Does aeroallergen sensitivity and allergic rhinitis in children cause milder COVID-19 infection?

Allergy Asthma Proc. 2021 Nov 1;42(6):522-529. doi: 10.2500/aap.2021.42.210087.

Abstract

Background: There are conflicting data with regard to the impact of respiratory and allergic comorbidities on the course of novel coronavirus disease 2019 (COVID-19) in children. Objective: This study aimed to investigate the relationship between allergic diseases and COVID-19 severity in pediatric patients. Methods: Seventy-five pediatric patients with COVID-19 were classified according to clinical severity and evaluated in the allergy/immunology and pulmonology departments 1 to 3 months after the infection resolved. Blood was collected from the patients for a complete blood cell count and assessment of immunoglobulin and total immunoglobulin E (IgE) levels, and skin-prick tests and spirometry tests were performed. Results: A total of 75 patients ages 5-18 years were evaluated. COVID-19 was asymptomatic/mild in 44 patients and moderate/severe/critical in 31 patients. Based on allergy evaluation, allergic rhinitis was diagnosed in 19 patients (25.3%), asthma in 10 patients (13%), and atopic dermatitis in 3 patients (4%). Aeroallergen sensitivity was detected in 26 patients (34.7%). COVID-19 infection was asymptomatic/mild in 15 patients with allergic rhinitis (78.9%) and in 21 with aeroallergen sensitivity (80.8%) (p = 0.038 and p = 0.005, respectively). There was no difference in severity between the patients with and without asthma (p = 0.550). The median (interquartile range) total IgE level was significantly higher in the asymptomatic/mild group (71.8 [30.7-211.2]) (p = 0.015). There were no differences in terms of spirometry parameters. Conclusion: Aeroallergen sensitization and allergic rhinitis in children may be associated with a milder course of COVID-19. The knowledge that atopy is associated with less-severe COVID-19 outcomes in children may guide clinical risk classification.

MeSH terms

  • Adolescent
  • Allergens / adverse effects*
  • Asthma / diagnosis*
  • Asthma / epidemiology
  • Asthma / immunology
  • COVID-19 / complications*
  • COVID-19 / diagnosis
  • COVID-19 / epidemiology
  • Child
  • Child, Preschool
  • Dermatitis, Atopic / diagnosis*
  • Dermatitis, Atopic / epidemiology
  • Dermatitis, Atopic / immunology
  • Female
  • Humans
  • Hypersensitivity / diagnosis*
  • Hypersensitivity / epidemiology
  • Hypersensitivity / immunology
  • Immunoglobulin E / blood
  • Male
  • Respiratory Function Tests
  • Rhinitis, Allergic / diagnosis*
  • Rhinitis, Allergic / epidemiology
  • Rhinitis, Allergic / immunology
  • SARS-CoV-2
  • Severity of Illness Index
  • Skin Tests / statistics & numerical data*
  • Turkey / epidemiology

Substances

  • Allergens
  • Immunoglobulin E