COVID-19 Allergy Articles




29 July 2020
Bacillus Calmette‐Guérin vaccination and socioeconomic variables vs COVID‐19 global features: Clearing up a controversial issue

"To the best of our knowledge, this is the first study assessing at the global level the impact of BCG vaccination on COVID‐19 outcomes by integrating a wide set of social, economic, geographic, and demographic controls, thus attenuating if not eliminating altogether the effects of possible confounding factors affecting previous studies on BCG and COVID‐19."


27 July 2020
COVID‐19 in severe asthmatic patients during ongoing treatment with biologicals targeting type 2 inflammation: Results from a multicenter Italian survey

"(...) Even if this study does not allow any definitive conclusion on the association between severe asthma, biological therapy, and SARS‐CoV‐2 infection, it might suggest that severe asthma patients during ongoing treatment with biologicals targeting type 2 inflammation may not have an increased risk for COVID‐19, in comparison with age‐ and geography‐matched nonasthmatic population."


 27 July 2020
Distinct effects of asthma and COPD comorbidity on disease expression and outcome in patients with COVID‐19

"(...) for the first time, we discovered distinct effects of asthma and COPD comorbidity on the development of severe COVID‐19, which may be associated with different ACE2 protein expression in lower airways."



14 July 2020
Clinical, radiological and laboratory characteristics and risk factors for severity and mortality of 289 hospitalized COVID‐19 patients

"Survived severe and non‐survived COVID‐19 patients had distinct clinical and laboratory characteristics, which were separated by principle component analysis. Elder age, increased number of affected lobes, higher levels of serum CRP, chest tightness/dyspnea, and smoking history were risk factors for mortality of severe COVID‐19 patients. Longitudinal changes of laboratory findings may be helpful in predicting disease progression and clinical outcome of severe patients."


13 July 2020
SARS‐CoV‐2, COVID‐19, skin and immunology ‐ what do we know so far?

"In order to update information gained, we provide a systematic overview of the skin lesions described in COVID‐19 patients, discuss potential causative factors and describe differential diagnostic evaluations. Moreover, we summarize current knowledge about immunologic, clinical and histologic features of virus‐ as well as drug‐induced lesions of the skin and changes to the vascular system in order to transfer this knowledge to potential mechanisms induced by SARS‐CoV‐2."





03 July 2020
COVID‐19 and asthma, the good or the bad?

"In summary, we have seen a new zoonotic coronavirus, SARS‐CoV‐2, infection that has had a devastating effect on the host immunity via the inhibition of interferons leading to aberrant innate immune response, macrophage inflammation in releasing a cytokine storm and exhaustion of the cellular immunity of T lymphocytes.9 Fortunately, due to chronic and sustained type 2 immune inflammation in the lungs of asthmatic patients, or by the medications they use for asthma control, it seems asthma may not be a major confounding disease in COVID‐19 infection, and this unexpected phenomenon may shed a new light on finding therapies or preventative strategies for SARS‐CoV‐2."


26 June 2020
COVID‐19: A series of important recent clinical and laboratory reports in immunology and pathogenesis of SARS‐CoV‐2 infection and care of allergy patients

"The “coronavirus disease 2019 (COVID‐19)” outbreak was first reported in December 2019 (China). Since then, this disease has rapidly spread across the globe and in March 2020 the World Health Organization (WHO) declared the COVID‐19 pandemic.1 Since the outbreak was first announced, our journal has extensively focused on the clinical features, outcomes, diagnosis, immunology, and pathogenesis of COVID‐19 and its infectious agent severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2).."


26 June 2020
ARIA‐EAACI statement on Asthma and COVID‐19

"An ARIA-EAACI statement has been devised to make recommendations on asthma, and not necessarily on severe asthma, based on a consensus from its members."



22 June 2020
Immunology of COVID‐19: mechanisms, clinical outcome, diagnostics and perspectives – a report of the European Academy of Allergy and Clinical Immunology (EAACI)

"We also summarize known and potential SARS‐CoV‐2 receptors on epithelial barriers, immune cells, endothelium and clinically involved organs such as lung, gut, kidney, cardiovascular and neuronal system. Finally, we discuss the known and potential mechanisms underlying the involvement of comorbidities, gender and age in development of COVID‐19. Consequently, we highlight the knowledge gaps and urgent research requirements to provide a quick roadmap for ongoing and needed COVID‐19 studies."


22 June 2020
Telemedicine allows quantitative measuring of olfactory dysfunction in COVID‐19

"For the first time, quantitative psychophysical analyses of olfaction were performed over a full course of COVID-19 in this homogenous cohort of relatively young adults, while previous studies used self-ratings, only. It is well accepted that self-ratings largely underestimate olfactory dysfunction. Usually required face-to-face contact seems to cause this systematic error, while telemedicine consultations allows safe testing for patients and staff. The comprehensive impairment without nasal symptoms supports the suggestion of a neurotropic and neuro-invasive virus that is site-specific for the olfactory system using angiotensin-converting-enzyme-receptor-2 (ACE2) for intracellular invasion."


20 June 2020
The role of peripheral blood eosinophil counts in COVID‐19 patients

"The majority of COVID‐19 patients (71.7%) had a decrease in circulating EOS counts, which was significantly more frequent than other types of pneumonia patients. EOS counts had good value for COVID‐19 prediction, even higher when combined with NLR. Patients with low EOS counts at admission were more likely to have fever, fatigue and shortness of breath, with more lesions in chest CT and radiographic aggravation, longer length of hospital stay and course of disease than those with normal EOS counts."



16 June 2020
Eosinopenia is associated with greater severity in patients with coronavirus disease 2019

"Based on accumulating data, patients with severe COVID-19 show a trend towards eosinopenia, which raises the concern whether eosinopenia is associated with the disease severity. Eosinophil, initially identified as a key effector cell of allergy, has now been demonstrated to possess antiviral capacities and serve to amply immune response and thus dampen inflammation. It is currently not known whether COVID-19 patients with eosinopenia are also more likely to develop into critically illness. This updated analysis aimed to investigate the association between eosinopenia and COVID-19 severity."


16 June 2020
COVID‐19 in a patient with severe asthma treated with Omalizumab

"ircumstantial evidence suggests that patients with allergic asthma might have a lower risk to develop severe forms of COVID‐19. In addition, the anti‐IgE antibody Omalizumab was shown to enhance anti‐viral immunity. We report a case of a 52‐year‐old man with severe allergic asthma treated with Omalizumab with no evidence of an asthma exacerbation, loss of asthma control or pneumonia during symptomatic COVID‐19 disease. We hypothesize that the underlying disease (allergic asthma) or the antibody used for treatment (Omalizumab), or both, might have exerted protective effects."


12 June 2020
COVID‐19 pandemic: Practical considerations on the organization of an allergy clinic – an EAACI/ARIA Position Paper

"This international Position Paper provides recommendations on operational plans and procedures to maintain high standards in the daily clinical care of allergic patients whilst ensuring necessary safety in the current COVID‐19 pandemic."

A compendium answering 150 questions
Clinical characteristics of 182

  Diagnosis and management of the drug hypersensitivity reactions

07 June 2020
A compendium answering 150 questions on COVID‐19 and SARS‐CoV‐2

"This paper answers pressing questions, formulated by young clinicians and scientists, on SARS‐CoV‐2, COVID‐19 and allergy, focusing on the following topics: virology, immunology, diagnosis, management of patients with allergic disease and asthma, treatment, clinical trials, drug discovery, vaccine development and epidemiology. Over 140 questions were answered by experts in the field providing a comprehensive and practical overview of COVID‐19 and allergic disease."


10 June 2020
Clinical characteristics of 182 pediatric COVID‐19 patients with different severities and allergic status

"Pediatric COVID‐19 patients tended to have a mild clinical course. Patients with pneumonia had higher proportion of fever and cough and increased inflammatory biomarkers than those without pneumonia. There was no difference between allergic and non‐allergic COVID‐19 children in disease incidence, clinical features, laboratory and immunological findings. Allergy was not a risk factor for developing and severity of SARS‐CoV‐2 infection and hardly influenced the disease course of COVID‐19 in children."


08 June 2020
Diagnosis and management of the drug hypersensitivity reactions in Coronavirus disease 19

"This review brings togetherall the published information about the diagnosis and management of drug hypersensitivity reactions due to current and candidate off‐label drugs andhighlights relevant recommendations. Furthermore, it gathers all the dermatologic manifestations reported during the disease for guiding the clinicians to establish a better differential diagnosis of drug hypersensitivity reactionsin the course of the disease."

Low prevalence of bronchial asthma 14420


01 June 2020
Is asthma protective against COVID‐19?

"(...) there are no published reports of other type 2 conditions associated with severe COVID-19. Herein, we share some clues supporting the hypothesis that type 2 conditions do not represent a risk factor, despite the most morbidity occurring due to SARS-CoV-2 induced lung damage."


26 May 2020
Low prevalence of bronchial asthma and chronic obstructive lung disease among intensive care unit patients with COVID‐19

"In an uncontrolled study, we could not rule out the contribution of COPD to the more severe outcomes of SARS-CoV-2 infection that was shown in the previous studies. However, patients with bronchial asthma do not seem to be at increased risk of SARS-CoV-2 induced ARDS. Our findings suggest that there is no need to change standard treatment for chronic respiratory diseases during pandemic of COVID-19. Additional studies are needed to prove this hypothesis."


20 May 2020
COVID‐19 Clinical trials: quality matters more than quantity

"Hopefully, the efforts of clinical researchers in the fight against the SARS Cov‐2 will result into the identification of effective treatments. To make this possible, clinical research should be oriented by guidelines for more harmonized high‐quality studies and by a united commitment of the scientific community to share personal knowledge and data. Allergists and clinical immunologists should have a leading role in this unprecedent challenge."




17 May 2020
Allergy and asthma in children and adolescents during the COVID outbreak: what we know and how we could prevent allergy and asthma flares?

"Coronavirus disease 2019 (COVID‐19) pandemic is affecting people at any age with a more severe course in patients with chronic diseases or comorbidities, males and elderly patients. The Center for Disease Control and Prevention (CDC) initially proposed that patients with chronic lung diseases, including moderate‐severe asthma, and allergy may have a higher risk of developing severe COVID‐19 than otherwise healthy people"


13 May 2020
Managing ocular allergy in the time of COVID‐19

"This spring, the majority of allergic patients are confined to their homes due to COVID‐19 pandemic restrictions. In the following weeks, these restrictions will be reduced andpeople will be allowed to take walks, go jogging, and return to work.Spring is the time for ocular allergy (OA) to emerge with signs and symptoms consequent to increasing pollen counts. Even when wearing a mask, the eyes may remain unprotectedleading to an increase in ocular symptoms and patients seeking treatment forOA. However, access to routine consultation may remain problematic for many patients."



13 May 2020
SARS‐CoV‐2 immunogenicity at the crossroads

"The outbreak of coronavirus disease 2019 (COVID‐19) caused by the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) poses a global health emergency and became a worldwide pandemic. We summarize the recent findings with respect to the function, structure and immunogenicity of the spike (S) protein, arising mutations, and implications on vaccine development and therapeutics."


     all.14353   all.14348

12 May 2020
Immune response to SARS‐CoV‐2 and mechanisms of immunopathological changes in COVID‐19

"Prevention of development to severe disease, cytokine storm, acute respiratory distress syndrome and novel approachs to prevent their development will be main routes for future research areas. As we learn to live amidst the virus, understanding the immunology of the disease can assist in containing the pandemic and in developing vaccines and medicines to prevent and treat individual patients."


05 May 2020
COVID‐19, chronic inflammatory respiratory diseases and eosinophils – Observationsfrom reported clinical case series

"Currently, the world is facing a global pandemic with a new coronavirus SARS‐CoV‐ 2 (Severe Acute Respiratory Syndrome CoronaVirus Type 2) causing infectious disease named COVID‐19 (CoronaVirus Infectious Disease 2019). Comparing the clinical presentation and epidemiological characteristics of COVID‐19 with previous coronavirus‐associated respiratory diseases (SARS‐CoV1 and MERS) revealedsome remarkable findings and differences. Moreover, the clinical course of SARS‐CoV‐2 infection showed the complexity of COVID‐19 profile with the variable clinical presentations."



02 May 2020
Asthma and COVID‐19: is asthma a risk factor for severe outcomes?

"My recommendations to people with asthma and those treating them are most importantly to optimize asthma control with standard therapies, but if asthma control is not optimal despite appropriate use of standard therapies, to have a low threshold for starting azithromycin prophylaxis (because of its innate antiviral (IFN-boosting) property, at this time of enormous threat from COVID-19."


     all.14345   all.14344

 24 April 2020
Handling of allergen immunotherapy in the COVID‐19 pandemic: An ARIA‐EAACI statement

"This manuscript outlines the EAACI recommendations regarding AIT during the COVID-19 pandemic and aims at supporting allergists and all physicians performing AIT in their current daily practice with clear recommendations how to perform treatment during the pandemic and in SARS-CoV-2 infected patients."


27 April 2020
Is global BCG vaccination‐induced trained immunity relevant to the progression of SARS‐CoV‐2 pandemic?

"Even though we are still in the midst of the coronavirus pandemic, the disproportionately smaller number of cases reported from disadvantaged/low income countries remains puzzling. We hypothesize that general BCG vaccination policies adopted by different countries might have impacted the transmission patterns and/or COVID-19 associated morbidity and mortality."


24 April 2020
Is BCG vaccination effecting the spread and severity of COVID‐19?

"As allergists and immunologists, we are very familiar with the T helper (Th)1 and Th2 balance in addition to orchestral roles of T regulatory and other effector cells, so we have to consider the possible roles of childhood immunizations within the context of the current coronavirus disease 2019 (COVID-19) outbreak."

  Advanced forecasting of SARS CoV 2 related deaths in Italy Germany Spain and New York State      Distinct characteristics Figure

COVID 19 in a designated infectious diseases hospital outside Hubei Province China

18 April 2020
Advanced forecasting of SARS‐CoV‐2 related deaths in Italy, Germany, Spain, and New York State

"Appropriate forecasting model can contribute to define strategic choices both in limiting the spread of SARS-Cov-2 virus, as well as in reducing the related mortality rate. Temporal trends of SARS-CoV-2 key epidemiological indicators (e.g., mortality, incidence of infected cases, etc.) to describe the ongoing pandemic caused by SARS-CoV-2 have been estimated; their accuracy is key to plan and implement adequate health interventions (e.g., increasing ICU availability distribute personal protection gear, an eventual vaccine, etc)."


13 April 2020
Distinct characteristics of COVID‐19 patients with initial rRT‐PCR positive and negative results for SARS‐CoV‐2

"Since the coronavirus disease 2019 (COVID‐19) caused by SARS‐CoV‐2 (severe acute respiratory syndrome coronavirus 2) first emerged in Wuhan, China in December 2019, the outbreak of COVID‐19 epidemic has become an increasingly serious global health concern. Currently, over 150 countries have reported COVID‐19 cases, and the situation has progressed to a pandemic associated with substantial morbidity and mortality."


02 April 2020
COVID‐19 in a Designated Infectious Diseases Hospital Outside Hubei Province, China

"In a designated hospital outside Hubei Province, COVID‐2019 patients could be effectively managed by properly using the existing hospital system. Mortality may be lowered when cases are relatively mild and there are sufficient medical resources to care and treat the disease."

  Intranasal corticosteroids in allergic rhinitis in COVID 19 infected patients An ARIA EAACI statement      Eleven faces of COVID 19

  Clinical characteristics of 140 patients infected with SARS CoV 2 in Wuhan Chinajpg

31 March 2020
Intranasal corticosteroids in allergic rhinitis in COVID‐19 infected patients: An ARIA‐EAACI statement

"Some sources have suggested that “corticosteroids” should be avoided during the for SARS-CoV-2 epidemic. This advice is about the use of oral corticosteroids unless there is a clear indication for their use. Patients with asthma should not stop their prescribed inhaled corticosteroid controller medication (or prescribed oral corticosteroids). Stopping inhaled corticosteroids often leads to potentially dangerous worsening of asthma, and avoiding oral corticosteroids during severe asthma attacks may have serious consequences."


20 March 2020
Eleven faces of coronavirus disease 2019

"All different clinical characteristics of COVID‐19 should be taken into consideration to identify patients that need to be in strict quarantine for the efficient containment of the pandemic."


19 February 2020
Clinical characteristics of 140 patients infected with SARS‐CoV‐2 in Wuhan, China

"Detailed clinical investigation of 140 hospitalized COVID‐19 cases suggests eosinopenia together with lymphopenia may be a potential indicator for diagnosis. Allergic diseases, asthma, and COPD are not risk factors for SARS‐CoV‐2 infection. Older age, high number of comorbidities, and more prominent laboratory abnormalities were associated with severe patients."

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