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Pediatric allergies in Japan: Coronavirus disease pandemic-related risk factors
Yuri Takaoka1, Akihiro Maeta2, Atsuko Nakano3
1Department of Pediatrics, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Habikino, Osaka, Japan.
Insights
The COVID-19 pandemic increased accidental food allergen ingestion and worsened allergic diseases in Japanese children. Increased home time and preventive measures were key risk factors, but prior allergen avoidance education improved management.
Area of Science:
- Pediatric Allergy and Immunology
- Epidemiology
- Public Health
Background:
- The COVID-19 pandemic significantly affected societal structures, including the health of children with allergies in Japan.
- School closures and public health measures introduced during the pandemic created new environmental and social conditions for children.
Purpose of the Study:
- To investigate the risk factors associated with pediatric allergic diseases during the COVID-19 pandemic state of emergency in Japan.
- To assess the impact of school closures on allergic conditions in children compared to pre-pandemic levels.
Main Methods:
- A survey was conducted among parents of pediatric patients (aged 0-15) diagnosed with allergies.
- Parents reported on the impact of school closures on their children's allergic conditions relative to the period before the COVID-19 pandemic.
Main Results:
- Approximately 4% of parents reported increased accidental food allergen ingestion during school closures, linked to increased home-based meal exposure.
- Exacerbation rates were highest for atopic dermatitis (13%), followed by allergic rhinitis (8%) and bronchial asthma (4%).
- Key risk factors included mask-related contact dermatitis, home allergens (mites, pets), and seasonal changes.
Conclusions:
- Increased time at home, COVID-19 preventive measures, and reduced doctor visits influenced allergic diseases.
- While social changes impacted children, effective allergen avoidance at home and prior patient education facilitated better disease management.
- Children with pre-existing allergen avoidance strategies demonstrated resilience in managing their conditions amidst pandemic-related social shifts.
Background:
The coronavirus disease 2019 (COVID-19) pandemic impacted various parts of society, including Japanese children with allergies.
Objective:
This study investigated risk factors for pediatric allergic diseases associated with the state of emergency owing to the COVID-19 pandemic in Japan, including during school closures.
Methods:
Parents of pediatric patients (0-15 years) with allergies were enrolled and queried regarding the impact of school closure on pediatric allergies compared to that before the COVID-19 pandemic.
Results:
A valid response was obtained from 2302 parents; 1740 of them had children with food allergies. Approximately 4% (62/1740) of the parents reported accidental food allergen ingestion was increased compared to that before the COVID-19 pandemic. Accidental ingestion during school closures was associated with increased contact with meals containing allergens meant for siblings or other members of the family at home. The exacerbation rate during the pandemic was highest for atopic dermatitis at 13% (127/976), followed by allergic rhinitis at 8% (58/697), and bronchial asthma at 4% (27/757). The main risk factors for worsening atopic dermatitis, allergic rhinitis, and bronchial asthma were contact dermatitis of the mask area (34/120 total comments); home allergens, such as mites, dogs, and cats (15/51 total comments); and seasonal changes (6/25 total comments), respectively.
Conclusion:
The main factors affecting allergic diseases were likely related to increased time at home, preventive measures against COVID-19, and refraining from doctor visits. Children with allergies were affected by changes in social conditions; however, some factors, such as preventing accidental ingestion and the management of allergens at home, were similar to those before the COVID-19 pandemic. Patients who had received instructions on allergen avoidance at home before the pandemic were able to manage their disease better even when their social conditions changed.
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