptoms of SARS-CoV-2 infection in China

Zhang,

Lin,

et al. 2023

Front. Immunol.

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BackgroundThe relationship between allergic diseases and the adverse outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been a subject of controversy. This study aimed to investigate the association between allergic diseases and the incidence and severity of symptoms in SARS-CoV-2 infection.MethodsClinical data of individuals, including children and their parents, infected with SARS-CoV-2 from December 2022 to January 2023 in China were retrospectively analyzed. The data were collected through questionnaires. Statistical analysis, including chi-squared tests, nonparametric analysis, one-way ANOVA, and logistic regression analysis, was used to examine the relationship between allergic diseases, prior medication, and the symptoms of SARS-CoV-2 infection.ResultsThere were 3,517 adults and 3,372 children with SARS-CoV-2 infection included in the study. Fever was found to occur at similar rates in children (86.5%) and adults (86.8%). However, other symptoms related to respiratory issues (such as cough and sore throat), neurological symptoms (headache, loss of smell, and loss of taste), and systemic symptoms (muscle soreness and weakness) were observed more frequently in adults (P < 0.001). Additionally, adults exhibited higher overall symptom scores, indicating greater severity. Allergic diseases were found to be associated with the incidence of certain SARS-CoV-2 infection symptoms in both children and adults. Specifically, children with allergic rhinitis (AR) were observed to be more susceptible to upper respiratory symptoms (OR: 1.320, 95% CI: 1.081-1.611, P = 0.006), while asthma patients were found to be more susceptible to severe respiratory symptoms (OR: 1.736, 95% CI: 1.250-2.411, P = 0.001). Similar patterns were identified in adults. Furthermore, AR was also suggested to be a risk factor for symptom severity in both children (OR: 1.704, 95% CI: 1.314-2.209, P < 0.001) and adults (OR: 1.736, 95% CI: 1.250-2.411, P = 0.001). However, prior medication for allergic diseases did not exhibit a preventive effect on SARS-CoV-2 infection symptoms.ConclusionsBoth children and adults with allergic diseases were found to be more prone to experiencing symptoms of SARS-CoV-2 infection, and these symptoms tended to be more severe.

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COVID-19 and Allergic Diseases: Lessons Learned and Future Priorities

Phillips,

Shaker

2023

The Journal of Allergy and Clinical Immunology: In Practice

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COVID-19 and Its Impact on Common Diseases in the Allergy Clinics

Cited by 4 publications

References 149 publications

COVID-19 Clinical Features and Outcome in Italian Patients Treated with Biological Drugs Targeting Type 2 Inflammation

COVID-19 Clinical Features and Outcome in Italian Patients Treated with Biological Drugs Targeting Type 2 Inflammation

Allergic diseases aggravate the symptoms of SARS-CoV-2 infection in China

COVID-19 and Allergic Diseases: Lessons Learned and Future Priorities

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