Handling of allergen immunotherapy in the COVID-19 pandemic: An ARIA-EAACI statement.
Wrocław Medical University1, Swiss Institute of Allergy and Asthma Research2, Transylvania University3, Woolcock Institute of Medical Research4, Humanitas University5, Federal University of Bahia6, University of Cagliari7, Tongji Medical College8, University of Porto9, Utrecht University10, Medical University of Łódź11, Boston Children's Hospital12, Johns Hopkins University13, University of Barcelona14, Chiba University15, University College Cork16, University of Manchester17, Nippon Medical School18, Medical University of Warsaw19, University of Edinburgh20, University of Bari21, European Union of Medical Specialists22, Vilnius University23, Celal Bayar University24, Charité25, Humboldt University of Berlin26, National Institutes of Health27, Wuhan University28
TL;DR: Allergen‐specific immunotherapy (AIT) is one of the most important treatment options for IgE‐mediated allergies and is based on immunological effects on the diseased patient.
Abstract: The current COVID‐19 pandemic influences many areas of social life, medical treatments and the way allergy diagnosis and treatment is performed. Allergen‐specific immunotherapy (AIT) is one of the most important treatment options for IgE‐mediated allergies and is based on immunological effects on the diseased patient. 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.
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01 Jan 2020
TL;DR: Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future.
Abstract: Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.
4,408 citations
Swiss Institute of Allergy and Asthma Research1, Medical University of Łódź2, Transylvania University3, University of Zurich4, Istituto Italiano di Tecnologia5, Boston Children's Hospital6, University of Toronto7, Medical University of Białystok8, Technische Universität München9, Medical University of Warsaw10, Medical University of Vienna11, Charles University in Prague12, McMaster University13, Spanish National Research Council14, Wrocław Medical University15, Utrecht University16, Vrije Universiteit Brussel17, University College Cork18, Stanford University19, Istanbul University20, University of Veterinary Medicine Vienna21, Complutense University of Madrid22, University of Edinburgh23
TL;DR: The differences between adequate innate and adaptive immune response in mild disease and the deep immune dysfunction in the severe multiorgan disease are characterized and the knowledge gaps and urgent research requirements are highlighted to provide a quick roadmap for ongoing and needed COVID‐19 studies.
Abstract: With the worldwide spread of the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) resulting in declaration of a pandemic by the World Health Organization (WHO) on March 11, 2020, the SARS-CoV-2-induced coronavirus disease-19 (COVID-19) has become one of the main challenges of our times The high infection rate and the severe disease course led to major safety and social restriction measures worldwide There is an urgent need of unbiased expert knowledge guiding the development of efficient treatment and prevention strategies This report summarizes current immunological data on mechanisms associated with the SARS-CoV-2 infection and COVID-19 development and progression to the most severe forms We characterize the differences between adequate innate and adaptive immune response in mild disease and the deep immune dysfunction in the severe multiorgan disease The similarities of the human immune response to SARS-CoV-2 and the SARS-CoV and MERS-CoV are underlined 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
128 citations
TL;DR: This review presents a report on the origin, transmission, symptoms, diagnosis, possible vaccines, animal models, and immunotherapy for this novel virus and will provide ample references for the researchers toward the ongoing development of therapeutic agents and vaccines and also preventing the spread of this disease.
Abstract: COVID-19 is highly contagious pathogenic viral infection initiated from Wuhan seafood wholesale market of China on December 2019 and spread rapidly around the whole world due to onward transmission. This recent outbreak of novel coronavirus (CoV) was believed to be originated from bats and causing respiratory infections such as common cold, dry cough, fever, headache, dyspnea, pneumonia, and finally Severe Acute Respiratory Syndrome (SARS) in humans. For this widespread zoonotic virus, human-to-human transmission has resulted in nearly 83 lakh cases in 213 countries and territories with 4,50,686 deaths as on 19 June 2020. This review presents a report on the origin, transmission, symptoms, diagnosis, possible vaccines, animal models, and immunotherapy for this novel virus and will provide ample references for the researchers toward the ongoing development of therapeutic agents and vaccines and also preventing the spread of this disease.
88 citations
Cites background from "Handling of allergen immunotherapy ..."
...The immune mechanisms in AIT and COVID-19 were also discussed (Klimek et al., 2020)....
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...In addition, Klimek et al., 2020 have suggested the allergen-specific immunotherapy (AIT) that confers a long-term clinical benefit (activates immune tolerance responses) for the diseases like allergic rhinoconjunctivitis, allergic bronchial asthma, 1200 | MOHAPATRA eT Al. etc. (Bousquet, Lockey, &…...
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TL;DR: The most relevant experimental studies further advancing the understanding of molecular and immune mechanisms with potential new targets for the development of therapeutics are discussed and critical approaches and strategies in asthma treatment linked to mechanisms and endotypes of asthma, particularly biologicals are critically appraised.
Abstract: In this review, we discuss recent publications on asthma and review the studies that have reported on the different aspects of the prevalence, risk factors and prevention, mechanisms, diagnosis, and treatment of asthma. Many risk and protective factors and molecular mechanisms are involved in the development of asthma. Emerging concepts and challenges in implementing the exposome paradigm and its application in allergic diseases and asthma are reviewed, including genetic and epigenetic factors, microbial dysbiosis, and environmental exposure, particularly to indoor and outdoor substances. The most relevant experimental studies further advancing the understanding of molecular and immune mechanisms with potential new targets for the development of therapeutics are discussed. A reliable diagnosis of asthma, disease endotyping, and monitoring its severity are of great importance in the management of asthma. Correct evaluation and management of asthma comorbidity/multimorbidity, including interaction with asthma phenotypes and its value for the precision medicine approach and validation of predictive biomarkers, are further detailed. Novel approaches and strategies in asthma treatment linked to mechanisms and endotypes of asthma, particularly biologicals, are critically appraised. Finally, due to the recent pandemics and its impact on patient management, we discuss the challenges, relationships, and molecular mechanisms between asthma, allergies, SARS-CoV-2, and COVID-19.
87 citations
Hospital Sant Joan de Déu Barcelona1, I.M. Sechenov First Moscow State Medical University2, University of Pisa3, Transylvania University4, Swiss Institute of Allergy and Asthma Research5, University of Porto6, University of Verona7, Universidad del Sagrado Corazón8, Humboldt University of Berlin9, Medical University of Vienna10, University of Lisbon11, First Faculty of Medicine, Charles University in Prague12, Lund University13, University Medical Center Groningen14, University of Toronto15, Technische Universität München16, University of Amsterdam17, Wuhan University18, National Institutes of Health19, Wrocław Medical University20, University of Wrocław21, Stanford University22, Monash University23, University College Cork24, University of Marburg25, Jagiellonian University Medical College26, University of Edinburgh27, National University of Singapore28, Beijing Tongren Hospital29, Spanish National Research Council30, McMaster University31, Universidad Francisco de Vitoria32
TL;DR: 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.
Abstract: In December 2019, China reported the first cases of the coronavirus disease 2019 (COVID-19). This disease, caused by the severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2), has developed into a pandemic. To date, it has resulted in ~9 million confirmed cases and caused almost 500 000 related deaths worldwide. Unequivocally, the COVID-19 pandemic is the gravest health and socioeconomic crisis of our time. In this context, numerous questions have emerged in demand of basic scientific information and evidence-based medical advice on SARS-CoV-2 and COVID-19. Although the majority of the patients show a very mild, self-limiting viral respiratory disease, many clinical manifestations in severe patients are unique to COVID-19, such as severe lymphopenia and eosinopenia, extensive pneumonia, a "cytokine storm" leading to acute respiratory distress syndrome, endothelitis, thromboembolic complications, and multiorgan failure. The epidemiologic features of COVID-19 are distinctive and have changed throughout the pandemic. Vaccine and drug development studies and clinical trials are rapidly growing at an unprecedented speed. However, basic and clinical research on COVID-19-related topics should be based on more coordinated high-quality studies. 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. A total of 150 questions were answered by experts in the field providing a comprehensive and practical overview of COVID-19 and allergic disease.
79 citations
References
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36,578 citations
"Handling of allergen immunotherapy ..." refers background in this paper
...In more severe cases, infection with COVID-19 can cause pneumonia, severe acute respiratory syndrome, kidney failure, and even death(4-8)....
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21,455 citations
TL;DR: Wang et al. as discussed by the authors used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death, including older age, high SOFA score and d-dimer greater than 1 μg/mL.
20,189 citations
TL;DR: There is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019 and considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere.
Abstract: Background The initial cases of novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the...
13,101 citations
"Handling of allergen immunotherapy ..." refers background in this paper
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Leiden University1, Loyola University Chicago2, University of North Carolina at Chapel Hill3, Utrecht University4, Erasmus University Rotterdam5, Moscow State University6, Texas A&M University–Texarkana7, University of Iowa8, University of Hong Kong9, Spanish National Research Council10, University of Giessen11
TL;DR: The independent zoonotic transmission of SARS-CoV and SARS -CoV-2 highlights the need for studying viruses at the species level to complement research focused on individual pathogenic viruses of immediate significance.
Abstract: The present outbreak of a coronavirus-associated acute respiratory disease called coronavirus disease 19 (COVID-19) is the third documented spillover of an animal coronavirus to humans in only two decades that has resulted in a major epidemic. The Coronaviridae Study Group (CSG) of the International Committee on Taxonomy of Viruses, which is responsible for developing the classification of viruses and taxon nomenclature of the family Coronaviridae, has assessed the placement of the human pathogen, tentatively named 2019-nCoV, within the Coronaviridae. Based on phylogeny, taxonomy and established practice, the CSG recognizes this virus as forming a sister clade to the prototype human and bat severe acute respiratory syndrome coronaviruses (SARS-CoVs) of the species Severe acute respiratory syndrome-related coronavirus, and designates it as SARS-CoV-2. In order to facilitate communication, the CSG proposes to use the following naming convention for individual isolates: SARS-CoV-2/host/location/isolate/date. While the full spectrum of clinical manifestations associated with SARS-CoV-2 infections in humans remains to be determined, the independent zoonotic transmission of SARS-CoV and SARS-CoV-2 highlights the need for studying viruses at the species level to complement research focused on individual pathogenic viruses of immediate significance. This will improve our understanding of virus–host interactions in an ever-changing environment and enhance our preparedness for future outbreaks.
5,527 citations