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Kreesaeng P, Tangbumrungtham N, Rachapattayakhom R, Roongpuvapaht B, Tanjararak K. Prevalence and Prognostic Factors Associated with Early Recovery of Olfactory Dysfunction in COVID-19 Patients. EAR, NOSE & THROAT JOURNAL 2024; 103:68S-75S. [PMID: 37743845 DOI: 10.1177/01455613231202207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND The prevalence of smell dysfunction, along with its risk factors, has been evaluated in previous literature; however, little has been established regarding its relation to other factors such as disease severity, history of coronavirus disease-2019 (COVID-19) vaccinations, and medical treatment for COVID-19 infection. These factors may impact the overall recovery of olfaction in COVID-19 patients. OBJECTIVE This study investigated the prevalence of early olfactory recovery from COVID-19 infection and its associated factors. METHODS This study was a prospective cohort study on 348 COVID-19 patients with a new onset of anosmia or hyposmia. Smell sensation scores on the olfactory self-assessment test were collected at baseline and every week until 6 weeks of follow-up. The primary outcome was the prevalence of early olfactory recovery. The secondary outcomes were analyzing factors associated with early olfactory recovery and the median time to complete recovery of smell loss. RESULTS The prevalence of early olfactory recovery was 63.1% (95% CI: 0.58-0.68), and significant associated factors in multivariate analysis included patients without allergic rhinitis (OR 2.22, 95% CI: 1.12-4.40, P = 0.023) and no alteration of taste perception (OR 1.62, 95% CI: 1.02-2.57, P = 0.042). The median time to complete recovery from smell loss was 2 weeks. CONCLUSION The present study found that the prevalence of early olfactory recovery within 2 weeks was 63.1%. The median time to olfactory recovery was also 2 weeks. Patients without allergic rhinitis and taste alteration had a significantly better chance of early recovery of olfactory function.
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Affiliation(s)
- Pattraporn Kreesaeng
- Department of Otolaryngology Head & Neck Surgery, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand
| | - Navarat Tangbumrungtham
- Department of Otolaryngology Head & Neck Surgery, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand
| | - Ratchaporn Rachapattayakhom
- Department of Otolaryngology Head & Neck Surgery, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand
| | - Boonsam Roongpuvapaht
- Department of Otolaryngology Head & Neck Surgery, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand
| | - Kangsadarn Tanjararak
- Department of Otolaryngology Head & Neck Surgery, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand
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Pfaar O, Bousquet J, Durham SR, Kleine‐Tebbe J, Larché M, Roberts G, Shamji MH, Gerth van Wijk R. One hundred and ten years of Allergen Immunotherapy: A journey from empiric observation to evidence. Allergy 2022; 77:454-468. [PMID: 34315190 DOI: 10.1111/all.15023] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 07/24/2021] [Indexed: 12/12/2022]
Abstract
One hundred and ten years after Noon's first clinical report of the subcutaneous application of allergen extracts, allergen immunotherapy (AIT) has evolved as the most important pillar of the treatment of allergic patients. It is the only disease-modifying treatment option available and the evidence for its clinical efficacy and safety is broad and undisputed. Throughout recent decades, more insights into the underlying mechanisms, in particular the modulation of innate and adaptive immune responses, have been described. AIT is acknowledged by worldwide regulatory authorities, and following the regulatory guidelines for product development, AIT products are subject to a rigorous evaluation before obtaining market authorization. Knowledge and practice are anchored in international guidelines, such as the recently published series of the European Academy of Allergy and Clinical Immunology (EAACI). Innovative approaches continue to be further developed with the focus on clinical improvement by, for example, the usage of adjuvants, peptides, recombinants, modification of allergens, new routes of administration, and the concomitant use of biologicals. In addition, real-life data provide complementary and valuable information on the effectiveness and tolerability of this treatment option in the clinical routine. New mobile health technologies and big-data approaches will improve daily treatment convenience, adherence, and efficacy of AIT. However, the current coronavirus disease 2019 (COVID-19) pandemic has also had some implications for the feasibility and practicability of AIT. Taken together, AIT as the only disease-modifying therapy in allergic diseases has been broadly investigated over the past 110 years laying the path for innovations and further improvement.
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Affiliation(s)
- Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery Section of Rhinology and Allergy University Hospital Marburg, Philipps‐Universität Marburg Marburg Germany
| | - Jean Bousquet
- Department of Dermatology and Allergy Charité, Universitätsmedizin Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health, Comprehensive Allergy Center Berlin Germany
- University Hospital Montpellier Montpellier France
| | - Stephen R. Durham
- Allergy and Clinical Immunology Asthma UK Centre in Allergic Mechanisms of Asthma Imperial College NIHR Biomedical Research Centre, National Heart and Lung Institute London UK
| | - Jörg Kleine‐Tebbe
- Allergy & Asthma Center Westend, Outpatient and Clinical Research Center Berlin Germany
| | - Mark Larché
- Department of Medicine McMaster University Hamilton ON Canada
- Firestone Institute for Respiratory Health, St. Joseph's Healthcare Hamilton ON Canada
| | - Graham Roberts
- Faculty of Medicine University of Southampton Southampton UK
- The David Hide Asthma and Allergy Research Centre St Mary's Hospital Isle of Wight UK
- NIHR Southampton Biomedical Research Centre University Hospital Southampton NHS Foundation Trust Southampton UK
| | - Mohamed H. Shamji
- Allergy and Clinical Immunology Asthma UK Centre in Allergic Mechanisms of Asthma Imperial College NIHR Biomedical Research Centre, National Heart and Lung Institute London UK
| | - Roy Gerth van Wijk
- Section of Allergology and Clinical Immunology Department of Internal Medicine Erasmus Medical Center Rotterdam The Netherlands
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Alvaro‐Lozano M, Sandoval‐Ruballos M, Giovannini M, Jensen‐Jarolim E, Sahiner U, Tomic Spiric V, Quecchia C, Chaker A, Heffler E, Klimek L, Brough H, Sturm G, Untersmayr E, Bonini M, Pfaar O. Allergic patients during the COVID-19 pandemic-Clinical practical considerations: An European Academy of Allergy and Clinical Immunology survey. Clin Transl Allergy 2022; 12:e12097. [PMID: 35070270 PMCID: PMC8762981 DOI: 10.1002/clt2.12097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 12/18/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has affected health care systems unexpectedly. However, data focusing on practical considerations experienced by health care professionals (HCPs) providing care to allergic patients is scarce. METHODS Under the framework of the European Academy of Allergy and Clinical Immunology (EAACI), a panel of experts in the field of immunotherapy developed a 42-question online survey, to evaluate real-life consequences of the COVID-19 pandemic in allergy practice. RESULTS The respondents in the survey were 618. About 80% of HCPs indicated being significantly affected in their allergy practice. A face-to-face visit reduction was reported by 93% of HCPs and about a quarter completely interrupted diagnostic challenges. Patients with severe uncontrolled asthma (59%) and anaphylaxis (47%) were prioritized for in-person care. About 81% maintained an unaltered prescription of inhaled corticosteroids (ICS) in asthmatics. About 90% did not modify intranasal corticosteroids (INCS) in patients with allergic rhinitis. Nearly half of respondents kept biological prescriptions unmodified for asthma. About 50% of respondents kept their allergen immunotherapy (AIT) prescription patterns unchanged for respiratory allergies; 60% for insect venom allergies. Oral immunotherapy (OIT) for food allergies was initiated by 27%. About 20% kept carrying out up-dosing without modifications and 14% changed to more prolonged intervals. Telemedicine practice was increased. CONCLUSIONS HCPs providing care to allergic patients were affected during the pandemic in diagnostic, management, and therapeutic approaches, including AIT for respiratory, insect-venom, and food allergies. Most HCPs maintained controller treatments for both asthma, and allergic rhinitis consistent with international recommendations, as well as biological agents in asthma. Remote tools are valuable in delivering allergy care.
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Affiliation(s)
- Montserrat Alvaro‐Lozano
- Pediatric Allergology and Clinical ImmunologyHospital Sant Joan de DéuBarcelonaSpain
- Childhood and Adolescence Allergic Illness GroupInstitut de Recerca Sant Joan de DéuBarcelonaSpain
- Facultat de Medicina i Ciències de la SalutUniversitat de BarcelonaBarcelonaSpain
| | - Mónica Sandoval‐Ruballos
- Pediatric Allergology and Clinical ImmunologyHospital Sant Joan de DéuBarcelonaSpain
- Childhood and Adolescence Allergic Illness GroupInstitut de Recerca Sant Joan de DéuBarcelonaSpain
| | - Mattia Giovannini
- Allergy UnitDepartment of PediatricsMeyer Children's University HospitalFlorenceItaly
| | - Erika Jensen‐Jarolim
- Institute of Pathophysiology and Allergy ResearchCenter for Pathophysiology, Infectiology and ImmunologyMedical University ViennaViennaAustria
- The Interuniversity Messerli Research Institute, Medical University Vienna, Veterinary University Vienna, and University ViennaViennaAustria
| | - Umit Sahiner
- Department of Pediatric Allergy and AsthmaHacettepe University School of MedicineAnkaraTurkey
| | - Vesna Tomic Spiric
- Faculty of MedicineUniversity of BelgradeBelgradeSerbia
- Clinic of Allergology and ImmunologyClinical Centre of SerbiaBelgradeSerbia
| | - Cristina Quecchia
- “Io e l’Asma” CenterChildren's HospitalASST Spedali CiviliBresciaItaly
| | - Adam Chaker
- Department of Otolaryngology and Center of Allergy and EnvironmentTUM School of MedicineTechnical University of MunichMunichGermany
| | - Enrico Heffler
- Personalized Medicine, Asthma and AllergyHumanitas Clinical and Research Hospital IRCCSRozzanoItaly
- Department of Biomedical SciencesHumanitas UniversityMilanItaly
| | - Ludger Klimek
- Center for Rhinology and AllergologyWiesbadenGermany
| | - Helen Brough
- Children's Allergy ServiceEvelina Children's HospitalGuy's and St. Thomas' HospitalLondonUK
- Paediatric Allergy GroupDepartment of Women and Children's HealthSchool of Life Course SciencesKing's College LondonLondonUK
| | - Gunter Sturm
- Department of Dermatology and VenerologyMedical University of GrazGrazAustria
- Allergy Outpatient Clinic ReummanplatzViennaAustria
| | - Eva Untersmayr
- Institute of Pathophysiology and Allergy ResearchCenter for Pathophysiology, Infectiology and ImmunologyMedical University ViennaViennaAustria
| | - Mateo Bonini
- Department of Cardiovascular and Thoracic SciencesFondazione Policlinico Universitario A. Gemelli – IRCCSUniversità Cattolica del Sacro CuoreRomeItaly
- National Heart and Lung Institute (NHLI)Imperial College LondonLondonUK
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital MarburgPhilipps‐Universität MarburgMarburgGermany
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Pfaar O, Agache I, Bonini M, Brough HA, Chivato T, Del Giacco SR, Gawlik R, Gelincik A, Hoffmann‐Sommergruber K, Jutel M, Klimek L, Knol EF, Lauerma A, Ollert M, O’Mahony L, Mortz CG, Palomares O, Riggioni C, Schwarze J, Skypala I, Torres MJ, Untersmayr E, Walusiak‐Skorupa J, Chaker A, Giovannini M, Heffler E, Jensen‐Jarolim E, Quecchia C, Sandoval‐Ruballos M, Sahiner U, Tomić Spirić V, Alvaro‐Lozano M. COVID-19 pandemic and allergen immunotherapy-an EAACI survey. Allergy 2021; 76:3504-3516. [PMID: 33655519 PMCID: PMC8013670 DOI: 10.1111/all.14793] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/05/2021] [Accepted: 02/10/2021] [Indexed: 02/06/2023]
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 to 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. METHODS Under the framework of the EAACI, a panel of experts in the field of AIT coordinated by the Immunotherapy Interest Group 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.
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Ding M, Dong X, Sun YL, Sokolowska M, Akdis M, van de Veen W, Azkur AK, Azkur D, Akdis CA, Gao YD. Recent advances and developments in COVID-19 in the context of allergic diseases. Clin Transl Allergy 2021; 11:e12065. [PMID: 34582102 PMCID: PMC8646609 DOI: 10.1002/clt2.12065] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 09/09/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Since the first reports of coronavirus disease 2019 (COVID-19) in Wuhan, China, in December 2019, there have been 198 million confirmed cases worldwide as of August 2021. The scientific community has joined efforts to gain knowledge of the newly emerged virus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the immunopathological mechanisms leading to COVID-19, and its significance for patients with allergies and asthma. METHODS Based on the current literature, recent advances and developments in COVID-19 in the context of allergic diseases were reviewed. RESULTS AND CONCLUSIONS In this review, we discuss the prevalence of COVID-19 in subjects with asthma, attacks of hereditary angioedema, and other allergic diseases during COVID-19. Underlying mechanisms suggest a protective role of allergy in COVID-19, involving eosinophilia, SARS-CoV-2 receptors expression, interferon responses, and other immunological events, but further studies are needed to fully understand those associations. There has been significant progress in disease evaluation and management of COVID-19, and allergy care should continue during the COVID-19 pandemic. The European Academy of Allergy & Clinical Immunology (EAACI) launched a series of statements and position papers providing recommendations on the organization of the allergy clinic, handling of allergen immunotherapy, asthma, drug hypersensitivity, allergic rhinitis, and other allergic diseases. Treatment of allergies using biologics during the COVID-19 pandemic has also been discussed. Allergic reactions to the COVID-19 vaccines, including severe anaphylaxis, have been reported. Vaccination is a prophylactic strategy that can lead to a significant reduction in the mortality and morbidity associated with SARS-CoV-2 infection, and in this review, we discuss the proposed culprit components causing rare adverse reactions and recommendations to mitigate the risk of anaphylactic events during the administration of the vaccines.
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Affiliation(s)
- Mei Ding
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Province Key Laboratory of Allergy and Immunology, Wuhan University, Wuhan, China
| | - Xiang Dong
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Province Key Laboratory of Allergy and Immunology, Wuhan University, Wuhan, China
| | - Yuan-Li Sun
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Province Key Laboratory of Allergy and Immunology, Wuhan University, Wuhan, China
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.,Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Willem van de Veen
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Ahmet Kursat Azkur
- Department of Virology, Faculty of Veterinary Medicine, University of Kirikkale, Kirikkale, Turkey
| | - Dilek Azkur
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, University of Kirikkale, Kirikkale, Turkey
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.,Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Ya-Dong Gao
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Province Key Laboratory of Allergy and Immunology, Wuhan University, Wuhan, China
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COVID-19 vaccination and allergen immunotherapy (AIT) - A position paper of the German Society for Applied Allergology (AeDA) and the German Society for Allergology and Clinical Immunology (DGAKI). Allergol Select 2021; 5:251-259. [PMID: 34533543 PMCID: PMC8439106 DOI: 10.5414/alx02245e] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 06/11/2021] [Indexed: 12/19/2022] Open
Abstract
Background: Vaccinations against severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) are intended to induce an immune response to protect against infection/disease. Allergen immunotherapy (AIT) is thought to induce a (different) immune response, e.g., to induce tolerance to allergens. In this position paper we clarify how to use AIT in temporal relation to COVID-19 vaccination. Four SARS-CoV-2 vaccines are currently approved in the EU, and their possible immunological interactions with AIT are described together with practical recommendations for use. Materials and methods: Based on the internationally published literature, this position paper provides specific recommendations for the use of AIT in temporal relation to a SARS-CoV-2 vaccination. Results: AIT is used in 1) allergic rhinitis, 2) allergic bronchial asthma, 3) insect venom allergy, 4) food allergy (peanut). Conclusion: For the continuation of an ongoing AIT, we recommend an interval of 1 week before and after vaccination for subcutaneous immunotherapy (SCIT). For sublingual immunotherapy (SLIT) and oral immunotherapy (OIT), we recommend taking them up to the day before vaccination and a break of 2 – 7 days after vaccination. Initiation of a new SCIT, SLIT, or OIT should be delayed until 1 week after the day of the second vaccination. For SCIT, we generally recommend an interval of ~ 1 week to COVID-19 vaccination.
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Pfaar O, Klimek L, Hamelmann E, Kleine-Tebbe J, Taube C, Wagenmann M, Werfel T, Brehler R, Novak N, Mülleneisen NK, Becker S, Worm M. COVID-19-Impfungen von Patienten mit Allergien und Typ2-entzündlichen Erkrankungen bei gleichzeitiger Antikörpertherapie (Biologika). ALLERGO JOURNAL 2021; 30:24-33. [PMID: 34393383 PMCID: PMC8349605 DOI: 10.1007/s15007-021-4846-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Oliver Pfaar
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Sektion für Rhinologie und Allergologie, Baldingerstraße, 35043 Marburg, Germany
| | - Ludger Klimek
- FA für Dermatologie u. Allergologie, Zentrum f. Rhinologie und Allergologie, An den Quellen 10, 65183 Wiesbaden, Germany
| | - Eckard Hamelmann
- Kinderzentrum Bethel, Evangelisches Krankenhaus Bielefeld gGmbH, Grenzweg 10, 33617 Bielefeld, Germany
| | - Jörg Kleine-Tebbe
- Dermatologie, Umweltmedizin, Allergie- und Asthmazentrum Westend, Spandauer Damm 130, Haus 9, 14050 Berlin, Germany
| | - Christian Taube
- Direktor d. Abt. f. Pneumologie, Universitätsklinikum Essen (AöR), Hufelandstraße 55, 45147 Essen, Germany
| | - Martin Wagenmann
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Thomas Werfel
- Klinik für Dermatologie, Allergologie und Venerologie, Med. Hochschule Hannover, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Randolf Brehler
- - Klinik für Hautkrankheiten -, Wilhelm-Univ. Münster, Abtlg. Dermatologie, Von-Esmarch-Str. 58, 48149 Münster, Germany
| | - Natalija Novak
- - Universitätsklinikum Bonn -, Klinik u. Poliklinik f. Dermatologie u. Allergologie, Sigmund-Freud-Str. 25, 53105 Bonn, Germany
| | | | - Sven Becker
- Universitätsklinik für Hals-, Nasen-, und Ohrenheilkunde, Universitätsklinik Tübingen, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany
| | - Margitta Worm
- Klinik für Dermatologie und Allergologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
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Pfaar O, Mahler V. Allergic reactions to COVID-19 vaccinations-unveiling the secret(s). Allergy 2021; 76:1621-1623. [PMID: 33432606 PMCID: PMC8013986 DOI: 10.1111/all.14734] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/07/2021] [Accepted: 01/08/2021] [Indexed: 02/06/2023]
Affiliation(s)
- Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery Section of Rhinology and Allergy University Hospital MarburgPhilipps‐Universität Marburg Marburg Germany
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Pfaar O, Klimek L, Hamelmann E, Kleine-Tebbe J, Taube C, Wagenmann M, Werfel T, Brehler R, Novak N, Mülleneisen N, Becker S, Worm M. COVID-19 vaccination of patients with allergies and type-2 inflammation with concurrent antibody therapy (biologicals) - A Position Paper of the German Society of Allergology and Clinical Immunology (DGAKI) and the German Society for Applied Allergology (AeDA). Allergol Select 2021; 5:140-147. [PMID: 33842829 PMCID: PMC8028287 DOI: 10.5414/alx02241e] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 03/23/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND After the beginning and during the worldwide pandemic caused by the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), patients with allergic and atopic diseases have felt and still feel insecure. Currently, four vaccines against SARS-CoV-2 have been approved by the Paul Ehrlich Institute in Germany, and vaccination campaigns have been started nationwide. In this respect, it is of utmost importance to give recommendations on possible immunological interactions and potential risks of immunomodulatory substances (monoclonal antibodies, biologicals) during concurrent vaccination with the approved vaccines. MATERIALS AND METHODS This position paper provides specific recommendations on the use of immunomodulatory drugs in the context of concurrent SARS-CoV-2 vaccinations based on current literature. RESULTS The recommendations are covering the following conditions in which biologicals are indicated and approved: 1) chronic inflammatory skin diseases (atopic dermatitis, chronic spontaneous urticaria), 2) bronchial asthma, and 3) chronic rhinosinusitis with nasal polyps (CRSwNP). Patients with atopic dermatitis or chronic spontaneous urticaria are not at increased risk for allergic reactions after COVID-19 vaccination. Nevertheless, vaccination may result in transient eczema exacerbation due to general immune stimulation. Vaccination in patients receiving systemic therapy with biologicals can be performed. Patients with severe asthma and concomitant treatment with biologicals also do not have an increased risk of allergic reaction following COVID-19 vaccination which is recommended in these patients. Patients with CRSwNP are also not known to be at increased risk for allergic vaccine reactions, and continuation or initiation of a treatment with biologicals is also recommended with concurrent COVID-19 vaccination. In general, COVID-19 vaccination should be given within the interval between two applications of the respective biological, that is, with a time-lag of at least 1 week after the previous or at least 1 week before the next biological treatment planned. CONCLUSION Biologicals for the treatment of atopic dermatitis, chronic spontaneous urticaria, bronchial asthma, and CRSwNP should be continued during the current COVID-19 vaccination campaigns. However, the intervals of biological treatment may need to be slightly adjusted (DGAKI/AeDA recommendations as of March 22, 2021).
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Affiliation(s)
- Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg
| | | | - Eckard Hamelmann
- University Hospital for Pediatrics and Adolescent Medicine, Children’s Center Bethel, University of Bielefeld
| | | | - Christian Taube
- Clinic of Pneumology University Hospital Essen – Ruhrlandklinik, Essen
| | - Martin Wagenmann
- Clinic of Otolaryngology, University Hospital Düsseldorf, Düsseldorf
| | - Thomas Werfel
- Department of Dermatology, Allergology and Venerology, Hannover Medical School, Hannover
| | - Randolf Brehler
- Department of Dermatology, Wilhelm University of Münster, Münster
| | | | | | - Sven Becker
- Department of Otorhinolaryngology, University Hospital, Tübingen, and
| | - Margitta Worm
- Allergology and Immunology, Department of Dermatotology, Venereology and Allergology, Charité Universitätsmedizin Berlin, Germany
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Galluzzi F, Rossi V, Bosetti C, Garavello W. Risk Factors for Olfactory and Gustatory Dysfunctions in Patients with SARS-CoV-2 Infection. Neuroepidemiology 2021; 55:154-161. [PMID: 33794531 DOI: 10.1159/000514888] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 01/30/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Smell and taste loss are characteristic symptoms of SARS-CoV-2 infection. The aim of this study is to investigate the prevalence and risk factors associated with olfactory and gustatory dysfunctions in coronavirus disease (COVID-19) patients. METHODS We conducted an observational, retrospective study on 376 patients with documented SARS-CoV-2 infection admitted to the San Gerardo Hospital in Monza, Italy, from March to July 2020. All patients answered a phone questionnaire providing information on age, sex, smoking status, and clinical characteristics. Adjusted odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated through logistic regression models including relevant covariates. RESULTS The prevalence of olfactory and gustatory dysfunctions in COVID-19 patients was 33.5 and 35.6%, respectively. Olfactory dysfunctions were significantly directly associated with current smoking and history of allergy, the multivariable ORs being 6.53 (95% CI 1.16-36.86) for current smokers versus never smokers, and 1.89 (95% CI 1.05-3.39) for those with an allergy compared to those without any allergy. Respiratory allergy in particular was significantly associated with olfactory dysfunctions (multivariable OR 2.30, 95% CI 1.02-5.17). Significant inverse associations were observed for patients aged 60 years or more (multivariable OR 0.33, 95% CI 0.19-0.57) and hospitalization (multivariable OR 0.22, 95% CI 0.06-0.89). Considering gustatory dysfunctions, after allowance of other variables a significant direct association was found for respiratory allergies (OR 2.24, 95% CI 1.03-4.86), and an inverse association was found only for hospitalization (OR 0.21, 95% CI 0.06-0.76). CONCLUSION Our study indicates that current smoking and history of allergy (particularly respiratory) significantly increase the risk for smell loss in COVID-19 patients; the latter is also significantly associated to taste loss. Hospitalization has an inverse association with the risk of olfactory and gustatory dysfunctions, suggesting that these may be symptoms characteristics of less severe SARS-CoV-2 infection.
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Affiliation(s)
| | - Veronica Rossi
- Department of Otorhinolaryngology, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Cristina Bosetti
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Werner Garavello
- Department of Otorhinolaryngology, San Gerardo Hospital, Monza, Italy.,Department of Otorhinolaryngology, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
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Pfaar O. Die Allergen-Immuntherapie – State of the Art 2020. Drug Res (Stuttg) 2020; 70:S24-S26. [DOI: 10.1055/a-1119-2783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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