The impact of COVID ‐19 pandemic on the management of patients with chronic urticaria: An observational two‐center study from Turkey

Abstract

The Coronavirus Disease 2019 (COVID‐19) outbreak significantly affected the clinical practice in hospitals and the management of many diseases. The aim of this study was to evaluate the effect of pandemic‐related factors on the severity and course of chronic urticaria (CU). A total of 194 CU patients who were on regular follow‐up, were enrolled in the study. The disease activity was assessed by means of the weekly urticaria activity score (UAS7) and urticaria control test (UCT). Patients were divided into two subgroups according to their disease aggravation as “aggravated” and “non‐aggravated”. Two groups were compared in terms of demographic, clinical, COVID‐19‐associated parameters, and parameters related with the effect of COVID‐19 pandemic on CU management. The omalizumab use was statistically higher (P = .017), and the systemic corticosteroid use was statistically lower (P = .025) in the “aggravated” group. Adherence to quarantine was significantly lower in the “aggravated” group (P = .027). 173 patients (89.2%) were unable to contact a dermatologist during the pandemic. Among 186 patients who received treatment for CU before the pandemic, 48 (25.8%) did not continue the existing treatment during the pandemic. CU aggravated in one patient with COVID‐19 and remained stable in the other. This study showed that CU patients, especially those on omalizumab therapy, had difficulties in attending medical care and even in the maintenance of their existing therapies during the pandemic. Creating novel follow‐up and treatment models as well as the increased use of teledermatology might be beneficial in the management of this life‐disturbing condition.

COVID-19 Disease Leading to Chronic Spontaneous Urticaria Exacerbation: A Romanian Retrospective Study

“…No COVID-19 death was reported in our group of CSU patients. This is consistent with recent studies showing preponderance for CSU exacerbation in the context of COVID-19 disease [ 10 , 26 ].…”

Retrospective evaluation of patients with chronic spontaneous urticaria using omalizumab during the COVID‐19 pandemic

“…In a study that observed the impact of COVID-19 pandemic on the management of patients with CSU, none of their patients using OMZ diagnosed with COVID-19. 13 In another report, of the 184 patients on OMZ for asthma or CSU, no patients tested positive for COVID-19. 14 In a cross-sectional, international, and multicenter study, it was reported that 26 of 79 chronic spontaneous urticaria patients with COVID-19 were using OMZ at the time of COVID-19…”

Navigating patients with atopic dermatitis or chronic spontaneous urticaria during the COVID-19 pandemic

“…Similar to patient with AD, patients with CSU reported great satisfaction with teledermatology ( 24 , 25 ). The mainstay treatment for CSU consists of second-generation non-sedating H1 antihistamines, cyclosporine and omalizumab.…”

“…A third of patients with CSU experiencing exacerbation of their condition have been reported when infected with the virus ( 24 – 26 ). This exacerbation may most likely be seen in patients with moderate-to-severe forms of the infection ( 25 ). In terms of pathogenesis, the SARS-CoV-2 virus is postulated to increase pro-inflammatory cytokines causing direct mast cell degranulation ( 27 ) and therefore explains the possible exacerbation experienced by CU patients ( 19 , 28 , 29 ).…”