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Ne CKH, Suaini NHA, Aung WT, Ong KGS, Samuel M, Tham EH. Impact of COVID-19 pandemic on adults and children with atopic dermatitis and food allergy: Systematic review. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2024; 3:100181. [PMID: 38026506 PMCID: PMC10665685 DOI: 10.1016/j.jacig.2023.100181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/26/2023] [Accepted: 08/09/2023] [Indexed: 12/01/2023]
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic caused significant disruptions to health care services and health impacts on patients with atopic dermatitis (AD) and/or food allergy (FA). Objective We evaluated the impact of the COVID-19 pandemic and disease on AD/FA patients. Methods A comprehensive systematic literature search was conducted from December 2019 to 2022. Screening and data extraction were done following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, and the Mixed Methods Appraisal Tool, or MMAT, was used to assess risk of bias. Results In total, 159 studies were included. Five of 7 studies reported no significant changes in overall incidence or prevalence of AD during the pandemic, although some studies noted an increase in the elderly and infants. Telehealth served as an effective alternative to face-to-face consultations, with mixed levels of patient and provider satisfaction. Dissatisfaction was most marked in patients with more severe disease, who thought that their disease was inadequately managed through telemedicine. Higher levels of general anxiety were recorded in both AD/FA patients and caregivers, and it was more pronounced in patients with severe disease. Most studies reported no significant differences in postvaccination adverse effects in AD patients; however, results were more varied in FA patients. Conclusion Our review identified the impact of COVID-19 pandemic- and disease-driven changes on AD/FA patients. Telemedicine is uniquely suited to manage atopic diseases, and hybrid care may be a suitable approach even in the postpandemic era. COVID-19 vaccines and biologics can be safely administered to patients with atopic diseases, with appropriate patient education to ensure continued care for high-risk patients.
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Affiliation(s)
| | - Noor Hidayatul Aini Suaini
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore, Republic of Singapore
| | - Win Thu Aung
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | | | - Miny Samuel
- Research Support Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Elizabeth Huiwen Tham
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore, Republic of Singapore
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
- Khoo Teck Puat-National University Children’s Medical Institute, National University Health System (NUHS), Singapore, Republic of Singapore
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Munblit D, Greenhawt M, Brough HA, Pushkareva A, Karimova D, Demidova A, Warner JO, Kalayci O, Sediva A, Untersmayr E, Rodriguez Del Rio P, Vazquez-Ortiz M, Arasi S, Alvaro-Lozano M, Tsabouri S, Galli E, Beken B, Eigenmann PA. Allergic diseases and immunodeficiencies in children, lessons learnt from COVID-19 pandemic by 2022: A statement from the EAACI-section on pediatrics. Pediatr Allergy Immunol 2022; 33:e13851. [PMID: 36282136 PMCID: PMC9538373 DOI: 10.1111/pai.13851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/23/2022] [Accepted: 08/31/2022] [Indexed: 11/28/2022]
Abstract
By the April 12, 2022, the COVID-19 pandemic had resulted in over half a billion people being infected worldwide. There have been 6.1 million deaths directly due to the infection, but the pandemic has had many more short- and long-term pervasive effects on the physical and mental health of the population. Allergic diseases are among the most prevalent noncommunicable chronic diseases in the pediatric population, and health-care professionals and researchers were seeking answers since the beginning of pandemic. Children are at lower risk of developing severe COVID-19 or dying from infection. Allergic diseases are not associated with a higher COVID-19 severity and mortality, apart from severe/poorly controlled asthma. The pandemic disrupted routine health care, but many mitigation strategies, including but not limited to telemedicine, were successfully implemented to continue delivery of high-standard care. Although children faced a multitude of pandemic-related issues, allergic conditions were effectively treated remotely while reduction in air pollution and lack of contact with outdoor allergens resulted in improvement, particularly respiratory allergies. There is no evidence to recommend substantial changes to usual management modalities of allergic conditions in children, including allergen immunotherapy and use of biologicals. Allergic children are not at greater risk of multisystem inflammatory syndrome development, but some associations with Long COVID were reported, although the data are limited, and further research is needed. This statement of the EAACI Section on Pediatrics provides recommendations based on the lessons learnt from the pandemic, as available evidence.
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Affiliation(s)
- Daniel Munblit
- Inflammation, Repair and Development Section, Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - Matthew Greenhawt
- Section of Allergy and Clinical Immunology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Helen A Brough
- Children's Allergy Service, Evelina Children's Hospital, Guy's and St. Thomas' Hospital, London, UK.,Paediatric Allergy Group, Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Anna Pushkareva
- European Academy of Allergy and Clinical Immunology (EAACI), Zurich, Switzerland
| | - Diana Karimova
- European Academy of Allergy and Clinical Immunology (EAACI), Zurich, Switzerland
| | - Anastasia Demidova
- European Academy of Allergy and Clinical Immunology (EAACI), Zurich, Switzerland
| | - John O Warner
- Inflammation, Repair and Development Section, Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - Omer Kalayci
- Pediatric Allergy and Asthma, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Anna Sediva
- Department of Immunology, 2nd Medical Faculty, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Eva Untersmayr
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | | | - Marta Vazquez-Ortiz
- Inflammation, Repair and Development Section, Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - Stefania Arasi
- Translational Research in Pediatric Specialities Area, Division of Allergy, IRCCS, Bambino Gesù Children's Hospital, Rome, Italy
| | - Montserrat Alvaro-Lozano
- Allergology and Clinical Immunology Department, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
| | - Sophia Tsabouri
- Child Health Department, University of Ioannina School of Medicine, Ioannina, Greece
| | - Elena Galli
- Pediatric Allergology Unit, Department of Pediatric Medicine, S.Pietro Hospital Fatebenefratelli, Rome, Italy
| | - Burcin Beken
- Department of Pediatric Allergy and Immunology, Acibadem University School of Medicine, Istanbul, Turkey
| | - Philippe A Eigenmann
- Pediatric Allergy Unit, Department of Woman, Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland
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Cheng CY, Tseng YL, Huang KC, Chiu IM, Pan HY, Cheng FJ. Association between Ambient Air Pollution and Emergency Room Visits for Pediatric Respiratory Diseases: The Impact of COVID-19 Pandemic. TOXICS 2022; 10:toxics10050247. [PMID: 35622660 PMCID: PMC9146083 DOI: 10.3390/toxics10050247] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/06/2022] [Accepted: 05/11/2022] [Indexed: 02/05/2023]
Abstract
The level and composition of air pollution have changed during the coronavirus disease 2019 (COVID-19) pandemic. However, the association between air pollution and pediatric respiratory disease emergency department (ED) visits during the COVID-19 pandemic remains unclear. The study was retrospectively conducted between 2017 and 2020 in Kaohsiung, Taiwan, from 1 January 2020 to 1 May 2020, defined as the period of the COVID-19 pandemic, and 1 January 2017 to 31 May 2019, defined as the pre-COVID-19 pandemic period. We enrolled patients under 17 years old who visited the ED in a medical center and were diagnosed with respiratory diseases such as pneumonia, asthma, bronchitis, and acute pharyngitis. Measurements of particulate matter (PM) with aerodynamic diameters of <10 μm (PM10) and < 2.5 μm (PM2.5), nitrogen dioxide (NO2), and Ozone (O3) were collected. During the COVID-19 pandemic, an increase in the interquartile range of PM2.5, PM10, and NO2 levels was associated with increases of 72.5% (95% confidence interval [CI], 50.5−97.7%), 98.0% (95% CI, 70.7−129.6%), and 54.7% (95% CI, 38.7−72.6%), respectively, in the risk of pediatric respiratory disease ED visits on lag 1, which were greater than those in the pre-COVID-19 pandemic period. After adjusting for temperature and humidity, the risk of pediatric respiratory diseases after exposure to PM2.5 (inter p = 0.001) and PM10 (inter p < 0.001) was higher during the COVID-19 pandemic. PM2.5, PM10, and NO2 may play important roles in pediatric respiratory events in Kaohsiung, Taiwan. Compared with the pre-COVID-19 pandemic period, the levels of PM2.5 and PM10 were lower; however, the levels were related to a greater increase in ED during the COVID-19 pandemic.
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Affiliation(s)
- Chi-Yung Cheng
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan; (C.-Y.C.); (K.-C.H.); (I.-M.C.); (H.-Y.P.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Department of Computer Science and Engineering, National Sun Yat-sen University, 70, Lian-Hai Road, Kaohsiung 804, Taiwan
| | - Yu-Lun Tseng
- Institute of Environmental Engineering, National Sun Yat-sen University, 70, Lian-Hai Road, Kaohsiung 804, Taiwan;
| | - Kuo-Chen Huang
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan; (C.-Y.C.); (K.-C.H.); (I.-M.C.); (H.-Y.P.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - I-Min Chiu
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan; (C.-Y.C.); (K.-C.H.); (I.-M.C.); (H.-Y.P.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Department of Computer Science and Engineering, National Sun Yat-sen University, 70, Lian-Hai Road, Kaohsiung 804, Taiwan
| | - Hsiu-Yung Pan
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan; (C.-Y.C.); (K.-C.H.); (I.-M.C.); (H.-Y.P.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Fu-Jen Cheng
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan; (C.-Y.C.); (K.-C.H.); (I.-M.C.); (H.-Y.P.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Correspondence: ; Tel.: +886-975056646; Fax: +886-7-7317123
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