Recent advances and developments in COVID‐19 in the context of allergic diseases

Abstract

Background Since the first reports of coronavirus disease 2019 (COVID‐19) in Wuhan, China, in December 2019, there have been 198 million confirmed cases worldwide as of August 2021. The scientific community has joined efforts to gain knowledge of the newly emerged virus named severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), the immunopathological mechanisms leading to COVID‐19, and its significance for patients with allergies and asthma. Methods Based on the current literature, recent advances and developments in COVID‐19 in the context of allergic diseases were reviewed. Results and Conclusions In this review, we discuss the prevalence of COVID‐19 in subjects with asthma, attacks of hereditary angioedema, and other allergic diseases during COVID‐19. Underlying mechanisms suggest a protective role of allergy in COVID‐19, involving eosinophilia, SARS‐CoV‐2 receptors expression, interferon responses, and other immunological events, but further studies are needed to fully understand those associations. There has been significant progress in disease evaluation and management of COVID‐19, and allergy care should continue during the COVID‐19 pandemic. The European Academy of Allergy & Clinical Immunology (EAACI) launched a series of statements and position papers providing recommendations on the organization of the allergy clinic, handling of allergen immunotherapy, asthma, drug hypersensitivity, allergic rhinitis, and other allergic diseases. Treatment of allergies using biologics during the COVID‐19 pandemic has also been discussed. Allergic reactions to the COVID‐19 vaccines, including severe anaphylaxis, have been reported. Vaccination is a prophylactic strategy that can lead to a significant reduction in the mortality and morbidity associated with SARS‐CoV‐2 infection, and in this review, we discuss the proposed culprit components causing rare adverse reactions and recommendations to mitigate the risk of anaphylactic events during the administration of the vaccines.

Acute asthma exacerbation due to the SARS-CoV-2 vaccine (Pfizer-BioNTech BNT162b2 messenger RNA COVID-19 vaccine [ComirnatyⓇ])

“…Th2 type disorders after inoculation are thought to be uncommon, but several case reports of Th2 type disorders with eosinophilia, such as AEP, DRESS, and EGPA, have been published in the wake of nationwide immunization (Ozturk et al, 2022) (Korekawa et al, 2022) (Ibrahim et al, 2022). Polyethylene glycol has been identified as a potential trigger of allergic reaction and is an integral part of the micellar delivery system of the BNT162b2 vaccines containing mRNA coding the spike protein of SARS-CoV-2, but the pathological mechanisms involved are not fully understood (Ding et al, 2021).…”

Omalizumab may protect allergic patients against COVID-19: A systematic review

“…3,17 It is recommended to continue biologics in allergic patients. 3,10,[31][32][33][34][35][36][37] Discontinuation of biologics may lead to an increased risk of asthma exacerbations, oral corticosteroid use and a greater likelihood of access to the emergency room and hospitalization which represent risk factors for SARS-CoV-2 infection.…”

International consensus statement on allergy and rhinology: Allergic rhinitis – 2023

“…In addition, AR is not a contraindication to receiving the COVID‐19 vaccine. Patients with AR were able to tolerate COVID‐19 vaccination without severe reactions 3418–3420 …”