Chronic spontaneous urticaria exacerbation in a patient with COVID‐19: rapid and excellent response to omalizumab

Criado, Paulo Ricardo; Criado, Roberta Fachini Jardim; Pincelli, Thais; Yoshimoto, Thais Akemi; Naufal, Gabriela G A; Abdalla, Beatrice Martinez Zugaib

doi:10.1111/ijd.15134

Cited by 26 publications

(40 citation statements)

References 4 publications

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“…Treatment with biologics should be continued in patients noninfected with SARS‐CoV‐2, with careful (tele)monitoring, unless there are arguments against this treatment. Safety and efficacy of the mentioned biologics in COVID‐19 patients have so far only been presented in case reports 95‐97 . Here, only mild cases were observed without any negative influence of the biologics to COVID‐19 severity.…”

Section: Discussionmentioning

confidence: 74%

Management of patients with chronic rhinosinusitis during the COVID‐19 pandemic—An EAACI position paper

Klimek

Jutel

Bousquet

et al. 2021

Allergy

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Background Chronic rhinosinusitis is regarded as a chronic airway disease. According to WHO recommendations, it may be a risk factor for COVID‐19 patients. In most CRSwNP cases, the inflammatory changes affecting the nasal and paranasal mucous membranes are type‐2 (T2) inflammation endotypes. Methods The current knowledge on COVID‐19 and on treatment options for CRS was analyzed by a literature search in Medline, Pubmed, international guidelines, the Cochrane Library and the Internet. Results Based on international literature, on current recommendations by WHO and other international organizations as well as on previous experience, a panel of experts from EAACI and ARIA provided recommendations for the treatment of CRS during the COVID‐19 pandemic. Conclusion Intranasal corticosteroids remain the standard treatment for CRS in patients with SARS‐CoV‐2 infection. Surgical treatments should be reduced to a minimum and surgery preserved for patients with local complications and for those with no other treatment options. Systemic corticosteroids should be avoided. Treatment with biologics can be continued with careful monitoring in noninfected patients and should be temporarily interrupted during the course of the COVID‐19 infection.

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Section: Discussionmentioning

confidence: 74%

Management of patients with chronic rhinosinusitis during the COVID‐19 pandemic—An EAACI position paper

Klimek

Jutel

Bousquet

et al. 2021

Allergy

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“…Also, omalizumab treatment was reported to reduce disease duration and viral shedding in rhinovirus infection in children with asthma, 31 possibly by enhancing anti‐viral immunity via downregulation of the high‐affinity IgE receptor on plasmacytoid dendritic cells (pDCs), which are essential for anti‐viral immune responses 32 . Moreover, recent reports have demonstrated the effective and safe use of omalizumab in COVID‐19 patients with urticaria, asthma, and urticarial vasculitis 18 . Based on these data, the most recent recommendations by several groups of experts are to continue omalizumab treatment in CU patients with mild‐to‐moderate COVID‐19 course, or when SARS‐CoV‐2 infection is suspected, and to only consider prolongation of the injection interval or treatment interruption in CU patients with severe COVID‐19 course 11 .…”

Section: Discussionmentioning

confidence: 99%

“…These effects may explain why there are several reports of urticaria and angioedema associated with COVID‐19 infection in the literature, and urticaria‐like lesions were ranked as the second most common cutaneous manifestation of COVID‐19 infection and reported to be present in 19% of patients in a series from Spain 17 . Also, COVID‐19 can lead to exacerbation of CU 18 . How often this happens remains unknown.…”

Section: Introductionmentioning

confidence: 99%

The global impact of the COVID‐19 pandemic on the management and course of chronic urticaria

Kocatürk

Salman

Chérrez-Ojeda

et al. 2020

Allergy

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Introduction The COVID‐19 pandemic dramatically disrupts health care around the globe. The impact of the pandemic on chronic urticaria (CU) and its management are largely unknown. Aim To understand how CU patients are affected by the COVID‐19 pandemic; how specialists alter CU patient management; and the course of CU in patients with COVID‐19. Materials and Methods Our cross‐sectional, international, questionnaire‐based, multicenter UCARE COVID‐CU study assessed the impact of the pandemic on patient consultations, remote treatment, changes in medications, and clinical consequences. Results The COVID‐19 pandemic severely impairs CU patient care, with less than 50% of the weekly numbers of patients treated as compared to before the pandemic. Reduced patient referrals and clinic hours were the major reasons. Almost half of responding UCARE physicians were involved in COVID‐19 patient care, which negatively impacted on the care of urticaria patients. The rate of face‐to‐face consultations decreased by 62%, from 90% to less than half, whereas the rate of remote consultations increased by more than 600%, from one in 10 to more than two thirds. Cyclosporine and systemic corticosteroids, but not antihistamines or omalizumab, are used less during the pandemic. CU does not affect the course of COVID‐19, but COVID‐19 results in CU exacerbation in one of three patients, with higher rates in patients with severe COVID‐19. Conclusions The COVID‐19 pandemic brings major changes and challenges for CU patients and their physicians. The long‐term consequences of these changes, especially the increased use of remote consultations, require careful evaluation.

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“…In a recent case report, omalizumab was initiated for a CU patient who had COVID-19 disease. 13 Various cutaneous manifestations as well as systemic findings…”

Section: T a B L E 1 The Demographic And Clinical Findings Of Patientmentioning

confidence: 99%

The impact of COVID ‐19 pandemic on the management of patients with chronic urticaria: An observational two‐center study from Turkey

Erdem

Ekinci

Altunay

et al. 2020

Dermatologic Therapy

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The Coronavirus Disease 2019 (COVID‐19) outbreak significantly affected the clinical practice in hospitals and the management of many diseases. The aim of this study was to evaluate the effect of pandemic‐related factors on the severity and course of chronic urticaria (CU). A total of 194 CU patients who were on regular follow‐up, were enrolled in the study. The disease activity was assessed by means of the weekly urticaria activity score (UAS7) and urticaria control test (UCT). Patients were divided into two subgroups according to their disease aggravation as “aggravated” and “non‐aggravated”. Two groups were compared in terms of demographic, clinical, COVID‐19‐associated parameters, and parameters related with the effect of COVID‐19 pandemic on CU management. The omalizumab use was statistically higher (P = .017), and the systemic corticosteroid use was statistically lower (P = .025) in the “aggravated” group. Adherence to quarantine was significantly lower in the “aggravated” group (P = .027). 173 patients (89.2%) were unable to contact a dermatologist during the pandemic. Among 186 patients who received treatment for CU before the pandemic, 48 (25.8%) did not continue the existing treatment during the pandemic. CU aggravated in one patient with COVID‐19 and remained stable in the other. This study showed that CU patients, especially those on omalizumab therapy, had difficulties in attending medical care and even in the maintenance of their existing therapies during the pandemic. Creating novel follow‐up and treatment models as well as the increased use of teledermatology might be beneficial in the management of this life‐disturbing condition.

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Chronic spontaneous urticaria exacerbation in a patient with COVID‐19: rapid and excellent response to omalizumab

Cited by 26 publications

References 4 publications

Management of patients with chronic rhinosinusitis during the COVID‐19 pandemic—An EAACI position paper

Management of patients with chronic rhinosinusitis during the COVID‐19 pandemic—An EAACI position paper

The global impact of the COVID‐19 pandemic on the management and course of chronic urticaria

The impact of COVID ‐19 pandemic on the management of patients with chronic urticaria: An observational two‐center study from Turkey

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