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Allergic diseases and immunodeficiencies in children, lessons learnt from COVID-19 pandemic by 2022: A statement from
Daniel Munblit1, Matthew Greenhawt2, Helen A Brough3,4
1Inflammation, Repair and Development Section, Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, UK.
Insights
The COVID-19 pandemic did not increase risks for most allergic children, with some respiratory allergies improving due to environmental changes. Standard treatments for pediatric allergies remain effective, though Long COVID associations require further study.
Area of Science:
- Pediatric Allergy and Immunology
- Infectious Diseases
- Public Health
Background:
- The COVID-19 pandemic significantly impacted global health, with over 6.1 million deaths and widespread effects on physical and mental well-being.
- Allergic diseases are common chronic conditions in children, prompting research into pandemic-related impacts on this population.
- Children generally face lower risks for severe COVID-19, and most allergic diseases do not heighten COVID-19 severity or mortality, except for severe asthma.
Purpose of the Study:
- To provide recommendations for managing pediatric allergic conditions based on lessons learned during the COVID-19 pandemic.
- To assess the impact of the pandemic on children with allergic diseases and their healthcare.
- To review evidence regarding COVID-19 severity, mortality, and long-term effects in allergic children.
Main Methods:
- Review of available evidence and clinical experience regarding pediatric allergic conditions during the pandemic.
- Analysis of the effectiveness of implemented mitigation strategies, such as telemedicine, for continuous care.
- Evaluation of environmental changes (e.g., reduced air pollution) and their effect on allergic conditions.
Main Results:
- Routine healthcare disruptions were managed through strategies like telemedicine, ensuring continued high-standard care for pediatric allergies.
- Improvements in respiratory allergies were observed, potentially linked to reduced air pollution and decreased exposure to outdoor allergens.
- No evidence suggests altering standard management for pediatric allergies, including allergen immunotherapy and biologics.
- Allergic children are not at increased risk for multisystem inflammatory syndrome, but limited data suggest potential associations with Long COVID.
Conclusions:
- The COVID-19 pandemic demonstrated the resilience of pediatric allergy care, with telemedicine proving effective.
- Environmental factors during the pandemic positively impacted certain allergic conditions in children.
- Current management strategies for pediatric allergies are largely supported by pandemic-era evidence, with ongoing research needed for Long COVID associations.
Abstract:
By the April 12, 2022, the COVID-19 pandemic had resulted in over half a billion people being infected worldwide. There have been 6.1 million deaths directly due to the infection, but the pandemic has had many more short- and long-term pervasive effects on the physical and mental health of the population. Allergic diseases are among the most prevalent noncommunicable chronic diseases in the pediatric population, and health-care professionals and researchers were seeking answers since the beginning of pandemic. Children are at lower risk of developing severe COVID-19 or dying from infection. Allergic diseases are not associated with a higher COVID-19 severity and mortality, apart from severe/poorly controlled asthma. The pandemic disrupted routine health care, but many mitigation strategies, including but not limited to telemedicine, were successfully implemented to continue delivery of high-standard care. Although children faced a multitude of pandemic-related issues, allergic conditions were effectively treated remotely while reduction in air pollution and lack of contact with outdoor allergens resulted in improvement, particularly respiratory allergies. There is no evidence to recommend substantial changes to usual management modalities of allergic conditions in children, including allergen immunotherapy and use of biologicals. Allergic children are not at greater risk of multisystem inflammatory syndrome development, but some associations with Long COVID were reported, although the data are limited, and further research is needed. This statement of the EAACI Section on Pediatrics provides recommendations based on the lessons learnt from the pandemic, as available evidence.
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