Protective Effect of Allergen Immunotherapy in Patients With Allergic Rhinitis and Asthma Against COVID-19 Infection: Observational, Nationwide, and Multicenter Study

Allergic diseases are associated with an increased susceptibility to respiratory tract infections. Although allergen immunotherapy (AIT) alters the course of allergies, there is limited evidence from clinical practice demonstrating its ability to enhance the host defense against pathogens. The aim o...

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Published in:	JMIR public health and surveillance Vol. 10; p. e50846
Main Authors:	Qin, Rundong, Feng, Yan, Zhang, Huanping, Zhao, Beibei, Lei, Wei, Sun, Hongying, Zhi, Lili, Zheng, Zhongsheng, Wang, Siqin, Yu, Yafeng, Jiang, Shengxue, Liu, Changshan, Ma, Xingkai, Ma, Hui, Wang, Huiying, Lin, Hang, He, Qiaojie, Wu, Lingying, Zhai, Yingying, Lu, Honglue, Chen, Shi, Ma, Yan, Jin, Xiaohong, Deng, Shan, Zhong, Nanshan, Chen, Ruchong, Li, Jing
Format:	Journal Article
Language:	English
Published:	Canada JMIR Publications 16-10-2024
Subjects:	Adolescent Adult Aged Allergens Allergies Antigens Asthma Asthma - therapy China - epidemiology Chronic illnesses COVID-19 COVID-19 - epidemiology COVID-19 - prevention & control COVID-19 - therapy COVID-19 diagnostic tests Cross-Sectional Studies in Public Health Desensitization, Immunologic - methods Disease Emergency medical care Female Hay fever Humans Hygiene and Infection Prevention Immunity (Disease) Immunology, Allergy, Rheumatology Immunotherapy Infections Infectious Diseases (non-STD/STI) Male Middle Aged Nose Observational studies Original Paper Pathogens Questionnaires Respiratory Medicine Respiratory tract Rhinitis Rhinitis, Allergic - epidemiology Rhinitis, Allergic - therapy Severe acute respiratory syndrome coronavirus 2 Steroids Surveys and Questionnaires Theme Issue: Novel Coronavirus (COVID-19) Outbreak Rapid Reports Viral infections Young Adult China COVID-19 antiviral effect questionnaire-based survey viral infection allergen immunotherapy asthma allergic rhinitis allergic disease trajectory clinical evidence
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Summary:	Allergic diseases are associated with an increased susceptibility to respiratory tract infections. Although allergen immunotherapy (AIT) alters the course of allergies, there is limited evidence from clinical practice demonstrating its ability to enhance the host defense against pathogens. The aim of this study was to investigate the protective effect of AIT against viral infection in patients with allergic rhinitis (AR) and allergic asthma (AS) based on clinical evidence. A multicenter, questionnaire-based survey was conducted during a tremendous surge in COVID-19 cases between February 10, 2023, and March 15, 2023, in 81 centers across China recruiting healthy volunteers and patients with AR and AS to investigate the clinical outcomes of COVID-19 infection. Of 10,151 participants recruited in the survey, 3654 patients and 2192 healthy volunteers who tested positive for COVID-19 were included in this analysis after screening. Overall, no significant differences in COVID-19 outcomes were observed between patients and healthy volunteers. An additional 451 patients were excluded due to their use of biologics as the sole add-on treatment, leaving 3203 patients in the further analysis. Of them, 1752 were undergoing routine medication treatment (RMT; the RMT group), whereas 1057 and 394 were receiving AIT and a combination of AIT and omalizumab (OMA) as adjunct therapies to RMT, respectively (AIT+RMT and AIT+OMA+RMT groups). The AIT group showed milder COVID-19 symptoms, shorter recovery periods, and a lower likelihood of hospitalization or emergency department visits than the RMT group (all P<.05). After adjusting for confounding factors, including demographic characteristics and COVID-19 vaccination, AIT remained a significant protective factor associated with shorter recovery time (adjusted odds ratio [OR] 0.62, 95% CI 0.52-0.75; adjusted P<.001) and a lower incidence of hospitalization or emergency department visits (adjusted OR 0.73, 95% CI 0.54-0.98; adjusted P=.03). Furthermore, the AIT+OMA+RMT group showed greater protection with a shorter recovery time (adjusted OR 0.51, 95% CI 0.34-0.74; adjusted P<.001) than the AIT+RMT group. Our multicenter observational study provides valuable clinical evidence supporting the protective effect of AIT against COVID-19 infection in patients with AR and AS.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3 all authors contributed equally None declared.
ISSN:	2369-2960 2369-2960
DOI:	10.2196/50846