Cat allergy in children and the effect of the COVID-19 pandemic

Abstract

Background: Cat allergen is among the most common household allergens and can cause respiratory allergies and anaphylaxis in children. Objective: The aim of this study was to evaluate the characteristics of cat allergies in children and the impact of the coronavirus disease 2019 (COVID-19) pandemic on these characteristics. Methods: The study included pediatric patients with cat allergen sensitization demonstrated by skin-prick test (SPT) over a period of 2 years: 1 year before and 1 year during the pandemic. Demographic data, clinical features, and laboratory findings were evaluated from the patients' records. Results: Of 7428 SPTs performed, 566 patients (7.6%) were sensitized to cat allergen (56% boys; median age, 11 years). Fifty-eight percent of the patients (n = 329) presented during the pandemic period, 44.5% (n = 252) had symptoms with cat exposure, and 9% (n = 51/566) had anaphylaxis. Allergic rhinitis and asthma were present in 76% (n = 431) and 46.6% (n = 264) of the patients, respectively. When compared to prepandemic period, patients who presented during the pandemic had higher rates of cat sensitization (15% in pandemic group versus 4.4% in prepandemic group of all SPTs performed; p < 0.05), cat ownership (29.1% versus 13.9%; p < 0.001), and symptoms on cat exposure (51% versus 34%; p < 0.001). Factors that predicted symptom development in the patients who were cat sensitized were induration > 5 mm on SPT (odds ratio [OR] 1.9 [95% confidence interval {95% CI}], 1.1‐3.2), cat ownership (OR 9.2 [95% CI, 4.9‐17.3]), close contact with a cat owner (OR 7.1 [95% CI, 4‐12]), allergic rhinitis (OR 3.1 [95% CI, 1.6‐5.8]), conjunctivitis (OR 4.7 [95% CI, 2‐10]), and atopic dermatitis (OR 2.2 [95% CI, 1‐4.7]). Conclusion: We observed an increase in the prevalence of cat allergy among children during the COVID-19 pandemic. Care must be taken in terms of anaphylaxis in patients who were cat sensitized.

Increasing Prevalence of Sensitization to Cat/Dog Allergens in the COVID-19 Pandemic

“…Research has demonstrated that numerous patients sensitized to cats and dogs also exhibit sensitization to additional respiratory allergens [6, 17, 18]. In the present study, we observed polysensitivity with nearly 85% of patients in both sensitization groups.…”

“…According to Kang et al [21], 34% of patients sensitized to cats developed symptoms after exposure to cats, while 22% of patients sensitized to dogs developed symptoms after exposure to dogs. In another study conducted on children in Turkey, 44.5% of the patients who were sensitive to cats were symptomatic [6]. In our study, 60% of patients with cat sensitivity and 22.5% with dog sensitivity were symptomatic.…”

“…To our knowledge, no case of anaphylaxis due to dog exposure has been reported in the literature. In the study by Buyuk Yaytokgil et al [6], 9% of the participants developed anaphylaxis after direct exposure to cats. Another study reported a prevalence rate of only 0.5% for anaphylaxis in patient [25].…”

“…Sensitivity to pet allergens and allergic diseases becomes important as cat and dog ownership increases. Even non-pet owners are at increased risk of pet allergen sensitization in areas with high pet ownership [2, 6]. This study found that both pet ownership and close contact with a pet owner were more common among symptomatic patients.…”

“…Pets are less common in Turkey than in Western countries (cats 15%, dogs 12%) [5]. Diagnosis of cat and dog allergies is based on various methods, including specific immunoglobulin E (sIgE) levels or skin prick testing (SPT) and consideration of symptoms experienced after exposure to these allergens [1, 6].…”