COVID‐19 pandemic and allergen immunotherapy—an EAACI survey

Abstract

Background As in many fields of medical care, the coronavirus disease 2019 (COVID‐19) resulted in an increased uncertainty regarding the safety of allergen immunotherapy (AIT). Therefore, the European Academy of Allergy and Clinical Immunology (EAACI) aimed to analyze the situation in different countries and systematically collect all information available regarding tolerability and possible amendments in daily practice of sublingual AIT (SLIT), subcutaneous AIT (SCIT) for inhalant allergies and venom AIT. Method Under the framework of the EAACI, a panel of experts in the field of AIT coordinated by the Immunotherapy Interest Group (IT IG) set‐up a web‐based retrospective survey (SurveyMonkey®) including 27 standardized questions on practical and safety aspects on AIT in worldwide clinical routine. Results 417 respondents providing AIT to their patients in daily routine answered the survey. For patients (without any current symptoms to suspect COVID‐19), 60% of the respondents informed of not having initiated SCIT (40% venom AIT, 35% SLIT) whereas for the maintenance phase of AIT, SCIT was performed by 75% of the respondents (74% venom AIT, 89% SLIT). No tolerability concern arises from this preliminary analysis. 16 physicians reported having performed AIT despite (early) symptoms of COVID‐19 and/or a positive test result for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). Conclusions This first international retrospective survey in atopic diseases investigated practical aspects and tolerability of AIT during the COVID‐19 pandemic and gave no concerns regarding reduced tolerability under real‐life circumstances. However, the data indicate an undertreatment of AIT, which may be temporary, but could have a long‐lasting negative impact on the clinical care of allergic patients.

A bird's eye view on the role of dendritic cells in SARS‐CoV‐2 infection: Perspectives for immune‐based vaccines

“… 105 Conversely, there are no concerns about a decreased tolerability of allergen immunotherapy in the COVID‐19 setting. 116 …”

Recent advances and developments in COVID‐19 in the context of allergic diseases

“…95 Additionally, there was no reduced tolerability even among patients combined with early COVID-19 symptoms and/or with positive SARS-CoV-2 results. 96 Therefore, patients should be encouraged to adhere to treatment during the pandemic to ensure a successful outcome of immunotherapy. 94,97,98 Biological therapeutics targeting type 2 inflammation pathways have been adopted in a wide range of allergic diseases.…”

Real‐life impact of COVID‐19 pandemic lockdown on the management of pediatric and adult asthma: A survey by the EAACI Asthma Section

“…Our results are also consistent with the first international survey investigating practical aspects and tolerability of allergen immunotherapy (AIT) during the COVID-19 pandemic. 30 Although the responders expressed no concern of reduced safety of AIT in real-life circumstances, the survey showed a significant under use of AIT during the pandemic. Although temporary, this phenomenon could be associated with a long-lasting negative impact on the clinical care of patients with airway allergy.…”