The effect of COVID‐19 on patients with chronic spontaneous urticaria treated with omalizumab and antihistamines: A cross‐sectional, comparative study

Abstract

Introduction: Chronic spontaneous urticaria (CSU) is defined as recurrent attacks of urticaria present for more than six weeks. The monoclonal anti-immunoglobulin E antibody, omalizumab, was approved for the treatment of CSU in patients who remain refractory to H1-antihistamines. Biologic agents are shown not to increase the risk of COVID-19 infection in different studies. Objective: In the present study, we aimed to determine the prevalance of COVID-19 infection in relation to the age, gender, presence of other comorbidities, and treatment given for CSU. Methods: We conducted a descriptive cross-sectional study of 233 patients diagnosed with CSU in a tertiary referral hospital. Demographical data, treatment given for CSU, the presence of COVID-19-related symptoms, history of close contact to a person with COVID-19 and COVID-19 real-time polymerase chain reaction (RT-PCR) results were determined via a telephone survey and checked from medical data records. Results: One hundred sixty patients were female; whereas 73 were male. The mean age was 44.76. Out of 233 patients with chronic urticaria, 125 had symptoms related to COVID-19 infection. RT-PCR testing for COVID-19 was performed in 156 patients. Of 156 patients with COVID-19 RT-PCR test, RT-PCR result was positive in 15 cases. Conclusions: No statistically significant relationship was found between COVID-19 RT-PCR positivity and the type of treatment administered for chronic urticaria when the patients are divided into omalizumab ± oral antihistamines and only oral antihistamines treatment groups (p = 0.150). Omalizumab seems to be safe in the era of COVID-19.

Impact of Anti-Type 2 Inflammation Biologic Therapy on COVID-19 Clinical Course and Outcome

“…In detail, they did not find any statistically significant difference between patients treated with omalizumab in addition to oral antihistamines and those receiving only oral antihistamines, in terms of SARS-CoV-2 RT-PCR positivity. 24 …”

The course of COVID-19 in patients with chronic spontaneous urticaria receiving omalizumab treatment

“…To best our knowledge, there is only one study in the literature that examines the risk factors for SARS-CoV-2 positive disease in CSU patients. In this study, it has been reported that gender, comorbid systemic diseases, CSU treatments (omalizumab and/or antihistamine treatments) were not identified as risk factors for SARS-CoV-2 positivity in CSU patients (14). In our study, result of regression analysis showed that demographic parameters such as age, gender, omalizumab treatment and laboratory parameters such as IgE levels, eosinophil counts were not predictive of SARS-CoV-2 positivity.…”

“…Abduelmula et al reported that none of the 184 CSU and asthma patients who received omalizumab were tested positive for SARS-CoV-2 (13). In another study, Bostan et al reported that 15 (9.6%) of the 233 patients with CSU were tested positive for SARS-CoV-2 and 2 patients were hospitalized due to SARS-CoV-2 disease (14). Kocaturk et al also reported that 11 (13.9%) of the 79 patients with CSU who had SARS-CoV-2 positivity 11 patients (13.9%) were hospitalized (8 mild disease and 3 severe disease) (15).…”

Navigating patients with atopic dermatitis or chronic spontaneous urticaria during the COVID-19 pandemic

“…Concerning omalizumab, expert opinion advises maintaining the treatment in patients with mild-to-moderate COVID-19 infection based on findings extrapolated from a meta-analysis of randomized controlled trials in CSU where similar rates of upper respiratory tract infections in omalizumab and placebotreated individuals were detected (31,32). Such recommendation has been substantiated by recent reports demonstrating the safety of omalizumab in COVID-19 patients with urticaria (28, 31,33). In patients with severe COVID-19 infection, it has been agreed to prolong intervals between the omalizumab injections or pause therapy (24).…”