The relationship between aeroallergen sensitivity variations and Covid 19 in patients with rhinitis Aeroallergen sensitivity and COVID-19
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Abstract
Objective: There have been studies evaluating the association between AR and COVID-19 infection, but these studies did not evaluate the sensitisation of patients. The objective of this study was to examine the impact of allergen sensitisation on the transmission of viral infections and the progression of the disease.
Material and Methods: Rhinitis patients admitted to the Adult Allergy Outpatient Clinic between April and June 2021 were included in the study. Aeroallergen sensitisation and COVID-19 disease status of the patients were evaluated.
Results: Data were collected from 260 patients. It was determined that 23.8% (n=62) of the patients had COVID-19 and 17.7% (n=11) had COVID-19 pneumonia. This rate was higher than the incidence of COVID-19 in the general population. The rate of COVID-19 infection was significantly higher in patients with pollen allergy compared to other groups (p=0.049). When the COVID-19 transmission periods of the patients were analysed, it was observed that 55% of them were infected between March and September in accordance with the pollen map. Patients taking steroids (INCS or ICS) did not have an increased risk of COVID infection, and concomitant asthma did not pose an increased risk. Having chronic diseases was found to be a risk factor.
Conclusions: This study provides clinical evidence of an increased frequency of infection in AR patients, especially in AR patients with pollen allergy. This result is valuable as it is a data not presented in existing studies. We also think that the risk of COVID-19 increases with pollen exposure. As pollen can suppress antiviral immunity, we recommend that chronic disease groups pay special attention to prevention methods, especially when pollen and respiratory virus seasons overlap.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Accepted 2023-08-21
Published 2023-08-22
References
Coronaviridae Study Group of the International Committee on Taxonomy of Viruses The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-CoV and naming it SARS-CoV-2. Nature microbiology, 2020, 5.4: 536-544.
Kailiang X., Huayong T, Yingfeng F, et al. The outbreak of Coronavirus Disease 2019：update on the characteristics and prevention strategies. Authorea. April 20, 2020.
Gao YD, Agache I, Akdis M, Nadeau K, Klimek L, Jutel M, et al. The effect of allergy and asthma as a comorbidity on the susceptibility and outcomes of COVID-19. Int Immunol. 2022 Mar 25;34(4):177-188.
Gani F, Cottini M, Landi M, Berti A, Comberiati P, Peroni D, et al.Allergic rhinitis and COVID-19: friends or foes? Eur Ann Allergy Clin Immunol. 2022 Mar;54(2):53-59.
Dyjack N, Goleva E, Rios C, Kim BE, Bin L, Taylor P,et al. Minimally invasive skin tape strip RNA sequencing identifies novel characteristics of the type 2-high atopic dermatitis disease endotype. J Allergy Clin Immunol. 2018 Apr;141(4):1298-1309.
Pfaar, L Klimek, M Jutel, CA Akdis, J Bousquet, H Breiteneder, et al. COVID‐19 pandemic: practical considerations on the organisation of an allergy clinic—an EAACI/ARIA Position Paper . Allergy, 2021;76(3):648-676.
Canonica GW, Bousquet J, Mullol J, Scadding GK, Virchow JC. A survey of the burden of allergic rhinitis in Europe. Allergy. 2007;62 Suppl 85:17-25.
Vezir E, Hizal M, Cura Yayla B, Aykac K, Yilmaz A, Kaya G,et al. Does aeroallergen sensitivity and allergic rhinitis in children cause milder COVID-19 infection? Allergy Asthma Proc. 2021 Nov 1;42(6):522-529.
Ren, J., Pang, W., Luo, Y., Cheng, D., Qiu, K., Rao, Y., et al. Impact of allergic rhinitis and asthma on COVID-19 infection, hospitalisation, and mortality. The Journal of Allergy and Clinical Immunology: In Practice, 2022;10(1): 124-133.
Hai W, Jia S, Yin Y, Yi-Ke D, Zhi-Chao W, Bo Liao, et al.Angiotensin-converting enzyme II expression and its implication in the association between COVID-19 and allergic rhinitis Allergy 2021 Mar;76(3):906-910.
J Zhang, X Dong, Y Cao, Y Yuan, Y Yang, Y Yan, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. 2020;75(7):1730-1741.
Jian L, Yi W, Zhang N,Welping W,Krysko O,Song W et al. Perspective: COVID-19, implications of nasal diseases and consequences for their management. J Allergy Clin Immunol. 2020;146(1):67-69.
Yang JM, Koh HY, Moon SY, Yoo IK, Ha EK, You S, et al.Allergic disorders and susceptibility to and severity of COVID-19: A nationwide cohort study. J Allergy Clin Immunol. 2020 Oct;146(4):790-798.
Beken B, Ozturk GK, Aygun FD, Aydogmus C, Akar HH. Asthma and allergic diseases are not risk factors for hospitalisation in children with coronavirus disease 2019. Ann Allergy Asthma Immunol. 2021 May;126(5):569-575
Jackson DJ, Busse WW, Bacharier LB, Association of respiratory allergy, asthma and expression of the SARS-CoV-2 Receptor, ACE2. J Allergy Clin Immunol. 2020;146:203-206.
Chang MC, Park YK, Kim BO, Park D Risk factors for disease progression in COVID-19 patients. BMC Infect Dis 2020; 20:445.
Bozek A, Winterstein J. Montelukasts ability to fight COVID-19 infection. J Asthma. 2020;4:1348-1349
Bousquet J, Akdis C, Jutel M, Bachert C, Klimek L,Agache I ARIA-MASK study group.Intranasal corticosteroids in allergic rhinitis in COVID-19 infected patients: An ARIA-EAACI statement. Allergy. 2020;75(10):2440-2444
Damialis A, Gilles S, Sofiev M, Sofieva V, Kolek F, Bayr D,et al.; COVID-19/POLLEN study group, Higher airborne pollen concentrations correlated with increased SARS-CoV-2 infection rates, as evidenced from 31 countries across the globe. Proc Natl Acad Sci U S A. 2021 118(12):e2019034118.
Jose O, Elke B, Francesca A, Andres N, Diego A. M, Heidrun B, Artemisia pollen is the main vector for airborne endotoxin. J Allergy Clin Immunol 2019;143:369-77.
Fouad SH, Allam MF, Taha SI, Okba AA, Hosny A, Moneer M, et al. Comparison of hemoglobin level and neutrophil to lymphocyte ratio as prognostic markers in patients with COVID-19. J Int Med Res. 2021 Jul;49(7):3000605211030124.
Henry BM, de Oliveira MHS, Benoit S, Plebani M, Lippi G. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. Clin Chem Lab Med. 2020 Jun 25;58(7):1021-1028. doi: 10.1515/cclm-2020-0369. PMID: 32286245.
Wang Y, Ju M, Chen C, Yang D, Hou D, Tang X,et al. Neutrophil-to-lymphocyte ratio as a prognostic marker in acute respiratory distress syndrome patients: a retrospective study. J Thorac Dis. 2018 Jan;10(1):273-282.
Shen Y, Huang X, Zhang W. Platelet-to-lymphocyte ratio as a prognostic predictor of mortality for sepsis: interaction effect with disease severity-a retrospective study. BMJ Open. 2019 Jan 25;9(1):e022896.
Wise SK, Lin SY, Toskala E, International consensus statement on allergy and rhinology: allergic rhinitis. Int Forum Allergy Rhinol 2018:8(2):108-352.
Ya-dong G, Ioana A, Mübeccel A, Kari N, Ludger K, Marek J. The effect of allergy and asthma as a comorbidity on the susceptibility and outcomes of COVID-19 International Immunology, Vol. 34, No. 4, pp. 177–188 https://doi.org/10.1093/intimm/ dxab107
Green, I., Merzon, E., Vinker, S. COVID-19 susceptibility in bronchial asthma. J. Allergy Clin. Immunol. Pract.2021; 9:684.
Yang, J. M., Koh, H. Y., Moon, S. Y. Allergic disorders and susceptibility to and severity of COVID-19: a nationwide cohort study. J. Allergy Clin. Immunol.2020; 146:790.
Sozener ZÇ, Lacin C, Kari N Akdis, M, . Akdis CA, Environmental factors in epithelial barrier dysfunction J Allergy Clin Immunol 2020;145:1517-28. https://doi.org/10.1016/j.jaci.2020. 04.024
Sbihi H, Boutin RC, Cutler C, Suen M, Finlay BB, Turvey SE. Thinking bigger:how early-life environmental exposures shape the gut microbiome and influencethe development of asthma and allergic disease. Allergy 2019;74:2103-15.
Haahtela T. A biodiversity hypothesis. Allergy 2019;74:1445-56.
Eguiluz-Gracia I, Mathioudakis AG, Bartel S, Vijverberg SJ, Fuertes E, Comberiati P, et al. The need for clean air: the way air pollution and climate change affect allergic rhinitis and asthma Allergy2020,75(9):2170-2184 https://doi.org/10.1111/all.14177.
Itazawa T, Kanatani KT, Hamazaki K, Inadera H, Tsuchida A, Tanaka T, et al; Japan Environment and Children’s Study Group. The impact of exposure to desert dust on infants’ symptoms and countermeasures to reduce the effects Allergy 2019,75(6):1435-1445
https://doi.org/10.1111/all.14166.
Ruiz-Hornillos J, Lopez-Matas MA, Berges Jimeno P, Henrıquez A, Blanco S, Seoane-Rodrıguez M, et al. Profilin is a marker of severity in allergic respiratory diseases. Allergy 2020;75:853-61.
Hew M, Lee J, Susanto NH, Prasad S, Bardin PG, Barnes S, et al. The 2016 Melbourne thunderstorm asthma epidemic: risk factors for severe attacks requiring hospital admission. Allergy 2019;74:122-30.
Agache I, Miller R, Gern JE, Hellings PW, Jutel M, Muraro A, et al. Emerging concepts and challenges in implementing the exposome paradigm in allergic diseases and asthma: a PRACTALL document. Allergy 2019;74:449-63.
Blume C, Swindle EJ, Dennison P, Jayasekera NP, Dudley S, Monk P, et al. Barrier responses of human bronchial epithelial cells to grass pollen exposure. EurRespir J 2013;42:87-97.
Chaudhary N, Marr KA. Impact of Aspergillus fumigatus in allergic airway diseases. Clin Transl Allergy 2011;1:4.
Gilles S, Blume C, Wimmer M, Pollen exposure weakens innate defense against respiratory viruses. Allergy. 2020;75:576–587. https ://doi.org/10.1111/all.14047
Çelik F, Soyöz Ö, Sancaklı Ö, Bölük S, Taşkırdı İ , Kaya M The Effect of the COVID-19 Pandemic Lockdown on Symptom Severity in School Children with House Dust Mite Sensitized Allergic Rhinitis. Rev Fr Allergol (2009). 2022 Jul 18. doi: 10.1016/j.reval.2022.07.006.
Gelardi M, Trecca E, Fortunato F, COVID-19: When dust mites and lockdown create the perfect storm. Laryngoscope Investig Otolaryngol 2020;5(5):788-90.
Gelardi, M., Trecca, E., Fortunato, F. COVID-19 lockdown and seasonal allergic rhinitis: our experience in 40 patients. Acta Biomed. 2021; 92:e2021215.
Dunker S, Hornick T, Szczepankiewicz G, Maier M., Bast M, Bumberger J, et al. No SARS-CoV-2 detected in air samples (pollen and particulate matter) in Leipzig during the first spread Sci Total Environ 2021, 10;755DOI: 10.1016/j.scitotenv.2020.142881
Klimek L, Jutel M, Bousquet J, Management of patients with chronic rhinosinusitis during the COVID-19 pandemic—An EAACI position paper. Allergy. 2021;76:677–688. https://doi.org/10.1111/all.14629
Graciela C, Torres-Garc D. J. Cervantes-Torres, S. Rosales-M, A. Fleury, G. Fragoso, Role of Systemic and Nasal Glucocorticoid Treatment in the Regulation of the Inflammatory Response in Patients with SARS-Cov-2 Infection Archives of Medical Research 2021;52 :143-150
Jae C. Won-Young K. Inhaled budesonide for early treatment of COVID-19 the Lancet; 2021 May Published:DOI:https://doi.org/10.1016/S2213-2600(21)00217-4
Scadding G K., Hellings P. W. , Bachert C. , Bjermer L. , Diamant Z. , Gevaert P.et al. Allergic respiratory disease care in the COVID-19 era: A EUFOREA statement World Allergy Organization Journal 2020;13:100124 http://doi.org/10.1016/j.waojou.2020.10012
Pfaar O, Hamelmann E, Klimek L Allergen immunotherapy during the COVID‐19 pandemic A survey of the German Society for Allergy and Clinical Immunology. Clin Transl Allergy
,12(3):e12134. doi: 10.1002/clt2.12134.
Yenigün A. Assesment of pateints with nasal polyposis by the neutrophil to lymphocyte ratio and eosinophil to lymphocyte ratio. Kulak Burun Boğaz Ihtis Drg 2015; 25 (4): 193-199.
Wu X, Xu Y, Jin L, Wang X, Zhu H and Xie Y Association of Preexisting Asthma and Other Allergic Diseases With Mortality in COVID-19 Patients: A Systematic Review and Meta-Analysis. Front. Med. 2021; 8:670744. doi: 10.3389/fmed.2021.