Subcutaneous Allergen Immunotherapy in Children: Real Life Compliance and Effect of COVID-19 Pandemic on Compliance

Int Arch Allergy Immunol. 2021;182(7):631-636. doi: 10.1159/000514587. Epub 2021 Apr 22.

Abstract

Background: Subcutaneous allergen immunotherapy (SCIT) is an effective treatment for allergic rhinitis, asthma, and venom allergy. Compliance is essential for SCIT to obtain maximal benefit as it is a long-term treatment.

Objectives: This study aimed to determine the level of real-life SCIT compliance in pediatric patients and the associated factors. Additional aims were to determine how SCIT compliance was affected by the COVID-19 pandemic and why some patients dropped out SCIT.

Method: Pediatric patients diagnosed with allergic rhinitis, allergic asthma, or venom allergy that received SCIT between September 2012 and July 2020 were analyzed.

Results: The study included 201 children (66.7% male) with a median (interquartile range) age of 12.8 years (9.4-15.2) at the time of the first SCIT injection. The overall compliance rate before COVID-19 pandemic was 86.1%. Short SCIT follow-up time and venom anaphylaxis were found to be risk factors for drop out. The leading causes of drop outs were moving to another city/country (32.1%), symptom improvement (17.8%), treatment ineffectiveness (14.2%), and adverse reactions (14.2%). Among the 108 patients that were still receiving SCIT during the COVID-19 pandemic, 31 (28.7%) dropped out the therapy. The most frequent reasons for drop-out were fear of being infected with COVID-19 (35.4%) and thinking that the AIT practise stopped due to COVID-19 pandemic (29%). Male gender and older age were found to be the independent risk factors for drop-out of SCIT.

Conclusions: Real life compliance in children was found 13.9% and it was higher than adults. Nearly one-third of children dropped out during the CO-VID-19 pandemic. Male gender and older age are associated with SCIT drop-out during the COVID-19 pandemic.

Keywords: Children; Compliance; Coronavirus disease 2019; Subcutaneous allergen immunotherapy.

MeSH terms

  • Adolescent
  • COVID-19* / prevention & control
  • COVID-19* / psychology
  • Child
  • Desensitization, Immunologic* / adverse effects
  • Desensitization, Immunologic* / methods
  • Desensitization, Immunologic* / psychology
  • Desensitization, Immunologic* / statistics & numerical data
  • Female
  • Humans
  • Hypersensitivity, Immediate / therapy*
  • Injections, Subcutaneous
  • Logistic Models
  • Male
  • Patient Compliance / psychology
  • Patient Compliance / statistics & numerical data*
  • Patient Dropouts / psychology
  • Patient Dropouts / statistics & numerical data
  • Turkey