Additional supporting information may be found online in the Supporting Information section. Allergy and asthma in children and adolescents during the COVID outbreak: What we know and how we could prevent allergy and asthma flaresTo the Editor, The coronavirus disease 2019 (COVID-19) pandemic is affecting people at any age with a more severe course in patients with chronic diseases or comorbidities, men, and elderly patients. The Centers for Disease Control and Prevention (CDC) initially proposed that patients with chronic lung diseases, including moderate-severe asthma, and allergy may have a higher risk of developing severe COVID-19 than otherwise healthy people ( https://www.cdc.gov/coron aviru s/2019-ncov/speci fic-group s/asthma.html ).Very few reports on pediatric patients with COVID-19 have been presented still now. Dong reported a nationwide case series of 2143 pediatric patients with COVID-19. 1 Children at all ages appeared susceptible to COVID-19, and without gender difference, symptoms were less severe than in adults, even though younger children, mainly infants, were vulnerable to infection. It has been, further, reported that infants and children usually developed mild respiratory symptoms, or they were likely asymptomatic. 2 After that, a study conducted in 140 hospitalized COVID-19 adult patients reported that no patient had asthma or allergy. 3 Another study, concerning 11 COVID-19 patients, reported two children with allergy, but no patient developed distinct symptoms and severe courses. 4 These last

In a Mediterranean country characterized by multiple pollen exposures, PFS is a complex and frequent complication of childhood SAR, with five distinct endotypes marked by peculiar profiles of IgE sensitization to panallergens. Prospective studies in cohorts of patients with PFS are now required to test whether this novel classification may be useful for diagnostic and therapeutic purposes in the clinical practice.

The COVID-19 pandemic has surprised the entire population. The world has had to face an unprecedented pandemic. Only, Spanish flu had similar disastrous consequences. As a result, drastic measures (lockdown) have been adopted worldwide. Healthcare service has been overwhelmed by the extraordinary influx of patients, often requiring high intensity of care. Mortality has been associated with severe comorbidities, including chronic diseases. Patients with frailty were, therefore, the victim of the SARS-COV-2 infection. Allergy and asthma are the most prevalent chronic disorders in children and adolescents, so they need careful attention and, if necessary, an adaptation of their regular treatment plans. Fortunately, at present, young people are less suffering from COVID-19, both as incidence and severity. However, any age, including infancy, could be affected by the pandemic. Based on this background, the Italian Society of Pediatric Allergy and Immunology has felt it necessary to provide a Consensus Statement. This expert panel consensus document offers a rationale to help guide decision-making in the management of children and adolescents with allergic or immunologic diseases.

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The present study demonstrates that VAS might be considered a useful tool to assess symptom perception, mainly in children with airflow limitation.