Aeroallergen immunotherapy associated with reduced risk of severe COVID-19 in 1095 allergic patients.

Autor:	Larenas-Linnemann D; Médica Sur Fundación y Hospital, Centro de Excelencia en Asma y Alergia, Mexico City, Mexico., Morfin-Maciel BM; Hospital San Angel Inn Chapultepec, Mexico City, Mexico., Bedolla-Barajas M; Nuevo Hospital Civil de Guadalajara 'Dr. Juan I. Menchaca'. Jalisco, Mexico., López-Bago A; Facultad de medicina, Universidad Autónoma de México (UNAM), Mexico City, Mexico., Navarrete Rodríguez EM; Hospital Infantil de México Federico Gómez, Department of Allergy and Clinical Immunology, Mexico City, Mexico., Mogica-Martínez MD; Medical Center Santa Monica, Tlalnepantla Estado de México, Mexico., Gereda JE; Clínica Ricardo Palma, Lima, Peru., Sarrazola Sanjuan M; Private Practice. Cucuta, Colombia., Cano Pedroza RY; Private Practice, Mexico City, Mexico., Cavallo MC; Allergy and Clinical Immunology Department, Hospital San Martín, Paraná ER Argentina., Romero Tapia SJ; School of Medicine, Universidad Juárez Autónoma de Tabasco. Villahermosa, Tabasco. Mexico., Jossen RA; Private Practice, Córdoba, Argentina., Fuentes Pérez JM; Hospital de Especialidades Dr. Bernardo Sepúlveda, Centro Médico Nacional Siglo XXI, IMSS, Mexico City, Mexico., Del Rio Navarro BE; Hospital Infantil de México Federico Gómez, Servicio de Alergia e Inmunología Clínica, Mexico City, Mexico., Rodríguez Zagal E; HGR1 IMSS. Dr. Carlos MacGregor, Mexico City, Mexico., Piraino Sosa PA; Private Practice, Asunción, Paraguay., Huerta Villalobos YR; Private Practice, Mexico City, Mexico., Chavez-Vereau P; Private Practice, Lima, Peru., García Imperial DA; Private Practice, Hospital H+ Querétaro. Estado: Querétaro, Mexico., Olivares Gómez M; Private Practice, Clinica Medellin poblado, Medellin- Antioquia, Colombia., Valle Rodríguez F; Hospital Ángeles Puebla, Puebla, Mexico., Zuñiga Reyes CO; Private Practice, Jalisco, Mexico., Rodríguez-González M; Private Practice, Mexico City, Mexico., Gallego Corella CI; Centro de Alergia y Asma de Tijuana (CAAT), Hospital Angeles, Tijuana, Baja California, Mexico., Ivancevich JC; Department of Allergy and Immunology, Clínica Santa Isabel, Buenos Aires, Argentina., García Cruz MLH; Department of Otorrrinolaringología y Cirugía de Cabeza y Cuello, Instituto Nacional de Enfermedades Respiratorias (INER), Mexico City, Mexico., Repka-Ramirez MS; Allergy, Asthma and Immunology Department, Hospital de Clínicas-FCM, Universidad Nacional, Asunción, Paraguay., Flores Morales ME; Clinica de Asma y Alergias, La Libertad, El Salvador., Fernández De Córdova Aguirre JC; Hospital Del Río, Cuenca, Ecuador., Luna-Pech JA; Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Mexico., Rivero Yeverino D; Hospital Universitario de Puebla. Puebla, Mexico., Martínez Guzmán E; Hospital Regional de Alta Especialidad Del Bajío, León, Guanajuato, Mexico., Pérez Ortiz CE; Hospital de Clínicas, Facultad de Ciencia Medicas, Universidad Nacional de Asunción, Asunción, Paraguay., Villa Médica L; Sanatorio San Roque, Marcos Juárez, Córdoba, Argentina.
Jazyk:	angličtina
Zdroj:	The World Allergy Organization journal [World Allergy Organ J] 2023 May; Vol. 16 (5), pp. 100779. Date of Electronic Publication: 2023 May 03.
DOI:	10.1016/j.waojou.2023.100779
Abstrakt:	Introduction: Allergen immunotherapy (AIT) brings along changes in the immune system, restoring dendritic cell function, reducing T2 inflammation and augmenting the regulatory cell activation. Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, interferes with the immune system causing immune suppression during the first phase and over-activation in more advanced disease. We decided to explore the interaction of both in a real-world observational trial. Methods: We registered COVID-19 outcomes in patients with allergic disorders in Latin America, treated with and without AIT. The registry was conducted during the first 1.3 years of the pandemic, with most of the data collected before COVID-19 vaccination was concluded in most countries. Data collection was anonymous via a web-based instrument. Ten countries participated. Results: 630/1095 (57.6%) of the included patients received AIT. Compared to patients without AIT, those treated with AIT had a reduced risk ratio (RR) for COVID-19 lower respiratory symptoms (RR 0.78, 95% CI: 0.6703-0.9024; p = 0.001662) and need for oxygen therapy (RR 0.65, 95% CI: 0.4217-0.9992; p = 0.048). In adherent patients on maintenance sublingual immunotherapy/subcutaneous immunotherapy (SLIT/SCIT) the RR reduction was larger [RR = 0.6136 (95% CI 0.4623-0.8143; p < 0.001) and RR: 0.3495 (95% CI 0.1822-0.6701; p < 0.005), respectively]. SLIT was slightly more effective (NS). We excluded age, comorbidities, level of health care attendance, and type of allergic disorder as confounders, although asthma was related to a higher frequency of severe disease. When analyzing patients with allergic asthma (n = 503) the RR reduction favoring AIT was more pronounced with 30% for lower respiratory symptoms or worse (RR 0.6914, 95% CI 0.5264 to 0.9081, p = 0.0087) and 51% for need of oxygen therapy or worse (RR 0.4868, 95% CI 0.2829-0.8376, p = 0.0082). Among severe allergic patients treated with biologics (n = 24) only 2/24 needed oxygen therapy. There were no critical cases among them. Conclusion: In our registry AIT was associated with reduced COVID-19 severity. Competing Interests: None of the authors has any direct COI related to the content of this manuscript. (© 2023 The Authors.)
Databáze:	MEDLINE
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