COVID‐19 pandemic: Practical considerations on the organization of an allergy clinic—An EAACI/ARIA Position Paper

Abstract

Background The coronavirus disease 2019 (COVID‐19) has evolved into a pandemic infectious disease transmitted by the severe acute respiratory syndrome coronavirus (SARS‐CoV‐2). Allergists and other healthcare providers (HCPs) in the field of allergies and associated airway diseases are on the front line, taking care of patients potentially infected with SARS‐CoV‐2. Hence, strategies and practices to minimize risks of infection for both HCPs and treated patients have to be developed and followed by allergy clinics. Method The scientific information on COVID‐19 was analysed by a literature search in MEDLINE, PubMed, the National and International Guidelines from the European Academy of Allergy and Clinical Immunology (EAACI), the Cochrane Library, and the internet. Results Based on the diagnostic and treatment standards developed by EAACI, on international information regarding COVID‐19, on guidelines of the World Health Organization (WHO) and other international organizations, and on previous experience, a panel of experts including clinicians, psychologists, IT experts, and basic scientists along with EAACI and the “Allergic Rhinitis and its Impact on Asthma (ARIA)” initiative have developed recommendations for the optimal management of allergy clinics during the current COVID‐19 pandemic. These recommendations are grouped into nine sections on different relevant aspects for the care of patients with allergies. Conclusions This international Position Paper provides recommendations on operational plans and procedures to maintain high standards in the daily clinical care of allergic patients while ensuring the necessary safety measures in the current COVID‐19 pandemic.

Management of the patient with allergic and immunological disorders in the pandemic COVID-19 era

“…In particular, obesity is a significant risk factor for COVID-19 and its severity, and may be intertwined with asthma [9]. An international Position Paper, recently published by EAACI, provides in nine sections on different relevant aspects for the care of patients with allergies, those recommendations are developed on operational plans and procedures to maintain high standards in the daily clinical care of allergic patients whilst ensuring necessary safety in the current COVID-19 pandemic [10].…”

“…Allergic patients with manifestation of asthma, rhinitis and conjunctivitis had acute relapses during the COVID-19 emergency both due to the massive spring exposure to allergens and other triggering factors such as internal and external pollutants [10,13] and to the sudden interruption of current treatment, for fear that the same drugs could facilitate SARS infection. On the contrary, in the current state of knowledge, intranasal corticosteroid therapy for allergic rhinitis can be continued in patients with COVID-19 at the recommended posology [8,10]. There are no evidences that such therapy can cause immunosuppression and discontinuing treatment for allergic rhinitis can lead to an increase in respiratory symptoms, especially sneezing, with potentially greater spread of the virus.…”

“…Asthmatics should adopt strict protection measures and the CDC statement should be used [9]. All recommendation should be updated regularly in light of the continuous acquisitions on COVID-19 [10,18]. Specialists are recommended to suggest to patients an emergency therapeutic protocol to be implemented in case of asthmatic exacerbation, and to give the possibility of direct telephone contacts, also to manage possible psychological tensions or real panic attacks in the doubt of having contracted the SARS-CoV-2 infection.…”

“…Allergen-specific immunotherapy (AIT) is the causal treatment of allergic conditions and is effective in reducing symptoms and therapeutic load in allergic rhinitis and asthma. In Venom allergy is considered a life-saving treatment [10]. Giving the limited experimental data so far it does not seem that suppression of Th2 Cell and the induction of a regulatory B and T response, which are clearly antigen specific, could interfere with the immune response to the SARS-CoV-2 virus.…”

A compendium answering over 140 questions on COVID-19 and SARS-CoV-2

“…Strategies for risk minimization should be elaborated, harmonized and followed as such in allergy clinics, centers and practices. 107 In the EAACI/ARIA Position Paper by Pfaar et al 108 experts in the field have developed practical recommendations for optimizing allergic patients 'care whilst ensuring the safety of all health care professionals ( Figure 3 ). General guidance from national health authorities should be strictly followed (i.e.…”