TY - JOUR
T1 - Considerations on biologicals for patients with allergic disease in times of the COVID-19 pandemic
T2 - An EAACI statement
AU - Vultaggio, Alessandra
AU - Agache, Ioana
AU - Akdis, Cezmi A.
AU - Akdis, Mubeccel
AU - Bavbek, Sevim
AU - Bossios, Apostolos
AU - Bousquet, Jean
AU - Boyman, Onur
AU - Chaker, Adam M.
AU - Chan, Susan
AU - Chatzipetrou, Alexia
AU - Feleszko, Wojciech
AU - Firinu, Davide
AU - Jutel, Marek
AU - Kauppi, Paula
AU - Klimek, Ludger
AU - Kolios, Antonios
AU - Kothari, Akash
AU - Kowalski, Marek L.
AU - Matucci, Andrea
AU - Palomares, Oscar
AU - Pfaar, Oliver
AU - Rogala, Barbara
AU - Untersmayr, Eva
AU - Eiwegger, Thomas
PY - 2020/11/1
Y1 - 2020/11/1
N2 - The outbreak of the SARS-CoV-2-induced coronavirus disease 2019 (COVID-19) pandemic re-shaped doctor-patient interaction and challenged capacities of healthcare systems. It created many issues around the optimal and safest way to treat complex patients with severe allergic disease. A significant number of the patients are on treatment with biologicals, and clinicians face the challenge to provide optimal care during the pandemic. Uncertainty of the potential risks for these patients is related to the fact that the exact sequence of immunological events during SARS-CoV-2 is not known. Severe COVID-19 patients may experience a “cytokine storm” and associated organ damage characterized by an exaggerated release of pro-inflammatory type 1 and type 3 cytokines. These inflammatory responses are potentially counteracted by anti-inflammatory cytokines and type 2 responses. This expert-based EAACI statement aims to provide guidance on the application of biologicals targeting type 2 inflammation in patients with allergic disease. Currently, there is very little evidence for an enhanced risk of patients with allergic diseases to develop severe COVID-19. Studies focusing on severe allergic phenotypes are lacking. At present, noninfected patients on biologicals for the treatment of asthma, atopic dermatitis, chronic rhinosinusitis with nasal polyps, or chronic spontaneous urticaria should continue their biologicals targeting type 2 inflammation via self-application. In case of an active SARS-CoV-2 infection, biological treatment needs to be stopped until clinical recovery and SARS-CoV-2 negativity is established and treatment with biologicals should be re-initiated. Maintenance of add-on therapy and a constant assessment of disease control, apart from acute management, are demanded.
AB - The outbreak of the SARS-CoV-2-induced coronavirus disease 2019 (COVID-19) pandemic re-shaped doctor-patient interaction and challenged capacities of healthcare systems. It created many issues around the optimal and safest way to treat complex patients with severe allergic disease. A significant number of the patients are on treatment with biologicals, and clinicians face the challenge to provide optimal care during the pandemic. Uncertainty of the potential risks for these patients is related to the fact that the exact sequence of immunological events during SARS-CoV-2 is not known. Severe COVID-19 patients may experience a “cytokine storm” and associated organ damage characterized by an exaggerated release of pro-inflammatory type 1 and type 3 cytokines. These inflammatory responses are potentially counteracted by anti-inflammatory cytokines and type 2 responses. This expert-based EAACI statement aims to provide guidance on the application of biologicals targeting type 2 inflammation in patients with allergic disease. Currently, there is very little evidence for an enhanced risk of patients with allergic diseases to develop severe COVID-19. Studies focusing on severe allergic phenotypes are lacking. At present, noninfected patients on biologicals for the treatment of asthma, atopic dermatitis, chronic rhinosinusitis with nasal polyps, or chronic spontaneous urticaria should continue their biologicals targeting type 2 inflammation via self-application. In case of an active SARS-CoV-2 infection, biological treatment needs to be stopped until clinical recovery and SARS-CoV-2 negativity is established and treatment with biologicals should be re-initiated. Maintenance of add-on therapy and a constant assessment of disease control, apart from acute management, are demanded.
UR - http://www.scopus.com/inward/record.url?scp=85095419977&partnerID=8YFLogxK
U2 - 10.1111/all.14407
DO - 10.1111/all.14407
M3 - Article
C2 - 32500526
AN - SCOPUS:85095419977
SN - 0105-4538
VL - 75
SP - 2764
EP - 2774
JO - Allergy: European Journal of Allergy and Clinical Immunology
JF - Allergy: European Journal of Allergy and Clinical Immunology
IS - 11
ER -
