A fifteen-year review of skin allergy testing in Irish patients with symptomatic rhinitis

Allergic rhinitis facts from an Irish pediatric population

Objective

Assessing the main allergens in the pediatric population from the largest urban area in the country.

Methods

Clinical letters of patients referred with possible allergic rhinitis (AR) were retrospectively reviewed over the past 5 years.

Results

Five hundred and fifty-five patients were included. Males suffer twice as often with AR than females and have high titers of allergens. House dust mites (44.7%) and grass pollen (29%) were the main allergens in our area, with 48% of patients sensitized to both allergens. Half of the patients had the diagnosis of AR confirmed with positive allergen-specific tests. For the other half, the diagnosis was based on a clinical assessment performed by a pediatric otolaryngologist.

Conclusions

Half of suspected AR children have environmental allergen sensitivity confirmed by testing, and a large number had a clinical diagnosis of AR after an otolaryngology consultation. Our findings can help clinicians to initiate AR treatment considering the most problematic allergens in the area.

Analysis of common allergens affecting patients with allergic rhinitis

Allergic rhinitis (AR) is an atopic disorder that affects the quality of life of the patients. AR symptoms include sneezing, nasal congestion, and mucus discharge. It is often associated with several other eye-, ear-, and nose-related symptoms along with fatigue and mood changes. The allergic reaction is triggered by an allergen. An understanding of the allergens that affect a patient is important for allergen avoidance, and ultimately, the treatment of AR. This study aimed to identify the common allergens affecting patients with AR. A total of 52 patients with AR were identified for this study. AR was diagnosed based on the presenting symptoms and measurement of IgE levels and absolute eosinophil counts. Skin prick tests (SPT) were performed to identify the allergen sensitivity of the patients. Patient history, family history, and a detailed account of the symptoms were recorded. Finally, correlation between family history and allergy severity was statistically evaluated. All patients presented symptoms of rhinitis with sinusitis and 61.5% of these were mild or moderate allergic. Few of the patients had ocular or otic symptoms. The duration of allergy was variable in these patients. A high proportion of patients were allergic to house dust mites (92.3%). The proportion of patients allergic to pollen, Parthenium, cockroach, cotton dust, and Aspergillus were 84.6%, 76.9%, 75%, 65.4%, and 61.5%, respectively. Around 71.2% of patients reported a family history of allergy. SPT severity was not associated with family history (p=0.266). This study successfully identifies the common allergens affecting patients with AR from Chennai, India. It highlights the importance of SPT for the identification of allergens in deciding the treatment regimen for AR.

Impact of Allergic Rhinitis and Asthma on COVID-19 Infection, Hospitalization, and Mortality

Background

It remains unclear if patients with allergic rhinitis (AR) and/or asthma are susceptible to corona virus disease 2019 (COVID-19) infection, severity, and mortality.

Objective

To investigate the role of AR and/or asthma in COVID-19 infection, severity, and mortality, and assess whether long-term AR and/or asthma medications affected the outcomes of COVID-19.

Methods

Demographic and clinical data of 70,557 adult participants completed SARS-CoV-2 testing between March 16 and December 31, 2020, in the UK Biobank were analyzed. The rates of COVID-19 infection, hospitalization, and mortality in relation to pre-existing AR and/or asthma were assessed based on adjusted generalized linear models. We further analyzed the impact of long-term AR and/or asthma medications on the risk of COVID-19 hospitalization and mortality.

Results

Patients with AR of all ages had lower positive rates of SARS-CoV-2 tests (relative risk [RR]: 0.75, 95% confidence interval [CI]: 0.69-0.81, P < .001), with lower susceptibility in males (RR: 0.74, 95% CI: 0.65-0.85, P < .001) than females (RR: 0.8, 95% CI: 0.72-0.9, P < .001). However, similar effects of asthma against COVID-19 hospitalization were only major in participants aged <65 (RR: 0.93, 95% CI: 0.86-1, P = .044) instead of elderlies. In contrast, patients with asthma tested positively had higher risk of hospitalization (RR: 1.42, 95% CI: 1.32-1.54, P < .001). Neither AR nor asthma had an impact on COVID-19 mortality. None of conventional medications for AR or asthma, for example, antihistamines, corticosteroids, or β2 adrenoceptor agonists, showed association with COVID-19 infection or severity.

Conclusion

AR (all ages) and asthma (aged <65) act as protective factors against COVID-19 infection, whereas asthma increases risk for COVID-19 hospitalization. None of the long-term medications had a significant association with infection, severity, and mortality of COVID-19 among patients with AR and/or asthma.