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

Prenatal exposure to acid suppressant medications and risk of allergen sensitization

In conclusion, in a cohort of children with a history of severe bronchiolitis those exposed to ASM prenatally are not at increased risk of developing food or environmental allergen sensitization by early childhood. The mechanism by which ASM exposure increases risk of childhood asthma remains unclear, but alterations in the gut microbiome merit consideration.

Effects of Exposure to Indoor Fine Particulate Matter on Atopic Dermatitis in Children

This study aimed to investigate the short-term effect of exposure to indoor fine particulate matter (PM2.5) on atopic dermatitis (AD) symptoms in children. Sixty-four children (40 boys and 24 girls) with moderate-to-severe AD, aged under 18 years were enrolled in the study. They were followed up from February 2019 through November 2020. Exposure to indoor PM2.5 in each household of the enrolled children and their AD symptoms were measured daily. The generalized linear mixed model was utilized for statistical analysis. Subdivision analysis was performed by stratifying the patients by age, sex, season, severity, the presence of family allergic diseases, sensitization, and indoor environment conditions including temperature and relative humidity. A total of 9,321 person-days of AD symptom data were collected. The average PM2.5 concentration was 28.7 ± 24.3 µg/m3, with the highest value in winter (47.1 ± 29.6 µg/m3). The overall effect of PM2.5 on AD symptoms was not statistically significant. However, an increase of 10 µg/m3 in indoor PM2.5 concentration increased AD symptom scores by 16.5% (95% CI: 6.5, 27.5) in spring and12.6% (95% CI: 4.3, 21.5) in winter, 6.7% (95% CI: 2.3, 11.3) at indoor temperatures of <25.5 °C, and by 15.0% (95% CI: 3.5, 27.7) with no use of an air purifier. The harmful effect of PM2.5 in boys, in children aged ≥6 years, and in children with inhalant allergen sensitization was significant, showing an increase in AD symptoms of 4.9% (95% CI: 1.4, 8.6), 12.0% (95% CI: 5.3, 19.1), and 7.0% (95% CI: 1.9, 12.3) per 10 µg/m3 of PM2.5, respectively. Furthermore, children with inhalant allergen sensitization plus severe symptoms (SCORing Atopic Dermatitis, SCORAD ≥ 30.7, median value) showed more harmful effects from exposure to PM2.5 (15.7% (95% CI: 4.5, 28.1) increase in AD symptom scores per 10 µg/m3 of PM2.5 increase). Indoor exposure to PM2.5 exacerbated AD symptoms in children in spring, winter, and at indoor temperatures of < 25.5 °C. In particular, this harmful effect was prominent in children with inhalant allergen sensitization and severe symptoms. Minimizing exposure to indoor PM2.5 is needed for the proper management of AD.

The Age, Sex, and Geographical Distribution of Self-Reported Asthma Triggers on Children With Asthma in China

Background: Asthma can be exacerbated by many triggers, and the heterogeneity of asthma triggers is clear among children with asthma. This study describes asthma triggers using a large-scale electronic dataset from the smartphone-based Chinese Children's Asthma Action Plan (CCAAP) app and aims to examine the difference in asthma triggers among different subgroups of children with asthma.Methods: Data from the smartphone-based CCAAP app between February 22, 2017, and November 23, 2020, were reviewed, and children with asthma who reported their asthma triggers were enrolled. Eight common asthma triggers were listed in the software: upper respiratory infection (URI), allergen sensitization, exercise, emotional disturbances, pungent odors, air pollution/smog, weather change, and tobacco smoke. We compared the incidence of asthma triggers among different subgroups (&lt;6 years vs. 6–17 years; boy vs. girl; eastern region vs. central region vs. western region).Results: We enrolled 6,835 patients with self-reported asthma triggers. When compared by sex, boys had a higher proportion of exercise-triggered asthma than girls (boys vs. girls, 22.5 vs. 19.7%, p &lt; 0.05). The proportion of patients &lt;6 years of age with URI-triggered asthma was higher than that of patients 6–17 years of age (&lt;6 vs. 6–17 years, 80.9 vs. 74.9%, p &lt; 0.001). Patients 6–17 years of age were more likely than patients &lt;6 years of age to report five of the asthma triggers: allergen sensitization (&lt;6 vs. 6–17 years, 26.6 vs. 35.8%, p &lt; 0.001), exercise (&lt;6 vs. 6–17 years, 19.3 vs. 23.7%, p &lt; 0.001), pungent odors (&lt;6 vs. 6–17 years, 8.8 vs. 12.7%, p &lt; 0.001), air pollution/smog (&lt;6 vs. 6–17 years, 9.4 vs. 16.2%, p &lt; 0.001), and tobacco smoke (&lt;6 vs. 6–17 years, 3.5 vs. 5.3%, p &lt; 0.001). In subgroups based on geographical distribution, asthma triggering of allergen sensitization was reported to be the most common in patients from the eastern region (eastern region vs. central region vs. western region, 35.0 vs. 24.6 vs. 28.0%, p &lt; 0.001). Exercise-triggered asthma was found to be the most prevalent among patients from the central region (eastern region vs. central region vs. western region, 21.6 vs. 24.8 vs. 20.4%, p &lt; 0.05). However, the proportion of patients with air pollution/smog as an asthma trigger was the lowest among those from the western region (eastern region vs. central region vs. western region, 14.1 vs. 14.1 vs. 10.8%, p &lt; 0.05).Conclusion: Children with asthma present different types of asthma triggers, both allergenic and nonallergenic. Age, sex, and geographical distribution affect specific asthma triggers. Preventive measures can be implemented based on a patient's specific asthma trigger.

Correlation between interleukin 4 (IL-4) expression and allergen sensitization in allergic rhinitis patients

Objective: The objective of this research was to measure the correlation of the expression of IL-4 with allergen sensitization in patients with allergic rhinitis. Methods: Descriptive analytics was used as a method in this research, with a cross-sectional approach. The subjects were 37 persons with allergic rhinitis who met the inclusion and exclusion criteria. This research was conducted in patients with clinical manifestations of symptoms of allergic rhinitis, and skin prick tests were carried out with ten types of allergens, which are: house dust, cotton, chicken feathers, shrimp, tuna, chicken egg-yolk, chicken egg-white, peanuts, tea, and chocolate. Venous blood sampling was performed for the Interleukin-4 (IL-4) test by using an ELISA device. Results: The respondents were 37 patients with allergic rhinitis, of which 26 (70.3 %) were women and 11 (29.7 %) were men. The highest sensitivity to inhaled allergens in patients with rhinitis was to house dust in 31 samples (83.8 %). The correlation of the expression of IL-4 with sensitization to allergens in patients with allergic rhinitis based on the Spearman test resulted in p > 0.05, not significant with some allergens in a negative correlation. Conclusion: There was no significant correlation between the expression of IL-4 and the sensitization to allergens in patients with allergic rhinitis.