Atopy and Allergic Diseases Have No Impact on the Severity of COVID-19

Objective: The clinical features of COVID-19 range from asymptomatic disease to severe pneumonia or even death. Therefore, many researchers have investigated the factors that could affect the severity of COVID-19. We aimed to assess the impact of aero-allergen sensitization and allergic diseases on the severity of COVID-19. Materials and Methods: We included 60 adult patients with symptomatic COVID-19 and allocated them into two groups equal in number as having severe and non-severe COVID-19. We evaluated the demographic features and allergic diseases in addition to clinical, laboratory and radiological findings of COVID-19. Skin prick tests (SPTs) with common aero-allergens, serum total IgE levels and blood eosinophil counts were evaluated 3 months after the patient’s recovery from COVID-19.Results: The mean age of the patients was 52 ± 11 years and 73.3% of the patients were male. There was no significant difference between the two groups in terms of age, gender, smoking habits, obesity and comorbidities. Although the frequency of sensitization to aero-allergens and the allergic diseases were similar, the history of allergic diseases in the family was higher in the severe group (p<0.001). The polysensitization in SPTs was associated with the presence of a cytokine storm during the infection (p=0.02). Total IgE levels and blood eosinophil counts were not significantly different between the two groups.Conclusion: The presence of atopy or allergic diseases does not seem to be related to the severity of COVID-19. However, polysensitization and a family history of allergic diseases are more prominent in those having a cytokine storm and severe COVID-19, respectively. Keywords: COVID-19, atopy, allergic disease, aero-allergen sensitization, cytokine storm

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Blood eosinophil counts and the development of obstructive lung disease: the Kangbuk Samsung Health Study

European Respiratory Journal ◽

10.1183/13993003.03823-2020 ◽

2021 ◽

pp. 2003823

Author(s):

Hye Yun Park ◽

Yoosoo Chang ◽

Danbee Kang ◽

Yun Soo Hong ◽

Di Zhao ◽

...

Keyword(s):

Cohort Study ◽

Lung Disease ◽

Obstructive Lung Disease ◽

Chronic Obstructive Lung Disease ◽

Health Study ◽

Chronic Obstructive ◽

Blood Eosinophil ◽

History Of ◽

The Impact ◽

Eosinophil Counts

The impact of blood eosinophil counts on the development of chronic obstructive lung disease (COPD) is unknown. We investigated whether a higher blood eosinophil counts was associated with the risk of developing obstructive lung disease (OLD) in a large cohort of men and women free lung disease at baseline.Cohort study of 359 456 Korean adults without a history of asthma and without OLD at baseline who participated in health screening exams including spirometry. OLD was defined as pre-bronchodilator FEV1/FVC<0.7 and FEV1<80% predicted.After a median follow-up of 5.6 years (interquartile range, 2.9–9.2), 5008 participants developed incident OLD (incidence rate, 2.1 per 1000 person-years; 95% CI, 2.1–2.2). In the fully-adjusted model, the HR (95% CI) for incident OLD comparing eosinophil counts of 100–<200, 200–<300, 300–<500 and ≥500 cells·μL−1 to <100 cells·μL−1 were 1.07 (1.00–1.15), 1.30 (1.20–1.42), 1.46 (1.33–1.60) and 1.72 (1.51–1.95) (p for trend <0.001). These associations were consistent in clinically relevant subgroups, including never, former, and current smokers.In this large longitudinal cohort study, blood eosinophil counts were positively associated with the risk of developing of OLD. Our findings indicate a potential role of eosinophil count as an independent risk factor for developing COPD.

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The impact of prior urethral sling on artificial urinary sphincter outcomes

Canadian Urological Association Journal ◽

10.5489/cuaj.3922 ◽

2016 ◽

Vol 10 (11-12) ◽

pp. 405 ◽

Cited By ~ 6

Author(s):

Matthew J. Ziegelmann ◽

Brian J. Linder ◽

Marcelino E. Rivera ◽

Boyd R. Viers ◽

Daniel S. Elliott

Keyword(s):

Retrospective Chart Review ◽

Artificial Urinary Sphincter ◽

Device Failure ◽

Kaplan Meier ◽

Hazard Ratios ◽

Urinary Sphincter ◽

Device Infection ◽

Significant Difference ◽

History Of ◽

The Impact

Introduction: We sought to evaluate device outcomes in men who underwent primary artificial urinary sphincter (AUS) placement after failed male urethral sling (MUS).Methods: We performed a retrospective chart review of 990 men who underwent an AUS procedure between 2003 and 2014. Of these, 540 were primary AUS placements, including 30 (5.5%) with a history of MUS. AUS revisions and explantations were compared between men stratified by the presence of prior sling. Hazard ratios (HR) adjusting for competing risks were used to determine the association with prior sling and AUS outcomes (infection/ erosion, urethral atrophy, and mechanical malfunction), while overall device failure was estimated using Kaplan-Meier and Coxregression analysis.Results: There was no significant difference in age, body mass index, prior prostatectomy, or pelvic radiation when stratified by history of MUS. However, patients with a history of MUS were more likely to have undergone prior collagen injection (p=0.01). On univariate and multivariate analysis, prior MUS was not associated with device failure (HR 1.54; p=0.27). Three-year overall device survival did not significantly differ between those with and without prior MUS (70% vs. 85%; p=0.21). Also, there were no significant differences in the incidence of device infection/erosion, mechanical malfunction, and urethral atrophy.Conclusions: AUS remains a viable treatment option for men with persistent or recurrent stress urinary incontinence after MUS. However, while not statistically significant, we identified a trend towards lower three-year device outcomes in patients with prior urethral sling. These findings indicate the need for longer-term studies to determine if slings pose an increased hazard.

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P747 Adherence to ECCO guidelines for cancer surveillance is associated to the detection of early cancer: A retrospective, single-centre, cohort study

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.875 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S598-S599

Author(s):

T L PARIGI ◽

G Roda PhD ◽

M Allocca ◽

F Furfaro ◽

L Loy ◽

...

Keyword(s):

Family History ◽

Skin Cancer ◽

Disease Duration ◽

Early Cancer ◽

Cancer Surveillance ◽

Early Cancer Diagnosis ◽

Increased Risk ◽

Significant Difference ◽

History Of ◽

The Impact

Abstract Background Patients with inflammatory bowel disease (IBD), such as ulcerative colitis (UC) and Crohn’s disease (CD) are at increased risk of developing gastrointestinal (GI) malignancies. The aim of this study is to assess the risk of malignancies in IBD patients and the impact of cancer screening according to the ECCO guidelines in a tertiary referral centre. Methods We retrospectively analysed the electronic database of all IBD patients followed by the IBD Centre of Humanitas Research Hospital, Milan, from January 2010 to October 2019, and collected all new diagnoses of solid and haematological tumours since 2010. The annual standardised incidence rate (SIR), rate of mortality and early cancer diagnosis were calculated and a descriptive analysis of drug exposure, disease duration, family history of any cancer, smoking habits was made. Results We included 5239 patients, with a total 19820 patient-years follow-up. Eighty-four malignancies in 81 patients were retrieved, 71 were included in the final analysis (38 CD, 32 UC, 31 females). Average age at tumour diagnosis was 52.9 years (range 19–78). 64% of patients were former or active smokers, 31% had a family history of cancer or IBD. Sixty-two per cent of patients were previously exposed or had 5-ASA at the time of cancer, 40% azathioprine, 43% anti-TNF or vedolizumab. The annual SIR for all kinds of malignancy was 0.358%. GI malignancies were the most frequent (n = 17, 23.9%, 47% UC, 53% in CD). Six over 8 GI tract malignancies in UC patients were found in the colon or rectum (mean disease duration 22.5 years), whereas in CD patients 5/9 were in the small-bowel (mean disease duration 7.0 years). Melanoma and breast cancer (n = 8 each) were the most common non-GI cancers, followed by prostate (n = 7) and bladder (n = 6). No significant difference in incidence was found between CD or UC. Non-Hodgkin lymphomas and leukaemia (3 and 1, respectively) only occurred in CD patients. Other tumours included thyroid (n = 5), lungs (n = 4), testicle (n = 3), ovary (n = 2), kidney (n = 2), head-nose-throat (n = 2), pancreas (n = 1), brain (n = 1), and non-melanoma skin cancer (n = 1). Death occurred in 11% of patients, 8 of them for late stage cancer. Only 2 were related to the concomitant IBD (1 colo-rectal and 1 anal cancer). In patients regularly screened according to the ECCO Guidelines (GI cancer, haematological and skin cancer), there was a significantly higher number of detection of early cancer (28 vs. 1, p = 0.003), although no differences in mortality rates were reported in the two groups (2 vs. 2, p = 0.10). Conclusion The overall incidence of cancer in our cohort was not different from the current literature available. Adherence to the ECCO Guidelines for cancer surveillance improves the detection of early cancer in IBD patients.

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The effect of exacerbation history on outcomes in the IMPACT trial

European Respiratory Journal ◽

10.1183/13993003.01921-2019 ◽

2020 ◽

Vol 55 (5) ◽

pp. 1901921 ◽

Cited By ~ 5

Author(s):

David M.G. Halpin ◽

Mark T. Dransfield ◽

MeiLan K. Han ◽

C. Elaine Jones ◽

Sally Kilbride ◽

...

Keyword(s):

Health Status ◽

Lung Function ◽

Triple Therapy ◽

Blood Eosinophil ◽

Severe Exacerbation ◽

Double Blind ◽

Exacerbation Rate ◽

Population Comparisons ◽

The Impact ◽

Eosinophil Counts

IMPACT, a 52-week, randomised, double-blind trial, assessed the efficacy and safety of fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) triple therapy versus FF/VI or UMEC/VI in patients with symptomatic COPD and a history of exacerbations.Subgroup analyses assessed whether the efficacy of FF/UMEC/VI versus FF/VI or UMEC/VI and UMEC/VI versus FF/VI varies according to prior exacerbation history, and the combined effects of exacerbation history and blood eosinophil counts. Three subgroups were defined: single moderate (1 moderate/no severe; n=3056 (30%)), frequent moderate (≥2 moderate/no severe; n=4628 (45%)) and severe (≥1 severe/any moderate; n=2671 (26%)). End-points included annual on-treatment moderate/severe exacerbation rate (pre-specified), lung function and health status (both post-hoc).Moderate/severe exacerbation rates (reduction % (95% CI)) were reduced in the FF/UMEC/VI group versus FF/VI (single moderate 20% (10–29), frequent moderate 11% (2–19), severe 17% (7–26)) and versus UMEC/VI (single moderate 18% (5–29), frequent moderate 29% (21–37), severe 26% (14–35)). Moderate/severe exacerbation rates were reduced in the FF/VI group versus UMEC/VI in the frequent moderate subgroup; a numerical reduction was observed in the severe subgroup (single moderate 2% (−12–18), frequent moderate 21% (11–29), severe 11% (−3–22)). Moderate/severe exacerbation rates were lower in the FF/VI group compared with UMEC/VI in patients with higher eosinophil counts. FF/UMEC/VI improved lung function and health status versus both dual therapies irrespective of exacerbation subgroup. UMEC/VI improved lung function versus FF/VI in all subgroups.Triple therapy was more effective than dual regardless of exacerbation history, consistent with results in the intent-to-treat population. Comparisons between dual therapies were influenced by prior exacerbation history and eosinophil counts.

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Atypical gnathostomiasis-confirmed cutaneous larva migrans, Vietnam

BMJ Case Reports ◽

10.1136/bcr-2021-243276 ◽

2021 ◽

Vol 14 (7) ◽

pp. e243276

Author(s):

Cuong Minh Duong ◽

Phuc Vinh Dinh Le ◽

Oanh Kieu Nguyet Pham ◽

Hong Quang Huynh

Keyword(s):

Case Report ◽

Skin Lesion ◽

Skin Lesions ◽

Larva Migrans ◽

Blood Eosinophil ◽

Serological Testing ◽

Third Stage ◽

History Of ◽

Serology Testing ◽

Eosinophil Counts

We reported a case of gnathostomiasis in a 42-year-old woman with an unclear history of eating high-risk foods and had a non-migratory skin lesion, negative serological testing and normal blood eosinophil counts. A diagnosis of gnathostomiasis was based on a live, third-stage Gnathostoma spinigerum larva that was randomly taken from the patient’s skin lesion by herself. The presenting case report demonstrates challenges in correctly diagnose cutaneous gnathostomiasis even in endemic countries due to atypical skin lesions, negative serology testing and the absence of eosinophilia and thus, the widely used classic triad of suggestive evidence of gnathostomiasis is not fulfilled.

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The Role of Concussion History and Gender in Recovery from Soccer-Related Concussion

The American Journal of Sports Medicine ◽

10.1177/0363546509332497 ◽

2009 ◽

Vol 37 (9) ◽

pp. 1699-1704 ◽

Cited By ~ 199

Author(s):

Alexis Chiang Colvin ◽

Jimmy Mullen ◽

Mark R. Lovell ◽

Robin Vereeke West ◽

Micky W. Collins ◽

...

Keyword(s):

Female Athletes ◽

Soccer Players ◽

Neurocognitive Testing ◽

Neurocognitive Performance ◽

Level Of Evidence ◽

Male And Female ◽

Significant Difference ◽

History Of ◽

And Gender ◽

The Impact

Background This study was designed to investigate differences in recovery in male and female soccer athletes. Hypotheses Soccer players with a history of concussion will perform worse on neurocognitive testing than players without a history of concussion. Furthermore, female athletes will demonstrate poorer performance on neurocognitive testing than male athletes. Study Design Cohort study (prognosis): Level of evidence, 2. Methods Computer-based neuropsychological testing using reaction time, memory, and visual motor-speed composite scores of the ImPACT test battery was performed postconcussion in soccer players ranging in age from 8 to 24 years (N = 234; 141 females, 93 males). A multivariate analysis of variance was conducted to examine group differences in neurocognitive performance between male and female athletes with and without a history of concussion. Results Soccer players with a history of at least 1 previous concussion performed significantly worse on ImPACT than those who had not sustained a prior concussion (F = 2.92, P = .03). In addition, female soccer players performed worse on neurocognitive testing (F = 2.72, P = .05) and also reported more symptoms (F = 20.1, P = .00001) than male soccer players. There was no significant difference in body mass index between male and female players (F = .04, P = .85). Conclusion A history of concussion and gender may account for significant differences in postconcussive neurocognitive test scores in soccer players and may play a role in determining recovery. These differences do not appear to reflect differences in mass between genders and may be related to other gender-specific factors that deserve further study.

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Triple therapy versus single and dual long-acting bronchodilator therapy in COPD: a systematic review and meta-analysis

European Respiratory Journal ◽

10.1183/13993003.01586-2018 ◽

2018 ◽

Vol 52 (6) ◽

pp. 1801586 ◽

Cited By ~ 54

Author(s):

Mario Cazzola ◽

Paola Rogliani ◽

Luigino Calzetta ◽

Maria Gabriella Matera

Keyword(s):

Relative Risk ◽

Combination Therapy ◽

Meta Analysis ◽

Blood Eosinophil ◽

Triple Combination ◽

Triple Combination Therapy ◽

Bronchodilator Therapy ◽

Long Acting ◽

The Impact ◽

Eosinophil Counts

We performed a meta-analysis to compare the impact of triple combination therapy with inhaled corticosteroids (ICS), long-acting β2-agonists (LABAs) and long-acting muscarinic receptor antagonists (LAMAs) versus LABA/LAMA combination therapy or single long-acting bronchodilator therapy in chronic obstructive pulmonary disease. The ICS/LABA/LAMA combination reduced the risk of exacerbation (relative risk 0.70, 95% CI 0.53–0.94) and improved trough forced expiratory volume in 1 s (mean difference in mL +37.94, 95% CI 18.83–53.89) versus LABA/LAMA combination therapy. The protective effect of triple combination therapy versus LABA/LAMA combination therapy against risk of exacerbation was greater in patients with blood eosinophil counts ≥300 cells·µL−1 (relative risk 0.57, 95% CI 0.48–0.68). While ∼38 patients had to be treated for 1 year with ICS/LABA/LAMA combination therapy to prevent one exacerbation compared to LABA/LAMA combination therapy, the number needed to treat (NNT) was ∼21 when compared to single long-acting bronchodilator therapy. The person-based NNT per year of ICS/LABA/LAMA combination therapy versus LABA/LAMA combination therapy was significantly (p<0.05) lower in patients with eosinophil counts ≥300 cells·µL−1 (NNT value: 8.58) than in those with counts <300 cells·µL−1 (NNT value: 46.28). The risk of pneumonia did not differ between ICS/LABA/LAMA combination therapy and its comparators. The number needed to harm was ∼195. This meta-analysis suggests that patients on single long-acting bronchodilator therapy or LABA/LAMA combination therapy, who still have exacerbations and have blood eosinophil counts ≥300 cells·µL−1, could benefit from ICS/LABA/LAMA combination therapy.

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Perinatal Cat and Dog Exposure and the Risk of Asthma and Allergy in the Urban Environment: A Systematic Review of Longitudinal Studies

Clinical and Developmental Immunology ◽

10.1155/2012/176484 ◽

2012 ◽

Vol 2012 ◽

pp. 1-10 ◽

Cited By ~ 55

Author(s):

Caroline J. Lodge ◽

Katrina J. Allen ◽

Adrian J. Lowe ◽

David J. Hill ◽

Cliff S. Hosking ◽

...

Keyword(s):

High Risk ◽

Longitudinal Studies ◽

Allergic Disease ◽

Allergic Diseases ◽

Risk Groups ◽

Perinatal Period ◽

Perinatal Exposure ◽

Increased Risk ◽

History Of ◽

The Impact

Background. The literature is contradictory concerning pet exposure and the risk of development of asthma and other allergic diseases. Using longitudinal studies, we aimed to systematically review the impact of pet ownership in the critical perinatal period as a risk factor for allergies in childhood.Methods. Medline database was searched for urban cohort studies with perinatal exposure to cats and/or dogs and subsequent asthma or allergic disease.Results. Nine articles, comprising 6498 participants, met inclusion criteria. Six found a reduction in allergic disease associated with perinatal exposure to dogs or, cats or dogs. One study found no association. Two found increased risk only in high-risk groups.Conclusion. Longitudinal studies in urban populations suggest that perinatal pets, especially dogs, may reduce the development of allergic disease in those without a family history of allergy. Other unmeasured factors such as pet-keeping choices in allergic families may be confounding the association seen in these high-risk families, and further study is required.

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Predictive Value of Radiologic Central Compartment Atopic Disease for Identifying Allergy and Asthma in Pediatric Patients

Ear Nose & Throat Journal ◽

10.1177/0145561321997546 ◽

2021 ◽

pp. 014556132199754

Author(s):

Kijeong Lee ◽

Tae Hoon Kim ◽

Sang Hag Lee ◽

Chang Ho Kang ◽

Bo-Kyung Je ◽

...

Keyword(s):

Pediatric Patients ◽

Central Compartment ◽

Atopic Disease ◽

High Serum ◽

Blood Eosinophil ◽

Peripheral Blood Eosinophil ◽

Allergen Sensitization ◽

Total Ige ◽

Serum Total Ige ◽

Allergy And Asthma

Introduction: Central compartment atopic disease (CCAD) has recently been suggested as a phenotype of chronic rhinosinusitis (CRS). This study aims to investigate the prevalence of the radiologic CCAD phenotype in CRS within a pediatric population and identify its ability to predict comorbid allergy and asthma. Methods: Computed tomography and endoscopic examination were conducted on pediatric patients with CRS either with or without nasal polyps. Allergen sensitization was determined with the multiple-allergen simultaneous test and skin prick test. Serum total immunoglobulin E (IgE), peripheral blood eosinophil percentage, and presence of asthma were also evaluated. Results: A total of 82 pediatric patients were enrolled. Overall, 55 (67.1%) of the participants demonstrated aeroallergen sensitization, and 31 (18.9%) of the 164 sides of sinuses were radiologically defined to fit the CCAD phenotype. Patients having CRS with the CCAD phenotype had a higher prevalence of aeroallergen sensitization (87.1% vs 62.4%, P = .008), particularly house dust mite (74.2% vs 53.4%, P = .035), and a higher incidence of asthma (16.1% vs 3.8%, P = .010). Additionally, patients having CRS with the CCAD phenotype demonstrated a high serum total IgE levels (51.6% vs 30.1%, P = .023) in comparison to patients having CRS without CCAD. Conclusion: In pediatric CRS, the radiological CCAD phenotype was associated with allergen sensitization and asthma. Furthermore, the CCAD phenotype was associated with high serum total IgE levels, suggesting allergy etiology should be considered with this type of pediatric patients with CRS.

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