‘Stay at home’: Is it good or not for house dust mite sensitized children with respiratory allergies?

Abstract

Background Lockdown was imposed for children for 75 days in Turkey to limit the spread of COVID‐19. During this period, children have to stay indoors, which might probably increase their exposures to indoor allergens and pollutants. Besides, reduced exposures to respiratory tract infections and outdoor pollutants might be favorable outcomes of this lockdown period. We evaluated the effects of the lockdown on house dust mite (HDM)–sensitized children with respiratory allergies. Methods Three‐month clinical and medication data of 165 mild‐moderate asthmatic children with or without allergic rhinitis (AR), who were grouped according to their HDM sensitization status, were retrieved from patient records. Demographics, asthma control tests, nasal visual analog scores, and outdoor air quality monitoring data were used for assessments in comparisons with the same period in the previous year. Results Eighty‐four patients had asthma, and 81 patients had asthma with AR. Sensitization to HDM was present in 61.8% of the children. Patients experienced reduced numbers of upper respiratory tract infections (P = .008) and reduced asthma exacerbations (P < .001) compared with the same period in the previous year. Asthma control tests were significantly improved (P < .001), and cumulative inhaled corticosteroid usages were significantly reduced (P < .001). Noteworthily, nasal symptoms were significantly worsened in HDM‐sensitized asthmatics with AR (P < .001). Conclusions This study highlighted that reduction in respiratory tract infections and outdoor pollution may play roles in asthma control and prevent exacerbations despite continuous indoor allergen exposure. Besides, worsening of nasal symptoms in HDM‐sensitized asthmatics with AR implies the importance of indoor avoidance measures for AR control.

COVID-19 lockdown, personal protective equipment, hyper-hygiene and allergy

“…), has been documented in spring 2020, compared to spring 2019 (9). Similar results have been demonstrated by Yucel et al (10) in a group of children with rhinitis and / or bronchial asthma with or without sensitization to dust mites. In the other hand, a substantial improvement in asthma symptoms (assessed by Asthma Control Test, drug use, frequency of exacerbations, etc.)…”

“…However, in children with associated mite allergic rhinitis it has been showed a significant increase in the severity of nasal and conjunctival symptoms in the period March-May 2020, compared to the same months of 2019. No significant increase in the same nasal/ocular symptoms was reported in subjects with asthma and nonallergic rhinitis (10).…”

“…has been observed during the 2020 lockdown compared to the same period of the previous year. The lower frequency of any viral infections due to school closures was considered the main cause of the favourable course of asthma in children (10). However, in children with associated mite allergic rhinitis it has been showed a significant increase in the severity of nasal and conjunctival symptoms in the period March-May 2020, compared to the same months of 2019.…”

Allergic rhinitis and COVID-19: friends or foes?

“…In the period of lockdown, allergic patients inevitably remained more confined to the home environment. Yucel et al (52) raised the question of relapses in patients allergic to HDM. This study carried out during 75 days of lockdown on 81 children showed an improvement in lung function and consequently in asthma symptoms, probably due to the reduction of respiratory tract infections and M a n u s c r i p t a c c e p t e d f o r p u b l i c a t i o n exposure to outdoor pollution.…”

COVID-19 Pandemic and Reduced Physical Activity: Is There an Impact on Healthy and Asthmatic Children?

“…Indeed, increasing evidence has shown that the exposure of children to environmental indoor stressors is associated with respiratory conditions including wheezing, asthma, and rhinitis ( 62 ). It should also be pointed out that co-exposure to indoor allergens may aggravate airway inflammation, resulting in worsening of symptoms in sensitized children ( 63 ). The multifactorial routes of exposure to indoor pollutants should therefore be considered, also with a view to future confinement episodes for possible new waves of SARS-CoV-2.…”