Impact of the COVID‐19 national lockdown in the allergic rhinitis symptoms in patients treated with immunotherapy at two allergy referral centers in Bogotá, Colombia

Abstract

Background Coronavirus disease‐19 (COVID‐19) “lockdowns” caused an abruptly restricted access to health care services such as immunotherapy for allergic rhinitis (AR) and led to higher exposure to indoor allergens. This study aimed to assess the impact of COVID‐19 lockdowns on AR symptoms reported by the patients treated with immunotherapy who attended the Hospital Fundación Santa Fe de Bogotá and Unidad Médico Quirúrgica de Otorrinolaringología, Colombia. Methods Pre–post study that included patients with AR confirmed diagnosis (prick test), treated with immunotherapy before and after COVID‐19 lockdowns on March–June 2020. Visual analog scales (VAS) and sociodemographic questionnaires were applied to assess AR symptoms (nasal obstruction, pruritus, rhinorrhea, and ocular symptoms) and their associated factors. Results A total of 318 participants were included, and their mean age was 18.9 years (SD: 12.8). The median number of immunotherapy doses applied before isolation was 11 (interquartile range [IQR]: 6–19), and the median number of immunotherapy doses missed during isolation was three doses (IQR: 2–3). Up to 38.4% of the AR patients reported that their symptoms got worse during lockdowns. A pre–post mean difference in the VAS score of 0.5 was found for nasal obstruction (p = .01), 0.7 for pruritus (p < .001), 0.7 points for rhinorrhea (p < .001), and 0.8 for ocular symptoms (p < .001). Factors associated with worsening of AR symptom scores were pet ownership, atopic dermatitis, lower educational level, and a low number of immunotherapy doses applied before lockdowns. Conclusion A large proportion of patients reported worsening of their AR symptoms, probably due to higher exposure to indoor AR allergens and interruption of immunotherapy during COVID‐19 lockdowns.

Incidence of Asthma, Atopic Dermatitis, and Allergic Rhinitis in Korean Adults before and during the COVID-19 Pandemic Using Data from the Korea National Health and Nutrition Examination Survey

“…Evidence of the effect of avoidance therapy for house dust mites and pet allergens according to the 2008 ARIA guidelines is insufficient [ 37 ]. Moreover, behavior changes related to quarantine increased exposure to indoor allergens including house dust mites, mold, animal dander, and cockroaches [ 4 , 38 , 39 ]. Increases in allergic disease incidence may have been associated with these exposures.…”

“…Increases in allergic disease incidence may have been associated with these exposures. A negative effect of COVID-19 lockdown was that, in 2020, up to 38.4% of allergic rhinitis patients reported a worsening of symptoms [ 38 ]. Those with house dust mite allergies reported higher sinonasal outcome test (SNOT-22) scores and increased use of systemic antihistamines and nasal decongestants compared to 2019 [ 40 ].…”

Coinfections and Superinfections Associated with COVID-19 in Colombia: A Narrative Review

“…Noticeably, the most affected countries were industrialized ones with strong public health systems and advanced medical facilities that have been severely strained in the course of the pandemic [ 26 ]. However, Latin America’s health care systems have been significantly disrupted as SARS-CoV-2 spread around the world [ 27 ]. These nations opted for strict quarantine and the promotion of self-care, following WHO guidelines, whose objective was to separate potential carriers of the virus from uninfected individuals and thus reduce the spread of the virus, corresponding to epidemiological fences, but the social, labor, educational, psychological, and emotional costs were high [ 28 ].…”

“…COVID-19 can be misdiagnosed with dengue. This situation complicates matters, so it can be difficult to distinguish between early infections and coinfections, generating an important risk for the population and demanding greater attention from health systems, because both viruses can cause serious complications, mainly through the cytokine storm in lung tissue caused by macrophage hyperactivation [ 13 , 27 , 64 ].…”

“…Mycobacterium tuberculosis (MTB) is an acid-fast bacterium and is the main causative agent of human tuberculosis. Evidence suggests a twofold increased mortality risk in patients with COVID-19 and tuberculosis [ 27 ]. For example, a systematic review reported an increased risk of mortality in patients with coinfection of these two microorganisms, although MTB and SARS-CoV-2 coinfections are poorly understood.…”